According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 15% of American adults over the age of 18 report some difficulty with hearing. It is estimated that >50% of adults in age of 70s and >80% of adults in age of 80s have some degree of hearing loss in both ears. Hearing loss may become advanced before a patient seeks any assistance. Typically, patients do not have as much trouble in one-on-one situations or in quiet environments but really begin to show issues in public, noisy places with misunderstanding in conversation. A very common complaint is that a patient may be able to HEAR what is being said but they cannot UNDERSTAND the words. Tinnitus or “ringing in the ears” can also precede hearing loss that is socially impactful and is often a first sign of hearing loss.
In order to hear, sound waves are caught by the external ear and transmitted through the ear canal to the ear drum. Vibration of the ear drum then moves three tiny bones located in the middle ear, aka the ossicles. These are sometimes known as the Hammer, Anvil and Stirrup or Malleus, Incus and Stapes. The Malleus is connected to the ear drum. The Stapes is connected to the fluid filled inner ear. Movement of these bones is in a lever action back and forth which causes shifting of fluid in the inner ear similar to a wave pool. The fluid movement then activates the hearing nerve resulting in electrical signals transmitted to the brain. These signals are interpreted in the brain as specific sounds.
Hearing loss can be brought about by a blockage or damage to any part of this pathway.
Hearing loss typically comes in two categories:
- Conductive hearing loss. This occurs when sound cannot reach the inner ear. Common causes are wax impaction, middle ear fluid or a hole in the ear drum.
- Sensorineural hearing loss. This occurs with damage to the inner ear or hearing nerve. Over time, damage can be accumulated in the inner ear as these cells are unable to repair themselves after an insult. This can be caused by normal aging, head trauma, illness, loud sounds and certain medications.
According to data in 2017 by the Lancet, Hearing loss can increase the risk of dementia by 94% with the risk escalating as hearing loss severity worsens. Hearing loss may also be a risk factor for falls given the close association of hearing and balance centers.
The most importance first step is to undergo hearing testing, known as an audiogram. Treatment of hearing loss depends on where the injury has occurred and could include amplification devices or surgery. A variety of hearing rehabilitation devices exist. For the vast majority of adults, hearing aids (HA) are the best option. Current technology has made significant advancements in both function and cosmetic appeal of these. There are implantable options for single sided deafness and hearing loss related to the ossicles, such as the bone anchored hearing aid. For those with significant hearing loss and poor performance with HAs, cochlear implants (CI) have become a very beneficial option.
The physicians at Southern ENT are able to provide a comprehensive hearing evaluation as well as a treatment strategy personalized to your specific needs. We offer the full complement of hearing rehabilitation solutions such as hearing aids and implantable devices, including cochlear implantation. Call our office at 205-838-3755 or click the “Request Appointment” link above to set up your hearing evaluation today!
References:
National Institute on Deafness and Other Communication Disorders, “Quick Statistics About Hearing”. https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
Singh-Manoux et al. “Prevention of dementia by targeting risk factors”. The Lancet. Vol 391, Iss 10130, P 1574-1575. 21 Apr 2018. https://doi.org/10.1016/S0140-6736(17)31363-6.
Ames et al. “Dementia prevention, intervention, and care”. The Lancet. Vol 390, Iss 10113, P2673-2734. 16 Dec 2017. https://doi.org/10.1016/S0140-6736(17)31363-6.
