Hearing Loss

Hearing loss is one of the biggest health concerns in the U.S. It is the third most commonly reported physical condition, following arthritis and heart disease. It affects roughly 20 percent of the American population and can strike people of all ages.

The most common causes of hearing loss are noise exposure and aging.

What Are the Symptoms of Hearing Loss?

Hearing loss is a progressive condition that worsens over time. Symptoms appear so gradually, you may be completely unaware of your affliction for some time. Even when hearing loss is suspected, it takes an average of seven years for a person to seek medical treatment.

Knowing the signs is helpful in spurring you to take action sooner. Any of the following might indicate hearing loss:

• Frequently asking people to repeat what they have said.
• Feeling like others mumble when they speak.
• Having difficulty following conversations in which background noise is present.
• Turning up the volume on the television or radio.
• Avoiding social gatherings in noisy places.

Often, a family member or friend will be the first to notice a hearing problem. Since treatment is most effective when begun early, if you think you might be suffering from diminished hearing, do not hesitate to schedule an appointment with a hearing specialist. The sooner, the better!

How Is Hearing Loss Diagnosed?

In order to diagnose hearing loss, your doctor will review your medical history, discuss your symptoms, and give you a physical examination followed by a hearing evaluation consisting of a series of audiological tests.

What Are the Types of Hearing Loss?

Treatment will depend on your type and degree of hearing loss. Conductive hearing loss occurs when there are problems in the outer ear, ear canal, eardrum or middle ear. It can be caused by any of the following:

• Ear infection.
• Fluid in the ears.
• Malformation or abnormalities of the outer or middle ear.
• Impacted earwax.
• Foreign object in the ear.
• Allergies.
• Perforated eardrum.
• Otosclerosis.
• Benign tumors.

Conductive hearing loss is often correctable with surgery or medications (typically antibiotics). Alternatively, it may be treated with hearing aids.

Sensorineural hearing loss involves a problem with the inner ear, and is frequently referred to as “nerve deafness.” It may be caused by any of these:

• Noise exposure.
• Head trauma.
• Aging (presbycusis).
• Viral disease.
• Autoimmune ear disease.
• Meniere’s disease.
• Malformation or abnormality of the inner ear.
• Otosclerosis.
• Tumors.

Sensorineural hearing loss can sometimes be treated with medications (corticosteroids) or surgery. More likely, hearing aids will be required.

Mixed hearing loss is a combination of both types. Treatment might involve a combination of medication, surgery and/or hearing aids.

In addition to the different types of hearing loss, it is important to consider the extent to which a patient is experiencing symptoms. Hearing loss is further categorized as being either monaural or binaural.

Unilateral hearing loss (sometimes referred to as single-sided deafness) affects one ear only, while bilateral hearing loss affects both ears.

Patients with unilateral hearing loss have normal hearing in one ear and impaired hearing in the other; they have difficulty hearing on one side and localizing sound. This type of hearing loss is usually associated with conductive causes. Individuals with bilateral hearing loss have impaired hearing in both ears. The condition is most often treated with hearing aids (two are more effective than one) or cochlear implants.

Noise-Induced Hearing Loss

Noise-induced hearing loss is the most common type experienced by younger individuals. It can be caused by exposure to a single loud sound, such as a gunshot or explosion, or by continuous exposure to loud noise over a period of time.

When sounds exceed 85 decibels (dB) they are considered hazardous to your hearing health. Continuous exposure to volume levels that high causes permanent damage to the hair cells in your ears.

Activities that put people at risk for noise-induced hearing loss include hunting, riding a motorcycle, listening to music at high volumes, playing in a band and attending rock concerts. An estimated 15 percent of Americans aged 20 to 69 have hearing loss that may have been caused by noise exposure. This type of hearing loss can be prevented by wearing earplugs and protective devices.

Hearing Loss Prevention

Protecting your ears is the key to hearing loss prevention. If your job exposes you to hazardous noises, make sure proper safety equipment is provided, and that it meets state and federal regulations. Hearing protection – earplugs and earmuffs – is essential when working around loud equipment. It’s always a good idea to bring along earplugs if you’re participating in a noisy recreational activity (e.g., a football game or rock concert), as well.

At home, limit your exposure to noisy activities, and keep the volume down – on the television, stereo and especially when it comes to personal listening devices like MP3 players. Prevent other types of hearing loss by refraining from inserting cotton swabs or other objects into your ears, blowing your nose gently through both nostrils and quitting smoking. Studies show those who use tobacco are more likely to suffer from hearing loss.

Regardless of your age, have your hearing tested regularly. Early detection is key. While noise-related hearing loss can’t be reversed, you can still take steps to avoid further damage to your hearing.

Communication Strategies (NOTE: accordion this out)

Communicating with a person who has a hearing loss can be stressful for both parties. Even when hearing devices are used, proper communication strategies are essential for maximizing the experience. Try the following tips when communicating with a hearing impaired individual.

• Maintain eye contact with the hearing impaired individual, facing them directly. Do not attempt to hold a conversation from another room; visual cues are an important component of successful communication.
• Make sure you have the person’s attention before beginning a conversation. It helps to state their name so they are aware you are addressing them, and can focus on your words.
• Speak slowly and concisely. Resist the temptation to shout, which can lead to distorted speech and make your words more difficult to understand. Pause between sentences to ensure what you are saying is understood.
• Do not cover your face with your hands or other objects. Individuals with hearing loss rely on visual cues to help follow the conversation, and sometimes find lip reading helpful. Avoid eating and drinking while conversing, as well.
• Try to find a quiet area free of background noise. This can be distracting and cause the hearing impaired individual to miss out on much of what you are saying.
• Repeat yourself if necessary. Try using a different word or rephrasing your sentence if it is too confusing. Refrain from complex words and phrases.
• Supplement your conversation by writing down important information. This might include jotting down the topic you will be discussing beforehand.
• Pay attention to the listener. If they look confused, offer to clarify what you have just said.
• Remember, communication is a two-way street. Give the other person a chance to speak, and do not interrupt.

Protecting Your Hearing

We are exposed to sound on a daily basis. Volume levels vary considerably, and can easily exceed 85 decibels (dB) – the threshold that is considered safe. Any prolonged exposure to noise exceeding this is harmful and can cause permanent, irreversible hearing loss.

Excess noise exposure isn’t the only cause of hearing damage. Diseases, drugs and injury may all contribute to hearing loss. Fortunately, there are steps you can take to protect your hearing and help prevent hearing impairment.

Protecting Your Hearing from Loud Noise

Noise-induced hearing loss is the most common cause of hearing loss in the U.S. The good news? It is easily preventable. Follow these tips to protect your hearing:

• Wear hearing protection when exposed to loud noise. Earplugs are a must in noisy environments such as rock concerts and sporting events. They should also be worn when riding a motorcycle or snowmobile, mowing the lawn, using power tools, etc. If your job exposes you to loud noise, your employer is required by OSHA to supply hearing protection.
• Turn down the volume. When listening to music or watching television, keep the volume low.
• Limit the number of noisy appliances running at the same time.
• Buy quieter products. Many appliances list dB ratings in their specifications. 

Preventing Hearing Loss from Diseases

Some diseases can cause hearing loss. Viruses that might damage hearing include measles, mumps, whooping cough and rubella. Bacterial diseases such as meningitis and syphilis can also lead to hearing damage. Acoustic neuroma – tumors on the hearing nerve (usually benign) – may contribute to hearing loss. Tips for preventing hearing loss from disease include:

• Make sure your child is vaccinated. Immunizations offer protection from many childhood infections that can cause hearing damage.
• If you are sexually active, use protection to prevent the spread of sexually transmitted diseases, some of which can cause hearing loss.
• Don’t delay seeking medical attention should you fall ill.

Protection from Ototoxic Drugs

Some drugs cause damage to the sensory cells responsible for hearing. These include certain antibiotics, chemotherapy drugs, salicylate pain relievers (e.g., aspirin), quinine (for treating malaria) and diuretics. In order to reduce your odds of hearing loss when taking medications, follow these tips:

• Take medications only as directed.
• If you experience symptoms of hearing loss such as tinnitus while taking new drugs, see your doctor immediately.

Preventing Ear Injuries

Head trauma can damage the temporal bones in the lower lateral walls of the skull, leading to hearing loss. To help prevent this type of injury, take the following precautions:

• Wear a seat belt at all times when in a car.
• Wear a helmet when riding a bike or motorcycle, and participating in contact sports.
• Don’t take unnecessary risks, such as standing on the top rung of a ladder.

There are other general steps you can take to protect your hearing. Refrain from inserting foreign objects in the ears; these can lead to impacted earwax, a perforated eardrum or damage to the skin. Cotton swabs and safety pins are notorious offenders. Use swim plugs when engaging in water activities and be sure to dry your ears thoroughly after swimming or bathing. Seek prompt medical attention if you are suffering from an ear infection.

Call Willamette ENT & Facial Plastic Surgery at (503) 581-1567 for more information or to schedule an appointment.