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Hearing loss is an invisible disability. According to the World Health Organization, it affects 460 million people worldwide.
The ear is an amazingly complicated organ. It consists of three sections – the outer ear, the middle ear and the inner ear.
The outer ear is the part of the ear we can see. Inside is the ear canal which leads to the ear drum, sometimes called the tympanic membrane, and this separates the outer ear from the inner ear.
The middle ear contains the eardrum itself and three small bones called ossicles which send the vibration of the eardrum to the inner ear. It is also responsible for maintaining balance by equalising the air pressure in the middle ear with the air pressure in the atmosphere.
The inner ear consists of the main hearing organ, called the cochlea, which is shaped like a snail, and the auditory nerve, which processes sound information from the ear and sends it along the auditory pathway to the brain.
Hearing loss happens when a problem, even a tiny one, occurs in any part of this complicated structure.
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There are four main types of hearing loss:
First, there is what’s called conductive hearing loss. This occurs when something stops the sounds from getting through the outer or middle ear and can often be treated with medicine, or surgery, depending on what is wrong.
Second is sensorineural hearing loss. This occurs when there is damage to the inner ear and/or the auditory nerve.
The third hearing loss is a mixture of the first two.
The fourth hearing loss – auditory neuropathy spectrum disorder – occurs when sound enters the outer ear, but can’t be processed properly because of damage to the inner ear, or the auditory nerve.
The degree of hearing loss people suffer also differs from mild or moderate, through to severe and profound.
If both ears are affected equally, the term used is bilateral, and if the loss is in one ear only, it is known as unilateral.
If hearing is lost as a child, before learning to talk, then deafness is referred to as pre-lingual and, if lost later in life, then it is known as post-lingual.
Symmetrical hearing loss means the degree of deafness is the same in both ears, but if it varies, then it is called asymmetrical.
Then there is progressive and sudden hearing loss and fluctuating or stable.
Finally, congenital hearing loss means one is born deaf and acquired hearing loss happens at a later stage in life.
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Do you notice that the volume on the television always seems too low and you are constantly turning it up? Do you find it difficult to understand what people are saying if there is a lot of noise around you? Can you hear people on the phone easily? Can you locate sounds accurately, or is it difficult to pinpoint the direction? Are you embarrassed to find you are having to ask people to repeat themselves?
If you are experiencing any or all of these symptoms above, then you should see your GP and get an appointment with a specialist. The sooner your problem is diagnosed, the sooner something can be done.
The most common type of hearing loss is sensorineural and it affects about 90% of people who have hearing difficulties. It comes on gradually, so a person probably doesn’t even realize anything is wrong until they begin to notice that sounds aren’t as loud, or as clear as they used to be, or the sound of voices seem further away, especially the higher pitched voices of children. This gradual hearing loss is often the result of getting older and the right treatment can help.
Less common is the inability to hear sounds in the middle of a range, neither too high or too low. Less common still is the inability to hear very low sounds, like a man’s base voice or the rumble of thunder.
Conductive or sudden hearing loss affects about 10% of people who have hearing problems and mainly occurs when the outer ear isn’t functioning properly, often because of a severe build up of wax in the ear. This can easily be rectified by a visit to your local health surgery, where they will syringe the ear and clear it of any build up.
Other more serious causes could be a blow to the head, either through a fall or an accident, and this unfortunately can sometimes cause permanent damage.
The effects of sudden hearing loss includes the ear feeling bunged up, as though it is full of cotton wool. Often there is a dull ringing noise and people tend to feel woozy and a bit dizzy.
If you are experiencing sudden and severe hearing loss in one ear, then you might have what’s called single-sided deafness, which can be very disconcerting. When this happens, a person will be unable to tell where a sound is coming from, or how loud it is, as the brain needs input from both ears to detect volume and direction.
Temporary hearing loss is usually caused by exposure to sudden and extreme sounds like gunfire or fireworks. Often, no lasting damage is done, but your ears may “ring” for a while until your hearing returns to normal.
Babies are screened at birth to detect if there is a problem with their hearing, but sometimes the signs are not picked up until later. If a child is slow to speak, or doesn’t speak at all, or if he or she isn’t startled by loud noises or is unable to tell which direction a sound is coming from, then it soon becomes obvious that everything is not well. At that point, a diagnoses is made and whatever treatment needed will be put into place.
It’s reassuring to know that hearing loss can sometimes be restored by the use of a hearing aid, or in some cases, having what’s known as a cochlear implant, or bone anchored hearing system installed. These two treatments are, unlike hearing aids, surgically implanted devices which stimulate the auditory nerve.
If you are in the hard of hearing category, then your hearing loss is probably severe, but you can still communicate by using spoken language with the help of a hearing aid or a cochlear implant.
If, however, you have very little or no hearing, then using sign language is the only means of any meaningful communication.
There are also a number of causes why a person becomes deaf later in life. It can be caused by an infectious disease like meningitis, measles or mumps, or exposure to explosive noise or just constant noise like music on headphones at a high volume.
If you notice even a small deterioration in your hearing, have your hearing tested. Don’t delay with this – the sooner you know exactly what the problem is, the sooner it can be treated. Everything starts with a visit to your local GP – you may have a build-up of wax or another minor problem that doesn’t need specialist help. You may have a medical problem causing hearing loss that is not permanent and can be dealt with by the GP. If your Doctor can’t help, you will be referred to a specialist – an audiologist.