moti's clinic

Hearing is one of the five senses that you or anyone else relies on for communication and a whole host of other things. Among the five senses, touch, smell, taste, hearing and sight, it is often hearing which is the most easily affected. You don't have to be a senior citizen to experience hearing loss as it is quite common among younger people as well. This problem is also getting more widespread with each passing day.

Ageing is not the only factor that brings hearing impairment. The causes are many. Certain medications, continuous exposure to loud noise, genetic involvement, injury and some medical conditions may cause hearing loss.

But if you think that you are facing hearing issues, then these symptoms should raise an alarm for you to see an ENT specialist:

1. You find it hard to hear phone conversations: Do you find yourself asking the person on the other end of the phone line to 'repeat' themselves, or find yourself pressing the phone instrument right into your ear? If you are trying so hard to hear, you might find yourself missing out on bits of the conversation as focussing to clearly hear the conversation is exhausting work. Getting a hearing test might be a good option if this sounds like you.
2. Your TV is blaring: Do you often find people around you shouting above the TV sound complaining that it's too loud? When you find it hard to hear the TV at the average volume and find yourself turning up the sound, this could signify a hearing loss. Doctors are seeing a growing number of patients visiting them after prolonged exposure to loud music and sounds.
3. You have trouble hearing in noisy environments: When you are out dining with friends or family at a busy restaurant or accompanying a friend shopping in a busy street, all that background noise makes it difficult to hear what the people are saying. People with hearing loss often have problems masking out background noise. 
4. You find yourself leaning closer to people to follow the conversation or staring at their lips trying to lip-read what's being said.
5. Family members telling 'you're going deaf'?: Trust the views of the people closest to you, they never lie about your health. Family members often are the first to sense signs of hearing loss as they find themselves repeating things to you or calling out louder to get your 'attention'.

Options to deal with hearing loss:

Some of the options to deal with hearing loss are mentioned below.

1. Once diagnosed with hearing problems, change your ways of communication - If you or your loved ones have been diagnosed with hearing problems, it is important that both adjust your ways to deal with the problem. Rather than getting angry at the other for not being able to communicate effectively, develop and strategize ways to make communication less problematic and erratic.
2. Cochlear implants - This is a newer technology which has become rapidly popular in the past decade or so. These are directly implanted into the inner ear and are designed to bypass the damaged areas of the ear and directly stimulate the auditory nerve. These have become very popular, although, are not a replacement of natural hearing. It is only prescribed for people who have severe hearing loss or are deaf.
3. Hearing aids - Although selecting a hearing aid is difficult as the patient needs to be comfortable, once it is completed, is one of the best solutions for the hearing impaired. The functionality of these devices can be extended with the hearing assistive technology or HAT devices that can focus the audio waves depending on the situations and give a more tailored approach for every individual's needs.

Prevention and treatment

Treatment: It is difficult to treat hearing loss as in most cases; it may be permanent, except sudden shocks, when your hearing might come back to normal. The only treatments for hearing loss are hearing aids or cochlear implants which can restore hearing partially.

Prevention: Prevention is the best method to avoid hearing loss and in most cases, you should wear ear protection such as mufflers or sound level reduction devices to protect your hearing. Also, practice listening to music, watching TV or movies at lower levels, especially if you are on the headphones. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

The ear has three parts – outer, middle, and inner – through which sounds waves pass through. On reaching the inner ear, the sound waves are transmitted through a fluid medium which is carried through to the brain to produce “sound.” Hearing loss can be due to problems anywhere in this circuit – from the outer ear to nerve issues in the middle ear.

There are two main types of hearing loss
Conductive hearing loss, where problems in the outer or middle ear cause problem conducting sound waves into the inner ear
Sensorineural hearing loss, where there is a problem in the nervous portion of the hearing process

Causes

Conductive hearing loss occurs due to poor conduction of sound waves to the middle ear, where it is processed to perceive the sound. Conductive hearing loss can happen due to the following reasons:

1. Wax: Excessive wax accumulated in the outer ear can prevent passage of sound into the middle ear
2. Infection: The outer or middle ear could be infected, affecting passage of sound waves
3. Tear in the eardrum: The eardrum is a membrane through which sound waves pass. A tear due to trauma or injury can hamper this process, leading to hearing loss.
4. Impact: When there is a bang on the head, there could be temporary hearing loss due to disruption of the hearing system
5. Hereditary: A lot of times, hearing loss is hereditary and an exact cause may not be traceable
6. Ear tumor: Middle ear tumors can also cause conductive hearing loss
7. Abnormal growth: Abnormal bone growth in the middle ear can cause blockage, leading to hearing loss
8. Post-surgical: The ear is a highly complex structure, and while surgical corrections are being done to treat a condition, it is very likely that other parts can be damaged

Symptoms

In most of the conditions mentioned above, there are some sound waves which pass through, so conductive hearing loss is often partial, wherein the person can hear but it is faint. Very rarely, it is complete where the person goes completely deaf.

Management

This would depend on the cause of the hearing loss.

1. Clearing up the wax can lead to improved hearing
2. A tear in the eardrum or fluid buildup would need surgical repair to restore hearing
3. Infections might require treatment with antibiotics and pain killers
4. Tumors or bone growths would also require surgical correction for restoring hearing
5. For outer ear blocks, audiometry is done only after the blocks are cleared
6. If post correction, the hearing is not completely restored, hearing aids can be used, which often results in complete restoration. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

Hearing loss is experienced by millions of people these days. Ageing is not the only factor that brings hearing impairment. The causes are many. Certain medications, continuous exposure to loud noise, genetic involvement, injury and some medical conditions may cause hearing loss.

There are quite a few myths that people have come to believe about hearing loss over the years. Since it is such a common phenomenon, here we take a look at the common myths surrounding hearing loss.

Myth no. 1: Hearing loss is exclusive to elderly.

Fact: As said before, hearing loss can be an outcome of various causes. Nearly half of the people suffering from the same are below the age of 55 years. No matter what your age is, you must always get your ears checked, especially if you are feeling that are you missing things.

Myth no. 2: Diagnosing hearing loss is easy.

Fact: Most people do not come to know about the condition until it gets worse. Also, your physician never really checks for hearing loss symptoms in a general check-up unless you ask for it specifically.

So, always get a check-up done, like you do for other probable diseases.

Myth no. 3: There's no effective solution for hearing loss.

Fact: Like there have been advancements in the medical field for everything else, there are aids available these days that improve your hearing and have finer adjustments for noise adaptation. Also, there are certain other procedures and surgeries that have proved to improve the condition in many.

So, seek help as soon as possible.

Myth no. 4: The sounds aren't loud enough; my ears are healthy and fine.

Fact: If there is a problem you're experiencing with hearing, you have got to accept that and get it treated. Avoiding a certain condition will only get things worse for you.

Also, hearing aids are no more a stigma. Ear aid devices have designs similar to earphones these days, which are comfortable enough to wear. Ignoring a medical condition or inability to accept the same would only do more harm instead of making things fine. If you wish to discuss about any specific problem, you can consult a Ent Specialist.

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:

1. The processor 
2. 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:

1. The area around the site of the implant is shaved or cleaned
2. The patient's vital signs are monitored through cables, patches and monitors attached to him or her
3. General anaesthesia is administered through IV or through a face mask
4. After the device is implanted, the patient is taken to the recovery room for the anaesthesia effect to lessen.