Hearing loss - Is It Only A Concern For Elderly?

Hearing Loss

Hearing loss It is the condition where a person finds difficulty in hearing which can be partial or total. Social stigma is always observed in India that only elderly people will have this problem but unfortunately, it can be found in any person of any age due to various reasons. As it is an internal impairment, it is ignored the most, unlike visual impairment. "Blindness cuts us off from things, but deafness cuts us off from people," -Helen Keller.


Types Of Hearing Loss

1. Conductive

A problem in the outer and middle ear which prevents sounds to reach the inner ear


2. Sensorineural

A problem in the inner ear which prevents sounds to reach the nerve and brain.


3. Mixed Hearing Loss

A problem in outer, middle and inner ear together. Degree of loss can range from minimal to profound According to Clark.


Normal Range Of Hearing Loss (dB HL)

Degree of hearing loss -10 to 15 Normal 16 to 25 Minimal/slight 26 to 40 Mild 41 to 55 Moderate 56 to 70 Moderately severe 71 to 90 Severe More than 90 Profound.


Causes Of Hearing Loss

  • Conductive - Medicine, surgery, removal of the foreign body helps in these cases.
  • Excess wax in the ear canal covering the whole canal
  • Deformity of the external part of ear and canal, Discontinuity of ear ossicles ( 3small bones present in the middle ear )
  • Excess calcium deposition in joint of ear ossicle(otosclerosis)
  • Ruptured eardrum,middle ear infection(fluid-filled )
  • Tumor
  • Physical trauma etc.

The following are some other causes of hearing loss;

1. Sensorineural Hearing Loss

Mostly irreversible, surgery, steroid application, using hearing aids, the cochlear implant helps.


2. Noise Pollution

Exposing self to excess noise listening to songs at high volume, mostly found in the locomotor pilot, construction worker, traffic police, factory workers, DJ, etc.


3. Age-related

With age, the inner ear starts deteriorating it's functioning, not preventable. A tumor (acoustic neuroma)


4. Accident

When people met with a physical head injury or accident then it might be a cause of hearing loss.


5. Medications

Some group of medicines which are toxic to ear like ototoxic drugs ex- cisplatin, carboplatin, gentamicin, streptomycin, quinine, a large amount of aspirin, etc.


6. Viral Infection

People suffering from any kind of viral infection related to ear might experience hearing loss.


7. Deformity Of The Inner Ear Hereditary (genetic)

When you are suffering from any deformity of the ear whether it might be genetic or due to an accident then you may experience hearing loss.


8. Mixed Hearing Loss

As a problem in outer/middle and inner ear treatment for both show positive results.


Symptoms Of Hearing Loss

  • Pain in ears (otalgia)
  • Watery discharge from the ear canal(otorrhea), which can be a clear fluid without foul smell or yellow fluid with a pungent odor.
  • Not able to extract the meaning of the whole sentence.
  • Extracting the meaning of a complete conversation is difficult( mostly perceiving consonants are difficult)
  • Following conversations group or from the backside is difficult Difficulty understanding conversation in background noise Not able to listen to T.v/radio in a normal volume, turning up the volume is always seen.
  • Ringing /buzzing sound in ears(tinnitus)
  • Request to repeat the sentence frequently.
  • Trying to Lip read to compensate for the hearing loss (looking at the lip of the speaker and guessing what the person is speaking) Most of the time family members.
  • Relatives can detect that a person is not hearing perfectly much before then the person himself reports the same.
  • A person with hearing loss frequently complains that people are speaking softly while talking to him/her.
  • Telephonic conversation/mobile is a difficult Consequence (effect) of hearing loss.
  • Hearing loss since birth (congenital hearing loss) leads to delay in speech and language development, if not treated before the age of critical developmental period of the child (0-3 years) Psychological problems like depression, low-self-esteem, Social isolation (communication problem), social withdrawal Hearing area of the brain gets deprived (auditory deprivation), Leads to Memory loss if untreated(dementia). Chances of fall increases (Vestibular problems) Life-threatening in some cases(not able to hear the horn, alarm sound, person calling from the backside).

How To Prevent Hearing Loss?

  • Radiation exposure of the mother during pregnancy should be avoided.
  • Marriages in blood relation(consanguinity) can lead to hearing loss in the newborn children, avoid the same.
  • Pre-mature delivery and delivery without the supervision of medical professionals can lead to the birth of a newborn with hearing loss.
  • Consumption of alcohol and cigarettes in the long-term (by parents) can lead to chances of hearing loss in newborns.
  • Avoid noisy places, use earplugs(noise blocker), Better use mobile on the speaker than using earphones, always limit the volume at permissible loudness level, don't underestimate the warning dialogue box shown in mobile.
  • Don't insert anything inside the ear, don't use oil, earbuds Request your doctor to prescribe non-ototoxic medicines if possible.
  • A healthy diet, maintain a stress-free active lifestyle, make sure Blood pressure and sugar be always within normal limits Don't take bath in rivers, swimming pools.

Take-Home Messages

If the child doesn't respond to loud sounds(clap from behind, drum beats), name-calling by mother then without wasting time get the help of hearing healthcare professional(Audiologist). Before cutting the birthday cake of your child, get the hearing test done of your child after 24 hrs of birth (DPOAE tests, done by Audiologist) or within 3 months of birth (BERA test done by Audiologist).

For older adults take a piece of paper, fold it and rub it near the ear don't touch, if u can not hear the soft scratch sound out of it, then consult Audiologist If you feel the hearing problem, pain, liquid coming out of the ear, block sensation or anything which is ear-related, don't waste time consult the ENT (otolaryngologist) and Audiologist (hearing specialist) Don't underestimate the advice given by them, follow those to help yourself.

Hearing tests include otoscopy, tuning fork test, pure tone audiometry, speech audiometry, special tests, immittance audiometry, otoacoustic emission, brain-stem evoked response audiometry, auditory steady-state response, etc. Don't get confused between ENT and Audiologist. ENT specialist should prescribe medicines and surgery if necessary, whereas Audiologist performs all the tests of hearing and management of sensorineural hearing loss by prescribing hearing aids,(always ask for digital programmable hearing aids) managing all the hearing related tests and management. ENT specialist and Audiologists work side by side. Get the disability certificate of disability percentage is more than 40% from the nearest government district hospital after the necessary process.

Annual Hearing check-up without fail is a must, so as to detect the problem at an early stage (early identification ) which leads to early intervention (treatment/management), ultimately it will be cost-effective, chances of positive results are more. Don't take this so lightly, the consequences can be life-threatening in some cases. For further information please consult with me (Dr.Satyabrata Panigrahi).

Author:

Dr.Satyabrata Panigrahi

Audiologist