Since hearing loss typically occurs gradually, many people do not realize the damaging effects that occur with hearing changes. As America ages and with Baby Boomers expected to live longer than any previous generation, hearing impairment will reach new levels in coming decades. Currently, only about one in five people with hearing loss seek appropriate treatment which is particularly alarming since untreated hearing loss can lead to an increase in depression, feelings of anxiety and isolation from family and friends.
Effects of Hearing Loss
Nearly 36 million Americans have some degree of hearing loss due to genetics, the environment in which they surround themselves, or simply as a result of the aging process. With hearing loss, it is often difficult to understand speech. What is not sufficiently appreciated is that the individual’s emotional and mental state may also be affected by the erratic and disrupted communication patterns caused by hearing loss. A person with hearing loss is four times as likely to manifest psychological disturbances than a person with normal hearing. There is also evidence that hearing loss can exacerbate the behavioral picture of patients with Alzheimer’s and other cognitive disorders, affecting memory, alertness, and general ability to cope, beyond the expected limiting factors of the disorder without the presence of hearing loss.
Types of Hearing Loss
There are three types of hearing loss:
Sensorineural hearing loss occurs in the inner ear and is the most common type of hearing loss caused by damage to the inner ear and/or auditory nerve due to one episode or more of prolonged exposure to loud noise, certain medications or simply the process of aging. Once damaged, the inner ear cannot be repaired. Sensorineural hearing decreases the ability to differentiate consonant sounds (thus the fine distinctions in words such as hat versus cat). Most sensorineural hearing losses can be treated effectively with hearing aids.
Conductive hearing loss occurs in the outer and middle ear. The most common causes are wax build-up in the ear canal, middle ear infection, a hole in the tympanic membrane or damaged ossicles.
In most cases, conductive hearing loss affects the lower frequencies or pitches and makes it difficult to hear vowel sounds. Since vowels contain the “power of speech,” the individual with conductive hearing loss perceives speech and other sounds as being much “quieter” than normal. The condition can often be medically treated.
Mixed hearing loss is a combination of a conductive and a sensorineural hearing loss.
Another condition that affects as many as 37 million people is called tinnitus – roaring, buzzing, clicking, whistling, hissing, or high pitched ringing in the ears or inside the head. Tinnitus may be constant or occur intermittently in one or both ears and varies greatly among individuals ranging from a mild occasional sound to an ever present chronic condition. Some people report their tinnitus is so bothersome that it interferes with their quality of life.
Many people with hearing loss also experience tinnitus although it is possible to have normal hearing and still have tinnitus. If tinnitus is suspected, a medical evaluation and a hearing test by licensed professionals should be conducted. It is important to have a medical examination to determine if there is an underlying condition causing the tinnitus.
Since tinnitus is a symptom associated with various disorders, there is no single treatment that will help everyone. The most effective treatment is the removal or prevention of the cause. Unfortunately, the cause of tinnitus usually cannot be identified or corrected. Therefore, tinnitus itself may need to be treated. There are a number of treatment options available including the use of amplification (hearing aid), which allows the wearer to hear background sounds in the environment, which takes away the focus on the tinnitus.
The Progression of Hearing Loss
The progression of hearing loss in most cases is subtle from a small amount of hearing loss to greater and greater loss. The implications vary depending on the degree of hearing loss.
Borderline / Normal Hearing:
- May have problems in difficult listening situations such as in groups or in noise.
- May need visual cues (to watch the speaker’s face and especially lips) to understand some conversations and certain speakers.
- May need to sit close to the speaker to understand the conversation.
If the problem is affecting the patient’s ability to function normally in everyday life, they should probably consider amplification (hearing aid) if the hearing loss is not medically treatable.
Moderate Hearing Loss:
- Having difficulty understanding conversations on the telephone.
- Having difficulty understanding one-on-one conversations.
- People have to speak up for person to understand what is said.
The problem is affecting the patient’s ability to function normally in everyday life and they should consider amplification if the hearing loss is not medically treatable.
Severe Hearing Loss:
- Impossible to function in difficult listening situations such as in groups or in noise.
- Impossible to understand conversations on the telephone.
- Having difficulty understanding one-on-one conversations.
- People have to speak up for person to understand even part of what is said.
- Needs to sit close to the speaker to understand even part of the conversation.
- Need visual cues (to watch the speaker’s face and especially lips) to understand even part of any conversation and any speaker.
- May have difficulty identifying loud environmental sounds (sirens, telephone ring, car horn, etc.) making safety a concern.
The problem is affecting the patient’s ability to function normally in everyday life and they should consider amplification (hearing aid). If the hearing loss is medically treatable, it is most likely a mixed hearing loss and may require amplification post-medical treatment.
Profound Hearing Loss:
With Profound Hearing Loss, it is impossible to understand one-on-one conversations and the quality of the patient’s speech is affected. The problem affects the ability to function normally in everyday life. If the hearing loss is medically treatable, it must be a mixed hearing loss, and will likely require amplification (hearing aid) post-medical treatment to detect speech.
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