Hearing Loss Menu

Questions About Hearing Loss

Signs of Hearing Loss

Facts on Adult Hearing Loss

Conductive Hearing Loss

Sensorineural Hearing Loss

Questions about Tinnitus

QUESTIONS ABOUT HEARING LOSS

How is hearing tested? Does it hurt?
Many methods have been developed to assess hearing ability, but the most common and the most reliable test has been the pure tone audiogram. Earphones will be placed on your ears and you will be asked to listen for a series of beeping tones that sound rather like notes on a piano. You will be asked to respond when you hear these sounds by raising your hand or pushing a button. Dr. Pianin will determine the softest volume that you can hear for a variety of tones from very low to very high pitched, and the results will be recorded on a graph called an audiogram. The entire test is performed in a certified sound booth so that your test results may be compared to what is normal for human beings. You will also be asked to repeat a series of one syllable words to determine how well you understand what you hear. Sometimes this test is repeated in the presence of background noise.

The entire evaluation takes about 30 minutes and there is no pain or discomfort involved. It simply requires some concentration on your part. The test results are used to determine your diagnosis and which, if any, hearing instruments will be most effective in correcting your hearing loss.

How do I know if I have hearing loss?

Hearing loss occurs to most people as they age. Hearing loss can also be a result of exposure to loud noise, medications, infections, head or ear trauma, congenital or hereditary factors and some disease processes. The vast majority of hearing problems do not require medical or surgical intervention. Some 90 to 95 percent of all cases of hearing loss can be corrected with hearing aids.

HAVE YOU HEARD THESE STATISTICS?

There are approximately 31.5 million people in the USA (as of 2005) with hearing loss. Hearing loss is the single most common birth "defect" in America. Approximately one third of all seniors aged 75 years and older have significant hearing loss. About 14 percent of all people aged 45 to 64 years have demonstrable hearing loss. Hearing loss negatively impacts quality of life, personal relationships and of course, the ability to communicate.

You may have hearing loss if...
You hear people speaking but you strain to understand their words.
You frequently ask people to repeat what they said.
You don't laugh at jokes because you miss the story or the punch line.
You frequently complain that "people mumble."
You ask others about details of a meeting you just attended.
You play the TV or radio louder than friends, spouse and relatives.
You cannot hear the doorbell or the telephone.
You find that when people look directly at you while they speak to you, it makes it easier to understand.

If you have any of these symptoms, you should call our office today.

I have been told that I have "nerve deafness" and that nothing can help me. Is this true?
Nothing could be further from the truth. First of all, "nerve deafness" is a misnomer. Hearing loss that occurs with increasing age or from hereditary factors is rarely caused by a deterioration of the hearing nerve, but is caused by damage to the tiny hair cells in the inner ear or cochlea. The vast majority of successful hearing aid users have been told they had "nerve deafness" at one time or another. "Nerve deafness" is simply a term that has been used to label any type of hearing loss that cannot be treated by medicine or surgery.

I am fairly certain that my loved onehas a hearing loss. How should I proceed?
As a doctor of Audiology, Dr. Pianin is an expert in the diagnosis and management of hearing problems. She will conduct all appropriate testing to determine if hearing aids might be of benefit. With today’s advanced technologies, the vast majority of hearing losses can be corrected with hearing aids. Only 20% of hearing losses in adults are caused by medical problems, but if indicated, an appropriate referral will be made for medical treatment.

My mother has become very hard of hearing but refuses to admit it or to do anything about it. How can I encourage her to get tested?
Hearing loss often occurs very gradually and is a problem only in certain listening conditions. It is easy for the listener to blame background noise, room acoustics or the speaking characteristics of others for inability to hear clearly. It is hard for many to accept that the problem is theirs and not the speaker’s. It may be useful to sit down with your mother and share with her how frustrating her hearing loss is for you. You have to get her attention before you can speak to her. You cannot talk to her from another room. She is always asking you to repeat what you say. It is just plain hard work to communicate with her and that makes visiting difficult and unpleasant. Many people don’t realize what an imposition their hearing losses are for friends and family members and end up socially isolated as a result. Approach your mother’s hearing loss from the standpoint that you would like to be able to visit with her more freely, and that might persuade her to seek help. Offer to make her an appointment with an audiologist and then go with her. Dr. Pianin is trained to counsel those with hearing loss and help them deal with their feelings of denial.

Many people still feel that the use of hearing aids creates a stigma associated with aging and/or disability. It sometimes helps to point out that the stigma of appearing inattentive, self-centered or just plain dumb is much worse than the "stigma" of hearing loss. The successful use of hearing aids is very common. Patients usually find that the benefits of better hearing outweigh their concerns that someone will see their hearing aids. And, with new smaller, sleek and stylish aids available, they are harder for others to see than ever!

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Common Signs of Hearing Loss

• You can hear, but can’t understand the words clearly.

  Among the first sounds that “disappear” are high pitched sounds, including women’s and children’s voices, birds chirping, turn signals and high pitched consonant sounds in words that sound alike, like “thin” and “fin”.
  

• You have difficulty hearing in background noise, such as in restaurants, parties, theaters, and religious services.
• You have difficulty understanding what is being said unless you are directly facing the person speaking.
• You feel that others mumble, slur their words, or talk too quickly.
• You have ringing or buzzing in your ears (tinnitus).
  

  Tinnitus can be caused by many things, including hearing loss, middle ear disorders, noise exposure history, and many non-ear related causes, such as medications.

• You have to ask people to repeat words or phrases, even though they feel they are speaking loud enough.
• You prefer the TV or radio louder than is comfortable for others.
• You have difficulty understanding conversation in a group of people, or when more than one person is speaking.
• You are beginning to avoid social situations, public facilities, group meetings, or family gatherings where listening may be difficult for you, and participation in such activities brings less enjoyment than it once did.
• You frequently nod your head “yes” in agreement when you are not fully sure what someone has said.

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Facts on Hearing Loss in Adults

• One in every ten (28 million) Americans has hearing loss.  As baby boomers reach retirement age starting in 2010, this number is expected to rapidly climb and nearly double by the year 2030.

• The prevalence of hearing loss increases with age, up to 1 in 3 over age 65. Most hearing losses develop over a period of 25 to 30 years.

• Among seniors, hearing loss is the third most prevalent, but treatable disabling condition, behind arthritis and hypertension.
• While the vast majority of Americans (95%) with hearing loss could be successfully treated with hearing aids, only 22% (6.35 million individuals) currently use them.  Only 5% of hearing loss in adults can be improved through medical or surgical treatment.
• 65% of adults with hearing loss are below retirement age.

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Types of Hearing Loss

• There are two main types of hearing loss, CONDUCTIVE and SENSORINEURAL.

CONDUCTIVE

Conductive hearing loss occurs when sound waves are blocked in the outer or middle ear and can't reach the inner ear, where hearing is still normal. This type of hearing loss is rarely severe or profound and usually affects all frequencies. People affected by conductive hearing loss often experience an overall reduction in the volume of sounds and find it difficult to hear faint sounds.
Most conductive losses are not permanent and can be treated medically or surgically. However, if left untreated, conductive hearing losses can result in permanent impairment.

Causes
The most common causes of conductive hearing loss are otosclerosis and otitis media:

Otitis Media
Otitis media, also called middle ear infection, is the most common cause of conductive hearing loss among children, but can also occur in adults. Otitis media, which occurs when the middle ear becomes inflamed and filled with fluid, can prevent the ear drum from vibrating properly, resulting in temporary hearing loss. This inflammation can be the result of a virus or respiratory infection. Typical symptoms include swelling, redness, earaches, irritation, hearing loss, fever and ear drainage.

Most cases of otitis media can be cured by antibiotics prescribed by a physician. In some cases of persistent otitis media, surgical treatment, such as the insertion of ventilating tubes, may be required.

Otosclerosis
Otosclerosis is the most common cause of conductive hearing loss in adults. A disorder of the middle ear bones, Otosclerosis is caused by a build-up of calcium around the stapes, preventing it from vibrating and sending sound signals to the inner ear. Over 90% of people with otosclerosis can regain normal hearing through surgical treatment.

Other Causes
Other causes of conductive hearing loss include:

• Temporary blockage (e.g. allergies, outer ear infections such as swimmer's ear, build-up of earwax or fluid due to cold)
• Perforation of the ear drum
• Fractured middle ear bone

SENSORINEURAL

Sensorineural hearing loss, also known as nerve deafness, accounts for 90% of adult hearing problems. Sensorineural hearing loss occurs when the hair cells in the cochlea (inner ear) become damaged and sound can't reach the brain (where sound is processed). Once the hair cells have been damaged, they cannot be repaired, making sensorineural hearing loss permanent. Hearing aids can help in most cases.

Like conductive hearing loss, sensorineural hearing loss usually results in the overall reduction in the loudness of sounds. However, sensorineural hearing loss also causes sounds to become distorted.

Causes
The two main causes of sensorineural hearing loss are aging and noise.

Aging
Hearing loss caused by the natural aging process is called Presbycusis. All of us gradually begin to lose hair cells as we age. As this happens our hearing becomes less acute. Around the age of 60 to 65, about 30% of the population have a hearing loss that is significant enough to affect their ability to hear everyday sounds, such as speech.
The first sign of Presbycusis is usually a reduction in the ability to hear high-frequency sounds, such as s, t, k, p, t, resulting in speech sounding muffled. This means that you can hear someone talking, but you can't tell if they said "sit" or "kit". Gradually the mid and low frequency tones may also be affected.

Noise- Induced
Excessive exposure to noise is one of the most common - yet also one of the most preventable - causes of permanent hearing loss. Every exposure to loud noise will cause some degree of temporary hearing loss; repeated exposure over a number of years will result in the gradual, painless process of permanent hearing loss.
Noise levels are measured in decibels (dB). Sounds louder than 80 dB are considered potentially hazardous to your hearing. The following chart helps you to understand what sounds are considered too loud for healthy hearing.

Sound Level (dB)		Example
Faint
	30	whisper, quiet library
Moderate
	50	rainfall, quiet office, refrigerator
	60	dishwasher, conversation
Very Loud
	70	traffic, vacuum cleaner, restaurant
	80	alarm clock, subway, factory noise
	90	electric razor, lawnmower, shop tools, subway
	100	garbage truck, chain saw, stereo system set above halfway mark, snowmobile
Extremely Loud
	110	rock concert, power saw
Painful
	120	jet takeoff, nightclub, thunder
	130	jackhammer
	140	shot gun
	180	rocket launching pad

When sound reaches an intense level, it can damage the hair cells of the inner ear. This results in a loss of electrical impulses for a range of pitches. Often the damage affects the high-pitched sounds first. Consequently, high-pitched speech sounds, such as the consonants "t", "s", "th", and "ch" become difficult for people to hear.

Click for a larger image of the noise thermometer.

 

 

 

Listen to your buds

Click here to learn more about ASHA's listen to your buds campaign aimed at teaching kids about safe listening levels for headphones.

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QUESTIONS ABOUT TINNITUS

What is Tinnitus?
Tinnitus is the term for the perception of sound when no external sound is present. It is often referred to as "ringing in the ears," although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus can be intermittent or constant, with single or multiple tones. Its' perceived volume can range from very soft to extremely loud.

How many people have Tinnitus?
50 million Americans experience tinnitus to some degree. Of these, about 12 million have tinnitus which is severe enough to seek medical attention. Of those, about two million patients are so seriously debilitated by their tinnitus, they cannot function on a "normal," day-to-day basis.

Tinnitus Management and Treatment
Generally, most patients will not need any medical treatment for their tinnitus. For patients who are greatly bothered by tinnitus, they may use some masking techniques such as listening to a fan or radio which would mask some of their tinnitus. In addition, other sound source generators can be obtained and be adjusted to sound-like environmental sounds and this is also effective in masking tinnitus. This generally is more advantageous if one is attempting to go to sleep. A tinnitus masker is utilized in some patients. It is a small electronic instrument built into a hearing aid case. It generates a noise which prevents the wearer from hearing his own head noise. It is based on the principle that most individuals with tinnitus can better tolerate outside noise than they can their own inner head noise.

Biofeedback training is effective in reducing the tinnitus in some patients. It consists of exercises in which the patient learns to control the various parts of the body and relax the muscles. When a patient is able to accomplish this type of relaxation, tinnitus generally subsides. Most patients have expressed that the biofeedback offers them better coping skills.

Other measures to control tinnitus include making every attempt to avoid anxiety, as this will increase your tinnitus. You should make every attempt to obtain adequate rest and avoid over-fatigue because generally patients who are tired seem to notice their tinnitus more. The use of nerve stimulants is to be avoided. Therefore, excessive amounts of coffee and smoking should be avoided. Tinnitus will not cause you to go deaf and statistically, 50 percent of patients may express that their tinnitus with time decreases or is hardly perceptible.

There are other medications which have been utilized to suppress tinnitus. Some patients benefit with these drugs and others do not. Each patient has an individual response to medication, and what works for one patient may not work for another. Some of these medications have been proven, however, to decrease the intensity of the tinnitus and make it much less noticeable to the patient. There is, however, no drug anywhere which will remove tinnitus completely and forever. There are some drugs which will also cause tinnitus. If you have tinnitus and are on medication, you should discuss the symptom of tinnitus with your physician. In many instances, once the drug is discontinued the tinnitus will no longer be present.

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