Hearing Loss
Symptoms of Hearing Loss
Many people who have hearing loss don’t even realize that they have a hearing problem. Many of our patients tell us things like, “People just mumble a lot these days,” or, “I hear fine, except when there is background noise,” but don’t believe that they have hearing loss. On average, people wait seven years between first having a problem with their hearing and consulting a professional about it.
Hearing loss is more complex than many people realize. Many patients who have hearing loss only have problems with hearing certain sounds, but not all types of sounds. They may understand conversation perfectly well in a quiet room, but cannot understand most words while in a group or a noisy public environment. In many cases, hearing loss affects sounds of higher pitches more than those of lower pitches, meaning that patients may have trouble hearing the higher-pitched voices of women and children while still hearing men’s deeper voices fairly well. Given that they can still hear certain sounds in certain situations, many patients with hearing loss are reluctant to bring up the issue with their healthcare providers because they don’t believe that they really have a problem.
Often, the person with hearing loss downplays the problem, while family members or friends may be more aware of the actual degree of hearing loss. At our audiology practice, we’ve seen many patients who only came to see us because their families “made” them come, only to discover that they actually did have a significant hearing problem.
Some of the symptoms of hearing loss include the following:
- Frequently asking others to repeat themselves or speak up
- Turning up the volume on the radio or TV, until it’s too loud for others in the room
- Difficulty following a conversation, particularly in a noisy room
- Difficulty following a conversation with more than one person at a time
- Frequently misunderstanding what others have said
- Avoidance of noisy or crowded social settings, or even of conversation in general
If you notice these signs in yourself or in a loved one, it’s time to get an evaluation by an audiologist.
If you want to get a sense of what life is like for people with hearing loss, check out this video.
Incidence of Hearing Loss
Hearing loss is very common. In fact, it’s the third most prevalent chronic condition in older Americans, after arthritis and hypertension (high blood pressure). Estimates indicate that about 1 in 3 Americans over age 65 has hearing loss. Unfortunately, hearing tests for older adults are not standard; only 16% of physicians screen for hearing loss. This can result in many cases of hearing loss going undetected and untreated for years.
Although it’s more common in older people, hearing loss can affect people of all ages. Nearly 15% of school-age children (ages 6 to 19) have some degree of hearing loss, which can affect their school performance and social lives if left untreated. Approximately 5 in 1000 babies are born with hearing loss, and need early treatment to protect their language development. Most children with hearing loss are born to parents of normal hearing, making treatment of hearing loss crucial for protecting the relationship between parent and child. We see patients in many different age groups at our Suburban Chicago audiology practice.
Types of Hearing Loss
Conductive Hearing Loss: This type may be due to an outer ear or a middle ear problem. Some of the causes of conductive hearing loss include excessive or compacted ear wax, damage to the eardrum, and fluid behind the ear drum.
Sensorineural Hearing Loss: This type is due to an inner ear problem or a problem with the nerves or brain regions that process sound, and is the most common type of hearing loss. Some of the causes of sensorineural hearing loss are genetics, exposure to excessive noise levels, certain medications, and aging.
Mixed Hearing Loss: This is a combination of a conductive with a sensorineural hearing loss.
Causes of Hearing Loss
There are many causes of hearing loss. The most common causes are aging and chronic exposure to loud noises.
Ear infections and excessive ear wax in the ear canal are also common causes of hearing loss. Together, these account for up to 30% of cases of hearing loss in older adults. Both are highly treatable. However, if an ear infection goes untreated for too long or a patient has many untreated ear infections, then the resulting damage to the ear can be permanent. This is why it’s important to talk to your doctor about any concerns you have about your hearing.
Hearing loss can suddenly occur at any age. No one is ever too young to be referred to an audiologist for hearing testing. Concern should be the number one reason to test hearing.
Tinnitus can be a symptom of hearing loss.
Untreated hearing loss can, minimally, cause communication problems at any age.
Genetics
Some families have a genetic hearing loss. Sometimes the hearing loss can express itself mildly in some family members, while others have a more severe degree of hearing loss. Some families have a hearing loss that originates at birth, while others the hearing loss begins in early adulthood.
Sometimes a hearing loss is linked to a syndrome that includes hearing loss.
Genetically based hearing losses can be of the conductive type, some are sensorineural, while others can be a mixture of both conductive and sensorineural.
Viral Infections
Viruses can attack the inner ear and cause temporary and permanent sensorineural hearing loss. Many times this type of hearing loss comes on suddenly and is associated with tinnitus (ringing or roaring sounds), vertigo, and decreased hearing.
Any sudden hearing loss is considered a medical emergency, and the patient should be referred to an Otolaryngologist for treatment as soon as possible. In many cases, the hearing can be restored if treated is started quickly. Patients with this type of hearing loss is a sensorineural hearing loss.
Osteoporosis
It has been found that those who are diagnosed with osteoporosis are at a higher risk of Sudden Sensorineural Hearing Loss (SSNHL) than the general population.
Medications
Some strong antibiotics that administered through an IV can affect the hearing and balance systems, causing varying degrees of permanent damage to the inner ear. Examples of potentially ototoxic antibiotics are: Streptomycin, Neomycin, Kanamycin, Amikacin, Gentamicin, Tobramycin, Vancomycin, Azithromycin, and Viomycin. Aminoglycosides with some mitochondrial DNA mutations can cause hearing loss.
Chemotherapeutic (antineoplastic) drugs, particularly those containing platinum (cisplatin and carboplatin), can cause tinnitus and hearing loss.
Ethacrynic acid and furosemide given IV have caused profound, permanent hearing loss in patients with renal failure who had been receiving aminoglycoside antibiotics.
Diabetes
People diagnosed with Diabetes should have their hearing tested annually. When a diabetic’s glucose levels are high, there can be a change in the nerve endings in the inner ear, cochlea, due to microvascular damage. This is similar to retinopathy and neuropathy of the eyes and feet.
There is a proven link between diabetes and hearing loss in adults over the age of 60.
Patients with Diabetes:
- When a patient is first identified with Diabetes, they should have their hearing screened
- Diabetic Patients have a progressive hearing loss
- Evidence suggests that diabetic patients need to have their hearing tested annually.
Heart Disease
Low-frequency hearing loss strongly correlates with cerebrovascular and peripheral arterial disease. Therefore, patients who present with this type of hearing loss should be referred to their doctor as they are at-risk for cardiovascular events.
One study found that women who are overweight and obese are 25% more likely to have a hearing loss than their peers with BMI’s below 40.
Autoimmune Diseases
Much like hearing losses due to a virus, Autoimmune hearing loss can occur very quickly and suddenly in one ear or both. It is described as an inappropriate attack on the ear. The changes in the inner ear can affect the balance and hearing systems. Varying degrees of hearing loss can be found. Examples of autoimmune disorders that can be linked to hearing loss can include polyarteritis nodosa, Wegener’s granulomatosis, Cogan’s Syndrome, Sjogren’s Syndrome, relapsing polychondritis, rheumatoid arthritis, systemic lupus erythematosus, and ulcerative colitis.
Lifestyle
- Smoking: Active and passive smoking has been linked to both conductive and sensorineural hearing loss.
- Loud Work Environment: Working in excessively loud noise environments and cause gradual hearing loss. Hearing protection should be worn in settings with sounds louder than 85 dB.
- Hobbies: Playing in and around noise can cause gradual hearing loss. Some activities can include, skeet shooting, hunting, motorcycling, snowmobiling, and playing in a rock band. Also, attending loud concerts and/or frequenting establishments with loud music can also cause hearing loss and tinnitus.
Treatment of Hearing Loss
The first step in treating hearing loss is to determine the underlying cause. If it’s something that can be treated, such as an ear infection, then this treatment may correct the hearing loss. However, in many cases (such as when hearing loss is due to noise exposure or aging), the hearing loss is not reversible.
In these cases, treatment of hearing loss includes hearing aids. These devices amplify sound to make it easier for the patient to hear. Modern hearing aids are advanced devices that use computer technology to detect sounds of interest and preferentially amplify these, while minimizing background noises. In addition, many other features are available to improve the wearer’s hearing function, including telecoils (which can connect to hearing loops to make it easier to hear in public spaces). When you come for your appointment at our Chicago audiology practice, Dr. Dawn Heiman will explain the various options to you.
Hearing Loss and Dementia
Many people are surprised to learn that there is a connection between hearing loss and dementia. Research has demonstrated that people with hearing loss are at a higher risk for developing dementia than are those of normal hearing. Scientists believe that being unable to hear well deprives the brain of an important source of stimulation, which contributes to the brain’s decline. Additionally, people with hearing loss tend to become socially isolated, and the loss of social support also damages the brain.
Those who receive treatment for their hearing loss greatly reduce their risk of dementia. Research has shown that those who use hearing aids are significantly less likely to develop dementia than are those whose hearing loss goes untreated. In addition, people who use hearing aids score significantly better on various measures of social, emotional, and psychological well-being than do those with untreated hearing loss.
In addition, hearing loss can sometimes be mistaken for dementia, because most of the exam that tests for dementia is given verbally. In some cases, a patient may test positive for dementia when they are actually cognitively healthy, but simply cannot hear the examiner properly. Ideally, hearing should be evaluated prior to testing for dementia.