Hearing Disorders and Deafness

Hearing Loss & Older Adults Noise-Induced Hearing Loss
Dr.Jennifer Maw, Ear Canal, San Jose Ca

It's frustrating to be unable to hear well enough to enjoy talking with friends or family. Hearing disorders make it hard, but not impossible, to hear. They can often be helped. Deafness can keep you from hearing sound at all.

What causes hearing loss? Some possibilities are:

  • Heredity
  • Diseases such as ear infections and meningitis
  • Trauma
  • Certain medicines
  • Long-term exposure to loud noise
  • Aging

There are three main types of hearing loss. One happens when your inner ear or auditory nerve is damaged. This is called sensorineural hearing loss and is usually permanent. The other kind happens when sound waves cannot reach your inner ear and is called conductive hearing loss. Earwax build-up, a punctured eardrum or middle ear problems can cause it. The third and most rare kind involves the brain and is called a central auditory processing problem. Untreated, hearing problems can get worse. If you have trouble hearing, you can get help. Possible treatments include hearing aids, cochlear implants, special training, certain medicines and surgery.


Hearing Loss and Older Adults



Hearing loss is one of the most common conditions affecting older adults. One in three people older than 60 and half of those older than 85 have hearing loss. Hearing problems can make it hard to understand and follow a doctor’s advice, to respond to warnings, and to hear doorbells and alarms. They can also make it hard to enjoy talking with friends and family. All of this can be frustrating, embarrassing, and even dangerous. Hearing loss happens for many reasons. Some people lose their hearing slowly as they age. This condition is known as presbycusis (prez-buh-KYOO-sis). Doctors do not know why presbycusis happens, but it seems to run in families. Hearing loss can also be caused by a virus or bacteria, heart conditions or stroke, head injuries, tumors, and certain medicines.

 

 


Do I have a hearing problem?

Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked by a doctor.

  • Do I have a problem hearing on the telephone?
  • Do I have trouble hearing when there is noise in the background?
  • Is it hard for me to follow a conversation when two or more people talk at once?
  • Do I have to strain to understand a conversation?
  • Do many people I talk to seem to mumble (or not speak clearly)?
  • Do I misunderstand what others are saying and respond inappropriately?
  • Do I often ask people to repeat themselves?
  • Do I have trouble understanding the speech of women and children?
  • Do people complain that I turn the TV volume up too high?
  • Do I hear a ringing, roaring, or hissing sound a lot?
  • Do some sounds seem too loud?

What should I do?

Call EARS Inc. and schedule an appointment for a hearing test and physician evaluation.

What treatments and devices can help?

Your treatment will depend on your hearing problem, so some treatments will work better for you than others. Here are the most common ones:

  • Hearing aids are tiny instruments you wear in or behind your ear. They make sounds louder. >Hearing Aids

  • To find the hearing aid that works best for you, you may have to try more than one. Ask your audiologist whether you can have a trial period with a few different hearing aids. You and your audiologist can work together until you are comfortable.

  • Personal listening systems help you hear what you want to hear while eliminating or lowering other noises around you. Some, called auditory training systems and loop systems, make it easier for you to hear someone in a crowded room or group setting. Others, such as FM systems and personal amplifiers, are better for one-on-one conversations.

  • TV listening systems help you listen to the television or the radio without being bothered by other noises around you. These systems can be used with or without hearing aids and do not require you to use a very high volume.

  • Direct audio input hearing aids are hearing aids that can be plugged into TVs, stereos, microphones, auditory trainers, and personal FM systems to help you hear better.

  • Telephone amplifying devices. Some telephones are made to work with certain hearing aids. If your hearing aid has a "T" switch, you can ask your telephone company about getting a phone with an amplifying coil (T-coil). If your hearing aid is in the "T" position, this coil is activated when you pick up the phone. It allows you to listen at a comfortable volume and helps lessen background noise. You can also buy a special type of telephone receiver and other devices to make sounds louder on the phone.

  • Mobile phone amplifying devices. To help people who use a T-coil hear better on mobile phones, an amplifying device called a loop set is available. The wire loop goes around your neck and connects to the mobile phone. The loop transmits speech from the phone to the hearing aid in your ear. It also helps get rid of background noise to make it easier to talk in a noisy environment.

  • Auditorium-type assistive listening systems. Many auditoriums, movie theaters, churches, synagogues, and other public places are equipped with special sound systems for people with hearing loss. These systems send sounds directly to your ears to help you hear better. Some can be used with a hearing aid and others without.

  • Cochlear (COKE-lee-ur) implants have three parts: a headpiece, a speech processor, and a receiver. The headpiece includes a microphone and a transmitter. It is worn just behind the ear where it picks up sound and sends it to the speech processor, a beeper-sized device that can fit in your pocket or on a belt. The speech processor converts the sound into a special signal that is sent to the receiver. The receiver, a small round disc about the size of a quarter that a surgeon places under the skin behind one ear, sends a sound signal to the brain. Cochlear implants are most often used with young children born with hearing loss. However, older adults with profound or severe hearing loss are beginning to receive these implants more often.
    > Cochlear Implants

  • Lip reading or speech reading is another option. People who do this pay close attention to others when they talk. They watch how the mouth and the body move when someone is talking. Special trainers can help you learn how to lip read or speech read.

Can my friends and family help me?

Yes. You and your family can work together to make hearing easier. Here are some things you can do:

  • Tell your friends and family about your hearing loss. They need to know that hearing is hard for you. The more you tell the people you spend time with, the more they can help you.

  • Ask your friends and family to face you when they talk so that you can see their faces. If you watch their faces move and see their expressions, it may help you to understand them better.

  • Ask people to speak louder, but not shout. Tell them they do not have to talk slowly, just more clearly.

  • Turn off the TV or the radio if it does not have to be on.

  • Be aware of noise around you that can make hearing more difficult. When you go to a restaurant, do not sit near the kitchen or near a band playing music. Background noise makes it hard to hear people talk.

Working together to hear better may be tough on everyone for a while. It will take time for you to get used to watching people as they talk and for people to get used to speaking louder and more clearly. Be patient and continue to work together. Hearing better is worth the effort.

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Noise-Induced Hearing Loss

Every day, we experience sound in our environment, such as the sounds from television and radio, household appliances, and traffic. Normally, we hear these sounds at safe levels that do not affect our hearing. However, when we are exposed to harmful noise —sounds that are too loud or loud sounds that last a long time—sensitive structures in our inner ear can be damaged, causing noise-induced hearing loss (NIHL). These sensitive structures, called hair cells, are small sensory cells that convert sound energy into electrical signals that travel to the brain. Once damaged, our hair cells cannot grow back.

What sounds cause NIHL?

NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by continuous exposure to loud sounds over an extended period of time, such as noise generated in a woodworking shop.

Sound is measured in units called decibels. On the decibel scale, an increase of 10 means that a sound is 10 times more intense, or powerful. To your ears, it sounds twice as loud. The humming of a refrigerator is 45 decibels, normal conversation is approximately 60 decibels, and the noise from heavy city traffic can reach 85 decibels. Sources of noise that can cause NIHL include motorcycles, firecrackers, and small firearms, all emitting sounds from 120 to 150 decibels. Long or repeated exposure to sounds at or above 85 decibels can cause hearing loss. The louder the sound, the shorter the time period before NIHL can occur. Sounds of less than 75 decibels, even after long exposure, are unlikely to cause hearing loss.

Although being aware of decibel levels is an important factor in protecting one’s hearing, distance from the source of the sound and duration of exposure to the sound are equally important. A good rule of thumb is to avoid noises that are “too loud” and “too close” or that last “too long.”

What are the effects of NIHL?

Exposure to harmful sounds causes damage to the hair cells as well as the auditory, or hearing, nerve (see figure). Impulse sound can result in immediate hearing loss that may be permanent. This kind of hearing loss may be accompanied by tinnitus—a ringing, buzzing, or roaring in the ears or head—which may subside over time. Hearing loss and tinnitus may be experienced in one or both ears, and tinnitus may continue constantly or occasionally throughout a lifetime.

Continuous exposure to loud noise also can damage the structure of hair cells, resulting in hearing loss and tinnitus, although the process occurs more gradually than for impulse noise.

Exposure to impulse and continuous noise may cause only a temporary hearing loss. If a person regains hearing, the temporary hearing loss is called a temporary threshold shift. The temporary threshold shift largely disappears 16 to 48 hours after exposure to loud noise. You can prevent NIHL from both impulse and continuous noise by regularly using hearing protectors such as earplugs or earmuffs.

Scientists believe that, depending on the type of noise, the pure force of vibrations from the noise can cause hearing loss. Recent studies also show that exposure to harmful noise levels triggers the formation of molecules inside the ear that damage hair cells and result in NIHL. These destructive molecules play an important role in hearing loss in children and adults who listen to loud noise for too long.

What are the symptoms of NIHL?

When a person is exposed to loud noise over a long period of time, symptoms of NIHL will increase gradually. Over time, the sounds a person hears may become distorted or muffled, and it may be difficult for the person to understand speech. Someone with NIHL may not even be aware of the loss, but it can be detected with a hearing test.

Who is affected by NIHL?

People of all ages, including children, teens, young adults, and older people, can develop NIHL. Approximately 15 percent of Americans between the ages of 20 and 69—or 26 million Americans—have high frequency hearing loss that may have been caused by exposure to loud sounds or noise at work or in leisure activities. Recreational activities that can put someone at risk for NIHL include target shooting and hunting, snowmobile riding, woodworking and other hobbies, playing in a band, and attending rock concerts. Harmful noises at home may come from lawnmowers, leaf blowers, and shop tools.

Can NIHL be prevented?

NIHL is 100 percent preventable. All individuals should understand the hazards of noise and how to practice good hearing health in everyday life. To protect your hearing:
  • Know which noises can cause damage (those at or above 85 decibels).
  • Wear earplugs or other hearing protective devices when involved in a loud activity (special earplugs and earmuffs are available at hardware and sporting goods stores).
  • Be alert to hazardous noise in the environment.
  • Protect the ears of children who are too young to protect their own.
  • Make family, friends, and colleagues aware of the hazards of noise.
  • If you suspect hearing loss, have a medical examination by an otolaryngologist (a physician who specializes in diseases of the ears, nose, throat, head, and neck) and a hearing test by an audiologist (a health professional trained to measure and help individuals deal with hearing loss).

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Dr.Jennifer Maw, Ear Canal, San Jose Ca

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