The sense of hearing is a complex one. The ears are divided into three parts: the outer ear, the middle ear and the inner ear. While the outer ear sends the sound to the middle of the ear, the middle ear sends the same to the inner ear through the conductor. The inner ear in turn sends the auditory signal to the brain where the signal is processed and gives rise to a sense of hearing. 

Problems in hearings can arise if there is a problem in any of these parts. However, more often than not it is the middle or inner ear that is affected. However, there may also be situations when there are problems in both the middle and the inner ear. In that case, it is known as a mixed hearing loss. 

What is Mixed Hearing? 

Loss If there is damage to the middle ear, it may precipitate a conductive hearing loss. Now, in addition to that, if there is a sensorineural problem, then it gives rise to mixed hearing. So, in the case of a mixed hearing loss, all the parts of the ear and even the brain may be involved. There may be damage to the outer ear, middle ear, inner ear, as well as the auditory nerve. 

Causes of Hearing Loss 

Since mixed hearing loss may result from damage to any part of the ear, it is necessary that the causes be grouped into different categories. 

  Sensorineural Hearing Loss 

Sensorineural loss may result from drugs, different illnesses, head trauma, malformation of the inner ear etc. Genetic predisposition may also precipitate such problems. 

  Conductive Hearing Loss 

Such type of hearing loss may result from excessive deposition of earwax, ear infections, perforation in eardrums, malformation of the middle or outer ear, as well as problems with the fluid in the middle ear. 

Symptoms of Hearing Loss 

Reduced hearing in either or both ears is considered to be delineating symptoms of mixed hearing loss. 

Treatment 

Since mixed hearing loss can result from sensorineural failure as well as damage to outer or middle ear, treatment needs to be divided into different groups too.   To treat Conductive Hearing Loss, doctors can use surgical or medical options. 

  For sensorineural hearing loss, doctors usually prescribe hearing aids. This indicates that treatment for mixed hearing loss may include treatment for conductive hearing loss as well as that for sensorineural hearing loss. So, it is usually a combination of both medical and surgical options. Physicians may prescribe both medicines and hearing aids or resort to surgical interventions and also prescribe hearing aids. Sometimes, physicians use special hearing aids or implants to treat mixed hearing loss. 

Conclusion 

In case a person is sensing reduced hearing in one or both ears, he/she needs to seek medical advice. It may be a symptom of mixed hearing loss. Getting in touch with an experienced physician is the first step towards that.

Mixed Hearing Loss - How To Treat It?

What causes hearing loss? + How to ensure you can help it as you age

The partial or total inability to hear is known as hearing impairment or hearing loss. It can be present at birth, or develop later in life.

There are a number of factors, which may cause hearing loss

1. Age - Age is the biggest factor when it comes to the loss of hearing, and you may lose the ability to hear as you age. This condition is known as presbycusis. It becomes difficult to understand high-frequency sounds like that of a child or a woman when you get old.

2. Noise - When you are exposed to loud noises for a prolonged period of time, it damages your ears. This leads to loss of hearing. 5% of the total population of the world is affected by noise (the degree of suffering varies). It may be a result of continuous exposure to loud music or a sudden exposure to a loud noise like an explosion.

3. Hereditary disorders - Hearing disorder may be inherited by the dominant or recessive genes of parents in the child. 70-80% of these cases inherit from the recessive genes, whereas 20-25% inherit hearing loss from the dominant genes.

4. Trauma - Serious injuries of the head/ears may cause loss of hearing, which may be either temporary or permanent. When damage is caused to the brain, the brain fails to process the message conveyed by the ears. So even if the ears are totally functional, a person may face the problem in hearing.

5. Perinatal problems - The ototoxic effects on the fetus due to excess intake of alcohol during pregnancy lead to hearing the loss in about 64% of the infants born to alcoholic mothers.

Also, premature birth can be associated with hearing loss due to high risk of being exposed to noise in neonatal units.

Knowing about the causes of hearing loss can lead you a step closer to preventing this disorder as you age.

Here are some useful tips that can help prevent hearing loss:

1. Be more aware - You should be diligent and aware of the situations, which may risk your hearing ability and should try to avoid such situations as much as possible. Limit your exposure to sources of hazardous noises like firearms, firecrackers, concerts and clubs.

2. Take precautionary measures - If your occupation calls for working at an environment of loud noises, use earplugs or earmuffs to block out the excessive noise. Also, make sure that you work in a place where employers take all the necessary measures of noise control under the federal or state regulations.

3. Monitor your use of gadgets - Monitor and control the use of hearing devices, and try to reduce the use of headphones/ earphones as much as possible.



What causes hearing loss? + How to ensure you can help it as you age

Usher syndrome is a genetic disorder that is characterized by complications in vision and hearing; the most common of them being partial/complete loss of hearing and retinitis pigmentosa. Retinitis pigmentosa is characterized by progressive deterioration of the retina, resulting in deprivation of peripheral vision and subsequent night blindness.

The symptoms and its rate of progression usually vary among people. Usher syndrome is classified into three types:

Type 1: In this type, children are born with balance issues and hearing loss problems. The symptoms of night blindness and loss of peripheral vision associated with  Retinitis Pigmentosa  only appear in the early stages of adolescence.
Type 2: In type 2, children are born with moderate to mild hearing loss problems. Retinitis Pigmentosa develops soon after the child reaches adolescence.
Type 3: In type 3 Usher Syndrome, children are usually born with normal hearing skills, however, loss of hearing and Retinitis pigmentosa occur soon after puberty.
Causes
Hearing loss in Usher syndrome occurs when the nerve cells that are present in the cochlear (inner ear s spiral cavity) are affected by genetic mutation. A similar problem occurs in the cells of the retina leading to loss of vision. These cells allow conversion of light into electrical signals for the brain to interpret them. Both the parents need to pass the mutated gene to the child for it to be affected. If the child has only one gene, then he/she rarely develops the symptoms.

Treatment
This disorder does not have any prescribed course of treatments. The vision loss that occurs in this disorder can be slowed down by nutritional therapy. This therapy involves providing the body with essential amounts of vitamin A which can help in reducing vision loss.

Usher Syndrome - Things You Must Know!

It is that time of the year when insects are all around. Suddenly one feels a buzzing sound or an itchy feel in the ear. To your horror, one feels a live insect is in your ear, which can be extremely annoying and is like a nightmare. Insects often get stuck when they enter our ears as they cannot fly or crawl out. They try to find their way out and their movements inside our ears can be very uncomfortable, painful and can be itchy as well. Moreover, they can easily produce infection.

In this scenario, do not try to remove an insect with cotton swab, tweezers or hair clip as it will make the situation worse and can lodge the insect deeper into the ear canal, which can possibly damag the eardrum, leading to permanent hearing loss. If an individual is not certain about the potential harm taht can be caused by the insect in the ear, one should seek medical care immediately. Insects in the ear are common reasons for visits to doctor's clinic, especially in children.

If one suspects an insect in ear, one may experience pain, swelling, blood or crackling. One may even feel biting, stinging, hearing loss or dizziness. It is best to stay calm in this situation as being active may lodge the bug further in ear or cause it to move further back or cause serious damage to the sensitive eardrum

One way to try to remove a bug in ear is by tilting the ear toward the ground and attempt to wiggle the ear. Grasp the earlobe and give it a wiggle. If the bug is not too far into ear canal, it may fall out on its own. If the bug is still alive and is not too far inside of the ear canal, it may simply come out on its own. If one stays calm and keep objects including fingers away from ears, it is likely that the bug will find its way back out of ear.

One can also try to flush the ear with warm water with a dropper or a bulb syringe. This can be done by holding head upright and stretching the ear canal by pulling the outer ear and then putting a steady stream of warm water into ear. Tilt head to the side to drain out the ear. Do not try this if one suspects that ear drum has been ruptured to prevent additional damage.

To avoid stinging or eardrum rupture from scratching or biting , one may use a drop or two of mineral, baby, or olive oil inside your ear canal to kill the insect. Finally, visit an ENT specialist doctor as they can remove the insect by special suction devices. Post insect removal, one must look out for signs of infection as swelling, dizziness, hearing loss, fever, and pain. Finally follow up with ENT specialist or Otolaryngologist for the final opinion.

How to Remove Insect from Ear at Home? 

BAHA Implant
Bone Anchored Hearing Aid (BAHA) is a device surgically implanted to help people suffering from a loss of hearing. Most conventional hearing aids transmit sound through air conduction. The BAHA device is suitable for conductive or mild-moderate mixed hearing loss.

Problems with hearing in the middle or outer ears can be helped with the BAHA device. The sound waves received by the BAHA device bypass the middle ear and get delivered straight to the functioning cochlea in both ears.

A BAHA device comprises of two parts:
a) The processor 
b) A fixture which is surgically implanted behind the ear in the bone.

The implant is embedded in the bone. The processor, which remains outside, is attached to the implant. There is a microphone on the processor that picks up sounds. The sounds are passed on to the implant. The implant vibrates which triggers the Cochlear. You can consider wearing a BAHA implant if other conventional hearing aids do not work for you. BAHA implants are also given to people with collapsed or irritated ear canals.

Cochlear Implant Surgery

A complex, small electronic device that helps hearing in people with severe hearing loss or deafness is used in the Cochlear Implant Surgery. The cochlear implant comprises of an external piece behind the ear and another piece that is surgically implanted under the skin. A cochlear implant comprises of four parts:
1. A microphone which picks up sounds from the surroundings
2. A speech processor which chooses and arranges the sounds the microphone picks up
3. A receiver/stimulator and transmitter that picks up signals from the speech processor and changes them into electric impulses
4. An electrode ray, a bunch of electrodes, receives impulses the stimulator sends and transmits them to different areas of the auditory nerves.
The implant does not cure deafness; it only gives you a useful portrayal of sounds in the environment and considerable aid in understanding speech.

The surgery is done in the following way:
i. The area around the site of the implant is shaved or cleaned
ii. The patient's vital signs are monitored through cables, patches and monitors attached to him or her
iii. General anaesthesia is administered through IV or through a face mask
iv. After the device is implanted, the patient is taken to the recovery room for the anaesthesia effect to lessen.

BAHA Implant and Cochlear Implant Surgery

You may find out that your child is suffering from hearing loss when he is born or he may be diagnosed with the condition later in life. Hearing loss in children is commonly caused by otitis media, birth problems and on the account of certain injuries or illnesses.

Signs and symptoms

The early-stage symptoms of hearing loss in children are as follows:

No reaction to extremely loud noises

No response or reaction to your voice

The child makes some sounds, which taper off

The other symptoms which follow include:

He may pull and rub his ears.

He may act cranky constantly without any proper reason.

He might stop paying attention.

Low energy levels are indicated.

He may find it hard to follow directions.

He may ask you to increase the volume of the radio or TV.

Fever and ear pain are also likely symptoms.

Treatment

Early hearing loss can affect a child s language learning skills. If the problem is diagnosed and treated soon, the problem with language can be avoided. The method of treatment depends on the cause of hearing loss in your child and the severity of hearing loss.

There are certain medicines for hearing---prescribed by your ENT Surgeon. Please take the point watchful waiting. Even, if you have the slightest doubt of hearing loss contact ENT immediately.

The primary treatment methods of hearing loss in children include the following:

Watchful waiting: Sometimes, the condition may resolve on its own and the treatment involves simple monitoring of your child for positive changes.

Medicines: There are certain medicines for hearing loss in children, which may be prescribed by your pediatrician.

Ear tubes: Ear tubes may be recommended if medicines and monitoring do not work. The tubes allow fluid to drain and help in preventing infections. A minor surgery has to be undertaken on your child for getting the ear tubes placed. This will solve hearing loss and other related issues.

Hearing aids: Hearing aids may be used to allow your child to hear better. It is safe for children to use ear tubes after the age of one month. For the right hearing aid for your child, you need to consult a hearing specialist.

Implants: Cochlear implants are used to treat hearing loss in many children. These are electronic devices that are put in the inner ear to benefit hearing. These should be used only if hearing aids did not succeed and these are meant to be used only in the case of children with serious hearing problems.

There are several other devices, which can help your child with hearing loss. For suggestions and recommendations, you must take your child to a hearing specialist.

Hearing Loss In Children - Signs And Treatment Of It!

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