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Hearing Loss

There are two types of hearing loss, Conductive hearing loss and Sensorineural hearing loss.

1. Conductive heating loss is related to outer and middle ear problems when sound is not transferred from the outer and middle ear to the inner ear. Conductive hearing loss can result from eardrum perforation, impacted ear wax, outer and/or middle ear diseases, head trauma, birth defects or heredity. Conductive hearing loss is treatable most of the time.

2. Sensorineural hearing loss (also called nerve deafness) is related to problems of the inner ear. Sensorineural hearing loss is usually related to wear and tear due to aging, which is called Presbycusis. This phenomenon causes older individuals to have difficulty understanding what is being said, or degeneration of the aural nerves leading from the inner ear to the brain. Sensorineural hearing loss can also be caused by excessive exposure to loud noise, use of "ototoxic" drugs, infections like measles and meningitis, an accident or other types of trauma to the ear or head, a birth (during, before or after) or hereditary deficiency.

Common Signs and Symptoms of Hearing Loss

Do you:

· Frequently have to ask for repetition?

· Have trouble hearing when spoken to from another room?

· Feel that you hear sound, but do not understand speech?

· Feel that people are mumbling?

· Have trouble hearing when there is noise around you?

· Need to turn the radio or TV volume up loud to hear well?

· Have difficulty hearing women’s or children’s voices?

· Have to turn one ear toward the person speaking?

· Have trouble hearing when you can’t see the speaker’s face?

· Need to be close to the person speaking?

· Become anxious or tired in social situations because you cannot understand?

· Have to strain to hear?

· Frequently misunderstand what is said?

· Have ringing, buzzing, roaring, or hissing sound in one or both ears?

· Finding hard to hear the person on the other side of the phone?

· Have difficulty following conversations (especially when two or more people are talking?)

· Say the wrong thing because of misunderstandings about what others are saying?

· Fell that some sounds seem too loud?

Do others tell you that you:

· Do not react to sounds?

· Do not respond when spoken to?

· Turn the radio or TV volume up too high?

· Speak loudly or shout in conversation?

· Are missing what is being said?

· Do not hear sounds coming from behind you?

· Have had a change in your speech?

What to do if you think you have a hearing loss:

See an Audiologist. The Audiologist will conduct a hearing test (called an “audiogram”) to assess your level of hearing, and the degree and extent of any hearing loss you may have.

The Audiologist will make recommendations about whether you should see an ear doctor (called an Otolaryngologist) to address the reason for your hearing loss or potential medical treatments for the hearing problem. Approximately 10% of all hearing losses can benefit from medical treatment or surgery.

The Audiologist will also give you information about other assistance available to you. There are a number of ways a hearing loss may be helped, including:

· Hearing aids

· Assistive Listening Devices (ALDs)

· Audiologic rehabilitation, including:

· Communication skills training

· Auditory training

· Speech reading

Reasons for Hearing Loss

· Wear and tear caused by aging

· Head injury or Viral or bacterial infections

· Exposure to loud sound

· Exposure to ototoxic medications

· An inherited condition

· Heart conditions

· Stroke

· Tumors

Hearing Aid(s) WILL do the followings

· Help you to understand speech better in most situations.

· Help you to hear in certain situations that are difficult for you.

· Help you to discriminate high-pitch sounds of speech, including consonants, so that you won’t only hear the person talking but you will better UNDERSTAND what they are saying.

· Increase your ability to participate more fully in group situations and meetings.

· Hopefully make life easier and more pleasant for you and those around you.

Hearing Aid(s) WILL NOT do the followings

· Restore your hearing to normal.

· Allow you to hear perfectly clear in the presence of background noise (even people with normal hearing have this difficulty.)

· Let you hear only what you want to hear.

· Enable you to hear extremely soft sounds.

Tinnitus (ringing in the ear)

People with hearing loss may also experience tinnitus. Tinnitus is ringing, buzzing, and chirping, whistling, roaring and other sounds in the ears. Sometimes tinnitus happens as a result of exposure to loud sounds, and it that may go away after few hours or few days depending on the volume and the length of the exposure time. Noise loud enough to cause tinnitus can cause hearing loss.

The noise can be intermittent or constant and can differ in volume. You can notice tinnitus most in quiet environment such as at night when you are trying to sleep, and it can worsen with background noise such as in the restaurants. See your ENT (Ear, Nose, and Throat doctor) or Otolaryngologist if tinnitus beats in time with your heart beat; as this is a sign of a blood vessel disease, and/or if the tinnitus is unilateral (in one ear and not the other.)

There are many causes of tinnitus. It can be as simple as wax in the ear canal to more serious symptoms, such as infection or a hole in the ear drum. Tinnitus may also be caused by an allergy, high or low blood pressure, tumor, diabetes, thyroid problems, head injury, ototoxic drugs, antidepressants and aspirin.

Please never use cotton swabs (Q-tips) to clean inside of the ear, as this will compress the wax and cause more damage than good. A little wax protects your ear against dust, lint and small insects that may crawl into your ear. If there is an excess buildup of wax, consult your physician for removal.

If tinnitus is not a result of hearing loss, the patient can use masker. A masker is a device that looks like a hearing aid but produces pleasant sounds in the ear which masks the tinnitus. If your tinnitus is a result of hearing loss, a hearing aid can help to amplify the sound and mask the noise. You may also be able use another device that produces white noise to teach the brain to ignore the tinnitus. You can turn on a fan, the radio or play soft music before bed time in order for the brain to get occupied with them and disregard the tinnitus. An interesting fact, Van Gogh cut his ear to prevent tinnitus.

Hearing Aids

The best solution for hearing loss is be fitted with a proper hearing aid(s). The hearing aid amplifies the sound so you can hear speech sounds and environmental sounds better. Clarity of the sound depends on the amount of nerve loss. Always remember, hearing loss is more noticeable than a hearing aid.

Styles of Hearing Aids

· In-The-Canal (ITC), hearing aids fit completely in the ear. These types of hearing aids are small and the least visible thus are more cosmetically acceptable. The only problem is that are not suitable for all types and degree of hearing loss.

· In-The-Ear (ITE) fits in to the canal but extends into the outer ear.

· Behind-The Ear (BTE) fits behind the ear. The hearing aid is connected to the ear mold in the ear by short plastic tube. These types of hearing aids are suitable for moderate to profound hearing losses.

· Body Aid hearing aids are connected with a wire to the ear mold in the ear. Body Aids are used for severe to profound hearing losses.

Benefits of Two Hearing Aids

For those who are hard-of-hearing one ear plus another ear equals four, which means that a hearing aid wearer can hear four times as much with two ears aided in comparison to one hearing aid. The sound reaches both ears and processes in the brain as one sound, thus, if the sound comes only through one ear the brain will have difficulty to balancing the sound and making a sense of it. The benefit of wearing two hearing aids is:

· Ability to recognize the direction of the sounds.

· Elimination of sound losing its intensity when traveling around the person’s head to reach the aided ear.

· Easier to listen to the sound and quickly respond to the sounds.

· No need to increase the volume of the hearing aids.

· Better overall hearing.

Taking Care of Your Hearing Aid

Protect hearing aids from heat such as in the car’s glove compartment, in the microwave or oven, or in directly in the sun. Never dry your hearing aid using hair dryer.
Protect hearing aids from moisture, humidity, perspiration and chemicals such as hair spray or powder.
Always keep a supply of fresh batteries on hand, replace dead batteries right away and remove the batteries at night to enhance the life of battery and reduce corrosion of the battery contact.
Remove and clean wax and other debris from the hearing aids every night before going to bed.
Do not swim or take a shower with hearing aids.
Remember to keep hearing aid and batteries out of the reach of children and pets.

Making Conversations Easier

People with hearing loss need support from their family and friends. Hear are some suggestions:

It’s very important for your family and friends to know about your hearing loss. The more they know, they more they can help you and be sensitive about your needs.
Ask your friends and family to face and you when they talk so that you can see their faces especially their lips. If you watch their lips move and see their facial expressions, it will help you to understand them better by picking the sounds you are missing as a result of hearing loss.
When you are having conversation, turn down or turn off the radio or television so you can concentrate on discussion.
When you are in the noisy environment such as restaurant, try to sit away from the bathroom and kitchen area, also avoid sitting in the corner where sound bounces from both walls and makes hearing difficult in the presence of background sounds. Background noise makes it hard to hear what people are saying.

Assistive Listening Devices (ALDs)

ALDs amplify specific sounds, and they can be used alone or in conjunction with a hearing aid. ALDs help you to hear when you are talking on the phone, visiting a friend, watching television or attending a concert.

· FM systems are personal amplifiers that make it easier to hear a person speaking in a noisy room, but works best with a single person.

· Alerting Devices help you hear certain sounds in your home. They alert you by flashing lights, loud bells or by producing vibrations. They are activated by the sound of phone, doorbell, alarm clock and smoke detector.

Group Listening Devices that can deliver quality sound to the person in large groups, such as theaters, concert halls, auditoriums, group listening and places of worship. Now a day such these places are equipped to cater to people with hearing loss. These systems send sounds directly to people with hearing loss. They either plug into hearing aids or rely on special receivers available on-site.
Direct audio input hearing aids enable you to amplify the television, CD player, and radio sounds at comfort level for you without disturbing people around you. These special hearing aids plug directly into TVs, radios, CD player, and personal listening systems.

· Walker Talker is personal communication device that enables you to hear your companion’s voice without amplifying the background noise in noisy places such as car or restaurants.

· Telephone Amplifying Devices that enable you to hear through hearing aids without feedback. Hearing aids with a telecoil switch amplify sounds coming through the hearing aid without producing feedback.

· Text Phone helps you see the words of phone conversation.

Infant Hearing Screening

You are never too young to have hearing loss- remember hearing loss is not a sign of aging. All infants should have their hearing checked a few days after birth before leaving the hospital. Good hearing is essential for child’s speech and language development. Since infants and toddlers can not communicate properly, most of the time their hearing loss goes undetected causing a delay in speech and language development. Even after infancy, hearing loss remains a risk. In many children, hearing loss is not detected till the age of five, when the period of speech and language development has passed. In this case the child may have increased speech, language, emotional, academic, behavioral and social difficulties. For this reason infant hearing screening is crucial.

Hearing Protection

Children, young adults, and adults are at risk of hearing loss if their work or play exposes them to loud noise such as fire arms, fire crackers, lawn mowers, tractors, or any loud machinery, and even listening to loud music. Your ear can get used to certain level of sound especially music, resulting in a need to turn the volume higher and higher as time goes by. Custom made Hearing Protection or Earplugs must be worn when you are around loud sounds, including loud concerts. Remember that music coming through earphones or walkmans should be kept at a safe volume level. As a general rule if a person standing approximately three feet away from you can hear your music, the volume is too high.

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This site designed by Akhtar Akhavan & edited by Shima Ebrahimi