We all know what it feels like not to hear something. It’s frustrating and sometimes makes you feel left out and isolated — but imagine if that feeling was a constant?
For people suffering from Hearing loss it can be a debilitating condition. This article will discuss what hearing loss is and provide information and guidance on where to start with diagnosing and treating the condition.
Hearing loss is the diminished hearing capacity in one or both ears. It can affect people of any age and can range from mild to profound in nature.
There are 3 main categories of hearing loss commonly referred to as Sensorineural, Conductive and Mixed hearing loss.
Some common indicators that you may be experiencing hearing loss include: Turning the TV up loud, asking for regular repeats, miss hearing conversation and some people will experience a ringing/buzzing sound in the ears.
If you are experiencing some or even all of these symptoms then you’re not alone. Studies indicate that 1 in 6 Australians are currently living with hearing loss. This ratio significantly increases for older Australians with 3 in 4 experiencing hearing loss over the age of 71 and is the third most common physical condition after arthritis and heart disease.
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Risks of Untreated Hearing Loss:
The effects of untreated hearing loss can be significant, recent studies indicate that even a mild hearing loss may increase the chances of cognitive conditions such as dementia by up to 30%.
Some of the main risks associated with untreated hearing loss are:
- Decrease in speech discrimination (ability to understand speech correctly)
- Depression & Anxiety due to social isolation
- Auditory Deprivation
- Viral or bacterial infections causing irreversible damage if untreated
- Significantly increased risk of cognitive conditions such as dementia.
- Increased risk of falling
- Divorce/separation from loved ones
Different Types of Hearing Loss:
There are 3 main categories of hearing loss, namely, conductive, sensorineural and mixed. Conductive hearing loss is usually referred to as temporary and is due to a physical obstruction restricting sound waves travelling sufficiently through the outer or middle ear. Sensorineural hearing loss is permanent as a result of damage occurring in the inner ear and/or auditory nerve. Mixed hearing loss as the name suggests is a mixture of both Conductive and Sensorineural. Your best option for treating a type of hearing loss is to seek treatment as early as possible and have regular hearing assessments to monitor your hearing thresholds and auditory health.
Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is damage to the inner ear and/or auditory nerve, leading to permanent hearing impairment.
It can be caused by a range of different conditions that damage the delicate structures of the inner ear, which are responsible for converting sound into electrical signals that are transferred to the brain for processing. The parts that make up this area are known as the Cochlea and the Auditory nerve.
Sensorineural hearing loss is the most common form of hearing loss and some causes of the condition include Presbycusis (Age-related factors), Noise-Induced (damage that occurred from noise exposure), genetics, results of virus or disease, side effects of some medications.
Common Symptoms of Sensorineural Hearing Loss
- Difficulty understanding certain voices, such as children’s and/or female voices.
- People sound like they are constantly mumbling when talking to you.
- Unable to hear certain sounds, such as Clock ticking, car indicators, alarms.
- Troubling hearing speech or sounds when background noise is present.
- Require turning the TV or radio up louder than other people may like it.
- You have difficulty understanding speech clearly in groups of people or meetings.
- Buzzing or ringing sounds in your ears (commonly known as tinnitus).
Conductive Hearing Loss
Conductive hearing loss occurs in the outer and/or middle ear system and causes the normal transfer of sound to be restricted into the inner ear. Although conductive loss can be permanent it is commonly referred to as a temporary loss as if the obstruction can be sufficiently corrected the transfer of sound can resume as normal.
Common causes of conductive hearing loss can be as simple as a build-up of earwax in the ear canal, or a build up of fluid or pressure in the middle ear as a result of infection. Medical treatment usually restores conductive hearing loss although if the damage caused is irreversible it may become permanent.
Common Symptoms of Conductive Hearing Loss
- Experiencing muffled hearing (often caused by fluid in the ears).
- Reduced ability to hear
- Dizziness
- Tenderness or ear pain.
- Fullness or blocked sensation in your ears.
- Ear drainage
- Sudden loss of hearing.
Mixed hearing loss
Mixed hearing loss as the name suggests is a mixture of both Sensorineural and Conductive hearing loss. The Sensorineural component is typically permanent and the Conductive component is typically treatable.
Common symptoms of mixed hearing loss
- Symptoms of mixed hearing loss are a combination of both the sensorineural and conductive symptoms mentioned above.
Causes of Hearing Loss:
There is a wide range of conditions that can cause hearing loss. outlined below are some of the more common factors that may result in hearing loss:
Noise Induced (Exposure to loud noise)
Prolonged and on occasion sudden exposure to loud noise can permanently damage the structures of your inner ear. Exposure to loud noise through work is the most common cause of noise-induced hearing loss, this is due to a large amount of time spent exposed to the damaging sound source on a regular basis. Importantly it is preventable and its effect can be reduced or eliminated by ensuring the adequate use of hearing protection which restricts the amount of sound entering the auditory pathway. Other sources of noise exposure include loud music, firearms use, power tools, lawnmowers and chainsaws.
Aging Process (Presbycusis)
Hearing loss is commonly associated with the ageing process. As we age the delicate hair cells in the inner ear collapse causing what we commonly refer to as age-related hearing loss. It is unavoidable in most people and regular hearing checks are recommended to monitor the progression of hearing loss particularly as we age.
Cerumen Occlusion (Ear wax)
Glands in our ear canals produce earwax to keep your ears moist and clean from dust and for most it will naturally work its way out of the ear. Unfortunately for some this is not the case and an excessive build-up of wax can accumulate in the ear canal blocking the sufficient transfer of sounds into the middle ear system. If earwax is a common problem for yourself then speak with your doctor or hearing care professional in regards to common treatment and management options available.
Perforated Eardrum
Loud noises, sharp objects being poked in the ear, significant pressure changes and ear infections can all result in a ruptured eardrum which will affect your hearing. The eardrum plays an important part in the transfer of sound and when damaged can restrict this process.
Hereditary
Hereditary hearing loss can be conductive, sensorineural or mixed, and some individuals are born with a genetic predisposition to suffer from hearing decline. Hereditary hearing loss may take place at birth or not take effect until later in life.
Health Conditions
Health factors can have a significant effect on an individual’s hearing. Conditions such as diabetes, virus or bacterial infections (such as otitis media), heart condition, stroke, brain injury, and cancer treatment may also lead to a deterioration in hearing.
How Is Hearing Loss Diagnosed?
Hearing loss is typically determined by the process of a hearing assessment with a hearing care professional. This process includes a number of stages which include a review of your medical history, physical examination of the visible components of the ear, audiometric testing, impedance testing and speech discrimination testing.
Medical History
Discussion to determine any prior or current mitigating factors or health concerns that may impact the auditory health of the patient.
Physical Examination
During this examination, the hearing care professional will assess the physical health of your outer ear system as well as assessing the health of the eardrum. The use of a tool called an otoscope is used to visually inspect the narrow section of your ear canal and eardrum.
Audiometric Testing
There are 4 main parts that make up the audiometric testing process to determine the full profile of the patient’s hearing assessment. They include Air-Conduction, Bone-Conduction, Speech Discrimination Testing and Impedance Testing.
The first part of the assessment is to create a profile of the patient’s hearing ability in the form of an audiogram using both air-conduction testing and bone-conduction testing to determine the lowest point the individual can hear at each frequency.
Air-Conduction is the first part of the process and involves the use of an audiometer and headphones or insert earphones. The patient will be required to respond when they can hear the presented tones at a range of different frequencies and at different levels until their lowest hearing threshold is determined.
Bone-Conduction is the second part of the process and requires the use of an audiometer and a bone conductor (also referred to as a bone-oscillator). The bone-conductor is placed on the mastoid bone behind the patient’s ear which transfers the sound through the skull directly into the patient’s cochlea bypassing the outer and middle ear. The patient will again be required to respond to presented tones at a range of different frequencies until the lower threshold is determined.
Once both air-conduction and bone-conduction testing is conducted then the audiogram is complete. This will give the hearing care professional the ability to determine the level of your hearing loss and whether it is likely permanent or temporary.
Impedance Testing is often conducted during a hearing assessment as it gives the hearing care professional an indication of how the middle ear system is functioning. Tympanometry is one part of this process and with the use of a tympanometer your hearing care professional will determine an objective understanding of your middle ear health. If a conductive component is identified in the audiometric testing this test is often used to confirm the component and identify the possible cause.
Speech Discrimination Testing is often used to assess the patients ability to process words correctly and is an important part of audiometric testing.
After the assessment has been conducted the hearing care professional will discuss your results with you and determine the best form of rehabilitation to assist you if required.
On occasion, medical concerns may be detected throughout the assessment which needs further attention. In this instance, a medical referral to your doctor and/or an Ear, Nose and Throat specialist may be required.
Different Treatment Options for Hearing Loss:
Treatment or Rehabilitation options for hearing loss depend on the needs, level and type of your hearing loss. It is important to treat a hearing loss as soon as it is identified to ensure the overall health of the auditory system and the bigger picture – the overall health of the brain.
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Hearing Aids
Hearing aids are small electronic devices that you can wear in or behind your ear. It amplifies sounds according to the patients’ damaged hearing frequencies making sounds louder and clearer in order for them to hear. When choosing a hearing aid it is important to know that there are many different types and styles available to suit all needs and budgets. When seeking information on hearing aids the advice of an Independent provider is recommended to ensure you are given all the hearing aid options that are available in the market. Different styles of hearing include behind-the-ear (BTE), receiver-in-canal (RIC), custom hearing aids (ITC, ITE, CIC), invisible in the canal (IIC) and bone conduction hearing aids (BAHA).
Behind-the-ear (BTE) hearing aid – This style is one of the most common styles prescribed across the world. The versatility of these devices fit all types of hearing loss from mild to profound and come in many different shapes and sizes.
These devices are very reliable and typically lower maintenance than others given the hearing aid sits behind the ear and the sound is transferred through a tube into the ear canal.
Although one of the larger styles of hearing aids, there are many newer models that come in smaller sizes with slim tubing and can be very discreet.
Receiver-in-canal – Receiver in canal hearing aids also commonly referred to as RIC hearing aids sit behind the ear which is attached to a receiver that sits in the ear canal. RIC devices are the most popular devices sold today and worth considering for anyone who is in need of hearing assistance.
RICs are perfect for those who prefer a more discreet hearing aid. They’re smaller than other types of devices, and their thin case helps them blend seamlessly behind your ear with a large range of colour options to suit every individual.
If connectivity is a must then a RIC device is the option for you with many models providing direct Bluetooth connectivity to both iPhone and Android devices enabling individuals to stream phone calls, Zoom meetings, Music and Movies directly to your hearing aids. They also are readily available in rechargeable models removing the need for regular battery changes.
Custom hearing aids (ITC, ITE, CIC) – are custom moulded to fit specifically into the patient’s ear and come in a wide range of sizes and styles.
In-the-Ear (ITE): The larger of the custom styles allows this style to have the most features of the custom style devices. Due to the larger size of the device, it allows for a larger battery size which increases the power output and battery life for this style of the device. Added features such as Tele-Coil, Program Buttons, Volume Wheels can also be added and the latest models also now come in a rechargeable option.
In-the-Canal (ITC): The ITC hearing aid is a smaller version of the ITE and boasts many of the same abilities. Given the reduction in size controls such as the volume wheel or program, buttons are typically not available as the reduced size removes the ability to add these features. For individuals looking for a more discreet option with a similar output to the ITE then this may be the option for you.
Completely-in-Canal (CIC): The CIC hearing aid is the smaller version of the custom hearing aid range. This style is very discreet and is a popular version of the custom style of hearing aids.
Invisible-in-canal – If a discreet hearing aid is what you prefer then the IIC devices are one of the most discreet hearing aid styles available on the market. They are custom-fit to sit deep in the ear canal and are virtually invisible to see once inserted. The IIC device will suit mild to moderate hearing loss profiles and come in a wide range of models.
There are many advantages to the Invisible-in-Canal hearing aid. Firstly as the name suggests they are virtually invisible when situated correctly in the ear canal which for individuals looking for discretion is a big plus.
Another major benefit of this style of device is the sound quality. Fitted deep in the canal it allows for a more natural sound utilising the users own ear and canal to funnel sound directly into the hearing aid.
Bone conduction hearing aids – This type of hearing aid is typically used for people who have a permanent type of conductive hearing loss or for individuals who are unable to wear a conventional type of hearing aid. This device is typically fixed into place behind the ear (on the mastoid bone) and transfers the sound through the mastoid bone into the cochlea, bypassing the outer and middle ear.
Cochlear Implants
Cochlear implants are surgically implanted electronic devices that provide sound to people with profound hearing loss where the use of a conventional hearing aid is not sufficient. It works by implanting a device directly into the inner ear which is used to artificially transfer sound electronically into the cochlea.
Assistive listening devices
Assistive listening devices also referred to as ALD’s are devices used to enhance specific trouble areas that a patient may have in regards to their hearing loss. For example, if the telephone is a concern then they are assistive telephones that amplify the sounds much louder than normal in order for hearing impaired people hear better. Bluetooth headsets that stream audio from the TV to headphones are another type of assistive device.
Sign Language
Where no audible hearing is present the use of sign language may be used in order to visually communicate with people. It is a method that uses hand signs, body postures and facial expressions to discuss topics without sound. It is commonly used throughout the deaf community.
Lip-reading
Speech reading (also known as lip reading) is a method for understanding spoken language by watching the speaker’s lips, facial, and tongue movements. We all utilise speech reading to a degree maybe without even realising.
Hearing Loss FAQ’s:
Below we will answer some of the most frequently asked questions about hearing loss.
Can hearing loss be prevented?
Hearing loss may not always be preventable, but certain types such as noise-induced loss can be avoided. You can take steps to reduce your risk, including wearing hearing protection when working in noisy places, reducing exposure around homes such as loud music, use of power tools and lawnmowers without protection. Most importantly it is about education and understanding the effect that noise is having on your hearing health.
When should I visit a professional?
If you have never had a hearing test before then you should have one as soon as possible, the earlier the age the better. This enables you to obtain a baseline picture of your hearing which can be used to compare against further testing.
If you feel there has been a change in your hearing or something doesn’t feel like it should then that is another indicator that you should be assessed, often something minor can turn into something major if left untreated.
Age-related hearing loss or also known as Presbycusis is the gradual hearing loss that most people experience as they grow older and is one of the most common health conditions experienced by older adults.
Because this type of hearing loss occurs gradually over time, you may not always be aware that it is occurring hence the importance of regular hearing assessments to monitor threshold changes.
Unfortunately, there is no current scientific cure for age-related hearing loss but maintaining a healthy lifestyle and restricting the impact of noise exposure may reduce the impact of the loss as you age.
Why do we lose our hearing as we get older?
Several factors can contribute to hearing loss as you get older, from age-related causes of hearing loss to noise that damages your ears.
As we age, the structures of our ears can deteriorate due to wear and tear over time. Hence, as we grow older, humans become vulnerable to losing their hearing senses.
Medical conditions that are more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medications that are toxic to the sensory cells in your ears can also cause hearing loss.
Noise-related hearing loss is caused by long-term exposure to noises that are either too loud or last for an extended time. Noise can damage the sensory hair cells in your ear, and this kind of trauma diminishes your ability to hear. Once these hair cells are damaged, they do not regenerate, and you will lose your hearing permanently.
How to cope with hearing loss?
There are helpful ways for you to cope with hearing loss. If you start to observe common symptoms, you should seek health professional advice for an accurate diagnosis and a proper treatment plan.
- Use of a hearing aid or ALD
- Ensure you are within 1-2 metres of the person you are talking to.
- Don’t be afraid to inform the people around you about your hearing problem so they speak clearer and more direct when conversing with you.
- Turn off unnecessary background noise such as TV, Radio
- Find an area with less background noise.
Can you recover from hearing loss?
Depending on the type of hearing loss you have it may be possible to recover all or part of the loss. Typically these will be conductive type hearing loss where after the medical intervention the obstruction is repaired or removed and the hearing can return back to normal.
It is important to seek treatment as soon as an issue is identified as untreated conditions may turn permanent with medical intervention.
What is the first sign of hearing loss?
Early signs of hearing loss include Inability to hear high pitched sounds, difficulty hearing when background noise is present, ringing in the ears, requiring repeats and difficulty hearing children’s voices.
Final Thoughts:
Although untreated hearing loss can have a significant impact on individuals and their loved ones it doesn’t have to be the case.
As discussed there are many different options available to treat the effects of hearing loss and give individuals the ability to live a normal life without their impairment affecting their ability to communicate, relationships and contribution to society.
The key to successful rehabilitation is to act early, if you or someone you know is experiencing hearing loss then it is crucial they act now in order to have the best outcome in the future.
If you would like to discuss any of the information in today’s article or speak with our hearing care professionals about your hearing loss then contact us on 08 8004 0077 for your FREE no-obligation appointment.
