Description: Loss of hearing occurs when the passage of sound waves to the brain is impaired. Hearing loss can be partial or complete, temporary or permanent, depending on the cause. There are two basic types of hearing loss: conductive and sensory. Conductive hearing loss is associated with problems of either the external ear (wax or infection of the external canal) or the middle ear (Eustachian tube dysfunction from infection or allergy, middle ear fluid, or fixation of one or all of the bones of the middle ear). Recurrent conductive hearing loss usually results from chronic ear infection or trauma. Sensory hearing loss in adults is a common occurrence, usually resulting from a deterioration of the cochlea and from the loss of hair cells in the inner ear responsible for transmitting sound to the nerves. Two of the most common hearing disorders in adults are presbycusis and tinnitus. Presbycusis is the gradual loss of hearing due to agent, and is prevalent in adults over the age of fifty. Tinnitus is a continuous buzzing or ringing in the ears with no obvious cause. Suspected hearing loss in infants deserves immediate attention, as undiagnosed hearing impairment can lead to diminished language skills and learning disabilities.

Symptoms: If hearing loss develops gradually, the individual may be unaware of it until it reaches a fairly advanced stage. Often, friends and family members notice signs of hearing loss before the person experiencing it does. Some signs that may point to a hearing problem include seeming inattentiveness, unusually loud speech, irrelevant comments, inappropriate responses to questions, requests for statements to be repeated, a tendency to turn one ear toward sound, and unusual voice quality.

Signs of hearing problems in infancy include failure to blink or startle at loud noises, failure to turn the head toward familiar sounds; greater responsiveness to loud noises than to voices; and a failure to babble, coo, or squeal. In toddlers, warning signs include failure to speak clearly by age two, showing no interest in being read to or in playing word games, habitual yelling or shrieking when communicating or playing, and greater responsiveness to facial expressions than to speech.

Incidence: Hearing and ear disorders affect 28 million Americans. Nearly 30% of adults over the age of sixty-five have sustained some degree of hearing impairment.

Causes: Hearing loss can be sudden or gradual. Sudden losses of hearing can be caused by infection, trauma, changes in atmospheric pressure, and ear wax buildup. Infection and inflammation often follow an upper respiratory infection or trauma to the ear, such as from the overuse or improper use of cotton swabs. Swimming in water that is overly chlorinated or contains high levels of bacteria can also lead to ear infections. Recurring ear infections are often linked to fungal infection and are frequently seen in people with allergies, cancer, diabetes, or other chronic diseases. Exposure to loud noises is an increasing problem in our society today. Recent statistics attribute approximately one-third hearing loss cases to exposure to loud noises, including jet planes, personal stereos, rock concerts, or any noise that exceeds 80 to 85 decibels. Sudden intense noise like a gunshot or dynamite blast can damage hearing instantly by tearing the tissue in the delicate inner ear.

Hearing loss associated with ear pain may result from eardrum damage, strain, an infected cyst in the eardrum or middle ear, mastoiditis, metabolic disorders such as hypothyroidism; vascular disorders such as hypertension; neurological disorders such as multiple sclerosis; blood disorders such as leukemia; and even tooth and/or mouth disorders. Hearing loss can also occur if the bones of the skull are out of alignment with one another.

Risk factors for hearing loss in infancy include a family history of hearing loss, known hereditary disorders; congenital abnormalities of the ears, nose or throat; maternal exposure to certain illnesses or drugs; and birth-related problems such as prematurity and/or lack of oxygen during delivery, low birth weight, or jaundice. Otitis media (middle ear infection) is the most common cause of hearing loss in children. For the most part, this is temporary, but recurring ear infections can cause permanent hearing loss due to inflammation and infection of the middle ear. Sensorineural hearing loss in children can also be caused by childhood diseases such as meningitis, mumps, and measles.

Treatments: Diagnosis and assessment of the degree of hearing loss is a complicated process involving a variety of different tests. Appropriate treatment depends on the underlying cause. Hearing loss in later years can be minimized by reducing your exposure to loud noises in the earlier years of your life. If you have to raise your voice to be heard over your surroundings, your environment is too noisy. If you cannot limit or avoid exposure to a noisy environment, you should wear ear protection. Any hearing loss that does not resolve on its own within two weeks should be evaluated by a health care professional. Hearing can be improved with proper diet and supplements.

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By James F. Balch, M.D. & Phyllis A. Balch, C.N.C.

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