Symptoms

Signs and symptoms of hearing loss may include:
Inattention
Not responding to name call or soft sounds.
You are not sure where sound is coming from, known as localization
Trouble hearing consonants
Difficulty in understanding words, especially in the presence of
background noise or in group discussions.
Frequently asking others to speak more slowly, clearly and loudly
Needing to turn up the volume of the television or radio or phone call
You noticeor ringing in the ears
Withdrawal from conversations
Muffling of speech and other sounds
Unclear Speech
Articulatory errors
You find yourself avoiding social situations
You feel exhaustion after attending social events, known as listening fatigue.

Hearing loss limits the child’s ability to develop effective auditory and speech capabilities. The impact of delayed diagnosis and proper intervention in infants and children with hearing loss has a severe negative effect on the overall speech and language, as well as the cognitive and social skills. Some possible signs of hearing loss in case of infant or toddler are as follows- doesn't respond to loud noises, does not look for or locate the source of sound, has ceased playing around with sounds and babbling, may still babble, but does not seem to be making any headway toward clearer speech and not responsive to voices, even when held.

The effects of hearing impairment are many and may incapacitate all aspects of life. Children's capacity to engage in age-appropriate activities, functioning speech communication skills, and language skills can all be affected by hearing loss.

Unilateral hearing loss for example, appears to have higher rates of grade failures, the need for additional educational support, and perceived classroom behavioral concerns. Some children with Unilateral hearing loss may have speech and language difficulties, but it is unclear whether they "catch up" as
they get older (Judith and Lieu, 2004).

Hearing loss is a result of ageing (presbycusis) and repeated exposure to loud noises. Your ears' ability to conduct sound may momentarily be diminished by other factors, such as heavy ear wax.

The majority of hearing loss types cannot be reversed. However, you can take steps to enhance your hearing with the help of your doctor or a hearing specialist.

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Causes

Hearing loss can occur at any stage of life, from birth to adulthood. The effects of hearing loss vary with age.

Hearing loss is a result of impaired auditory sensitivity and/or diminished speech intelligibility of the psychological auditory system.

There are Three types of Hearing Loss, based on its causes.

These conditions might be temporary or permanent. They are caused by problems in either the outer or middle ear, which prevents the sound entering the inner ear. People who experience this condition may find that voices and sounds appear faint. In most of the cases, conductive hearing loss can be helped medically or surgically.

  • Foreign bodies
  • Cotton Swab residue
  • Infection of the ear canal or middle ear
  • Fluid in the middle ear
  • Collapsing ear canals
  • Exotosis (Bony growth in the ear canal wall)
  • Retracted eardrum
  • Perforation or scarring of the eardrum
  • Wax build-up
  • Unusual growths or tumors in the ear
  • Otitis media ( inflammation or infection located in the middle ear,  Otitis media can occur as a result of a frequent cold, sore throat, or respiratory infection.)
  • Cholesteatoma (Abnormal growth of the skin filled with air or fluid in the middle ear and temporal bone located behind the ear drum. It may cause constant discharge, hearing loss.)
  • Tympanosclerosis (Usually benign, scarring/whitish plaques on tympanic membrane.)
  • Otosclerosis (condition in which there is an abnormal growth of bone of the middle ear. This bone prevents structures within the ear from working properly and causes hearing loss. In some cases people with otosclerosis, hearing loss may also become severe.)
  • Mastoiditis (Infection of the spaces within the mastoid bone. It is usually associated with otitis media.)

Permanent hearing loss occurs when inner ear nerves become damaged and do not properly transmit their signals to the brain. Those who suffer from this condition may complain that people seem to mumble or that they hear, but do not understand, what is being said. The aging process is a very common cause of sensorineural hearing loss.

As we get older, the inner ear nerves and sensory cells gradually will not function efficiently or cells may die. The condition is not often medically or surgically treatable. In most cases, the symptoms can be significantly minimized with usage of amplification devices.

Sensorineural hearing loss may be caused by:

  • Aging (Age related hearing loss)
  • Head trauma
  • Tumours (such as acoustic neuroma)
  • History of exposure to loud noise / Excessive noise exposure
  • Ototoxicity (Ototoxic drugs, which are medications that damage hearing medications such as heavy dosage of Aspirin, Gentamicin, etc,.)
  • Viral infections, such as measles or mumps
  • Damaged inner hair cells functioning
  • Inner ear developmental anomalies such as (Aplasia)
  • Meningitis
  • Auditory Neuropathy Spectrum Disorder
  • Stroke
  • High fever
  • Meniere's disease
  • Acoustic tumors
  • Heredity

Some of the people may have a combination of both sensorineural and conductive hearing loss.

Sometimes a sensorineural hearing loss coexists with a conductive hearing loss (SNHL).When this is the case, the hearing loss is referred to as mixed. In other words, with a mixed hearing loss there is at the same time damage to the outer and middle ear’s ability to conduct sound into the inner ear and the brain and also damage to the inner ear (cochlea) or Auditory nervous system (auditory nerve). 

In most of the cases this type of hearing loss is often gradual and not immediately noticed by the person affected. Sometimes friends or family will notice a person's hearing problems before the person recognizes his/her own hearing loss.

Although each person may experience symptoms of hearing loss differently, Following includes some of the most common symptoms:

  • Family members may complain about that the person is having hearing loss noticed as he/she listens to the television or radio as too loud
  • Often ask others to repeat what they've just said.
  • Inability to hear people clearly and fully during conversations.
  • People may seem to mumble and those experiencing hearing loss may not hear all parts of a conversation.
  • The person with hearing loss doesn't answer the phone call or doorbell because they didn't hear it ringing.
  • Frequent requests for repetition or clarification.
  • Tendency to need to stare at people lips and facial expressions when they are talking in order to make it easier to understand.
  • Fatigue at the end of the day from straining to hear.
  • Avoidance of social situations, as having difficulty to hear in nosy environments.

Diagnosis

Finding out the reason for hearing is very important. For kids, the sooner the better to help develop their speech, language and cognitive skills. Diagnosing hearing in adults generally takes longer time, as many ignore, or compensate by relying on other modalities such as lip reading, paying attention at the speaker.

However, the benefit of treatment or rehabilitation after the diagnosis may not be as good as if we diagnose early and go for early treatment options. Delayed diagnosis also adversely affect a persons cognitive ability such as stress, frustration, concentration, social isolation and memory issues (Dementia), etc.,

If hearing loss is accompanied by any other issues such as tinnitus, vertigo, dizziness, or other health conditions it is very important to evaluate hearing as soon as possible.

Depending on your symptoms and signs an Audiologist would prescribe any of the following tests for proper diagnosis of hearing loss.

Physical exam

Includes OTOSCOPIC EXAMINATION, it is a tool which shines a beam of light to help to visualize and examine the condition of the ear canal and eardrum.  Examining the ear reveals  possible causes of your hearing loss, such as earwax or inflammation from an infection and also helpful to look for any structural causes of your hearing problems.

Immittance Audiometry

The primary purpose of this test is to determine the status of the outer and middle ear and also measures how middle ear responds to sound energy and how it reacts dynamically to changes in atmospheric pressure. The secondary purpose is to evaluate the acoustic reflex pathways, which include facial nerve and auditory nerve.

Pure Tone Audiometry

It is a behavioral test aimed at measuring the severity of individuals hearing sensitivity. This measure involves the peripheral and central nervous system. It helps to find type and degree of hearing loss

Speech Audiometry

It has been a fundamental too in comprehensive audiological assessment. It provides information on individuals word recognition abilities with and without presence of noise.

Brainstem Evoked Response Audiometry

Auditory brain stem response is a complex electrical response to particular type of electrical stimuli that represents neural activity that generated at several anatomical sites across the auditory pathways. Electrical activity generated by the eight cranial (vestibularcochlear) nerve and neural centers and tracts within the brainstem that are responsive to auditory stimulation. It can be recorded in newborns, infants, children and adults.

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Treatment

Hearing aids: 
If your hearing loss is due to damage to your inner ear, a hearing aid can be helpful. An audiologist can discuss with you the potential benefits of a hearing aid and fit you with a device.

Cochlear Implant:

Cochlear implants are intended to provide pre-lingually and post-lingually deafened children, who obtain limits functional benefit from conventional hearing aids. Eligibility for Cochlear Implants (CI) with the criteria of severe to profound hearing loss.

Frequently Asked Questions

What are the signs of hearing loss?

Symptoms of hearing loss include:
difficulty understanding what others are saying, asking people to repeat themselves, struggling to hear in crowded places with distracting background noise, the perception that others are mumbling or not speaking clearly, listening to the television or music at a higher volume than others, experiencing a ringing or buzzing in the ears.

What causes hearing loss?

A number of factors can cause hearing loss. The most common include aging, noise exposure, ear infections, excessive earwax, ear or head trauma, genetics, birth defects, benign growths or tumors, otosclerosis, Meniere’s disease and reactions to drugs.

Are there different types of hearing loss?

Yes. There are three types of hearing loss: Sensorineural, conductive and mixed. Sensorineural is the result of damage to the inner ear nerves. Conductive is the result of obstructions in the outer or middle ear. Mixed hearing loss is a combination of the other two types; this means that in one ear you have an issue with the outer or middle ear and the inner ear.

Can hearing loss be prevented?

Some types of hearing loss are preventable. Noise-induced hearing loss can be avoided by wearing proper hearing protection when exposed to occupational or recreational noise and turning down the volume on your TV, radio or personal music device. To prevent other types of hearing loss, avoid sticking cotton swabs or other objects in your ears, blow your nose gently through both nostrils and swallow or yawn frequently when traveling by airplane.

What are hearing aids?

Hearing aids are instruments that amplify sounds in order to enable those with hearing loss to hear more clearly.

What type of hearing aid is best for me?

Your audiologist will work closely with you to take into account several factors – the type and severity of your hearing loss, your lifestyle, the size and shape of your outer ears and inner ear canals and your manual dexterity – in order to determine the best hearing device for you.

What is a cochlear implant?

A cochlear implant is an electronic device that converts sound to digital signals that are sent to the brain, bypassing damaged nerve cells, where they are translated as sound. Whereas hearing aids amplify sounds, cochlear implants enable the user to understand speech and speak more clearly. They help patients with severe or profound hearing loss who can’t benefit from hearing aids.

Who are the people to approach when having hearing loss?

Audiologists are healthcare professionals who evaluate, diagnose and treat hearing loss and other auditory conditions like tinnitus and balance disorders.
Audiologists are trained to work with all ages, from newborns to the elderly, however some do specialize in certain age groups or conditions. An audiologist holds an advanced degree in audiology.

What Types of Tests and Treatments Do Audiologists Perform?

Common services and treatments provided by an audiologist include:

  • Diagnostic hearing tests
  • Audiologic evaluations
  • Hearing aid fittings and consultations
  • Hearing aid repairs and maintenance
  • Aural rehabilitation
  • Pediatric hearing loss detection and treatment
  • Hearing loss prevention and protection programs
  • Earmold and earplug fitting and consultation
  • Custom musician's earplugs and monitors
  • Tinnitus treatment programs
  • Dizziness and balance testing and treatment
  • Hearing rehabilitation and auditory training
  • Cochlear implant candidacy evaluations and implant programming
How do I know If I Have Hearing Loss?

If you exhibit the following symptoms, consider visiting an audiologist:

  • You hear mumbling when people are speaking to you
  • You have to ask people to repeat what they said
  • You laugh at jokes even though you may not have heard the details
  • You frequently complain that people mumble
  • You need to ask others about the details of a meeting you just attended
  • You play the TV or radio louder than your friends, spouse or relatives
  • You cannot hear the doorbell or the telephone
  • You find that looking at people when they speak to you makes it easier to understand
  • You miss environmental sounds, such as birds chirping or leaves blowing
  • You find yourself avoiding certain restaurants because they are too noisy
  • You hear a ringing sound in your ears, especially when it is quiet.
What Are the Signs of Hearing Loss in Children?

Hearing loss in children can occur at any time in life from acquired factors such as ear infections, head trauma, certain medications and genetic factors. You may suspect your child has a hearing loss if you observe any of the following:

  • Failed newborn hearing screening
  • Delays in speech and language acquisition, including baby babbling
  • Frequent ear infections
  • Not startled by loud sounds
  • Not turning to the location of sounds after six months of age
  • Difficulty following verbal directions
  • Daydreaming in many situations
  • Concerns by school teachers or failed school hearing screening
  • Loud volume on the TV or radio
  • Complaints from the child that they cannot hear
How can I prevent my hearing loss from getting worse?

Hearing loss cannot always be prevented; however, there are important things you can do to ensure you are making your hearing health a priority and taking precautionary measures.

  • Use hearing aids to address your hearing loss! If you lift weights and exercise your muscles, the nerves fire to the muscle and keep it strong. If you don't exercise your muscles, they'll weaken and atrophy. That's why it's important to use hearing aids to stimulate the hearing nerve. This helps the clarity of your hearing stay as much intact as it can. Hearing aids make the most out of the hearing ability you have left and keep your brain's ability to recognize speech in top shape.
  • Limit your noise exposure. If you work in a noisy environment or plan to attend a loud event, like a concert, then ear protection is a must. Regular earplugs provide some protection, which is better than nothing, but most hearing care providers can fit you with custom earplugs for maximum comfort and protection.
  • Get annual hearing tests so you can monitor your hearing health and take action as soon as any changes occur.
What are the treatment options for hearing loss?

Depending on your symptoms, if your hearing loss is caused by a blockage like a wax buildup (conductive hearing loss), then having it cleared by your hearing healthcare professional could drastically improve your hearing ability.

However, the most common hearing loss originates from damage to the sensory organ and/or nerve in the inner ear (sensorineural hearing loss), and nerve damage is permanent. The good news is that 95% of sensorineural hearing loss cases can be effectively helped through the use of hearing aids.

Is it possible to have hearing loss in only one ear?

Yes, although it’s not very common. The vast majority of people with hearing loss have a loss in both ears (bilateral loss). However, some causes of hearing loss in only one ear (unilateral loss) may be:

  • Congenital or genetics
  • Illness or infection
  • Head or ear trauma
Will my hearing loss worsen over time?

It depends on the type of hearing loss you're experiencing. For the majority of people who have hearing loss, it will get worse with time. Whether you have hearing loss from continued noise exposure or it's simply a combination of aging and genetics, time is not on your side. This is why it's important to visit a hearing provider at your earliest convenience and treat any hearing loss you may be experiencing.

Does earwax cause hearing loss?

Absolutely. Earwax can build up or become impacted and then partially or completely block your ear canal. In fact, earwax is the most common cause of conductive hearing loss.

Why do I hear better when I look at the speaker?

People who are generally unaware of their hearing loss will often notice that when they can see someone speak, they understand them better. Without even realizing it, you're engaging in some natural speechreading. Technically, speechreading is the process of visually detecting non-vocalized sounds (those which don't require breath behind them, like consonants) at the same time as using residual hearing and auditory cues. Therefore, your brain is using a combination of what you can hear and what you can see in order to better understand.

Why can't I hear women and children's voices clearly?

Similar to the reason it’s often hard for people with hearing loss to hear in crowded environments, you’re most likely experiencing these difficulties due to a hearing loss in high frequencies. Women and children have slightly higher-pitched voices than men do, so more of their speech patterns may be falling exactly within the range of your hearing loss.

Why can't I understand speech in crowded environments?

[Text Wrapping Break]Most people lose their ability to hear high frequency sounds first, as the area of the inner ear is most damaged due to everyday noises. High frequency sounds in speech are softer consonants that do not have a lot of power behind them, such as /s/, /f/, /t/, /k/, /p/. These tend to be sounds at the beginning or ending of words and may be perceived as a difference of hearing 'cat' vs. 'cap.' As a result, any loud or distracting noises make it difficult for you to comprehend what is being said.

Is it okay to use cotton swabs to clean my ears?

Unless you're using the cotton swab to clean the very outside of your ear (the part that sticks out from your head), the answer is no.

Your ear canal is self-cleaning, and a little earwax actually helps to keep things like dirt and dust from getting to the important parts of the ear. There's a layer of tissue that lines your ear canal and grows outward at about the same pace as your hair and nails. When you use a cotton swab to clean your ear, in addition to the risk of harming the canal or eardrum, you also risk pushing the wax in further and causing more build-up and possibly impaction.

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