Hearing loss – Types, Causes and Treatment (Cochlear Implant)
Hearing loss can cause far reaching effects: Irrespective of age, hearing loss can affect anyone at any time. Undiagnosed and untreated hearing loss is associated with social stigma, isolation, depression, low self-esteem, low confidence, risk of falls, accidents, high blood pressure, and other health issues. Whatever may be the consequences of hearing loss, it must be addressed in time to prevent future complications.
Facts about Hearing Loss
- Diagnosis is made by conducting a hearing test by Audiologist
- People with sudden hearing loss may feel dizziness or ringing in one or both the ears (Tinnitus).
- Majority of the people who receive treatment form an ENT specialist recover hearing.
- Adults in the age group of 40 and 50 years are prone to hearing loss.
- Majority of the hearing loss cases go undiagnosed – owing to negligence and misdiagnosis.
- In time diagnosis and prompt treatment lead to early recovery.
Symptoms of Hearing loss
- Difficulty understanding everyday conversation
- Difficulty understanding what is being heard
- Repeatedly turning TV and Radio volume high
- Difficulty conversing in noisy places – such as bus stations, main roads, railway stations, airports, restaurants and other such public places
- Frequently requesting others to repeat words
- Ringing in ears, unusual sounds – such as buzzing, whistling and hissing sounds in the ears
- Low self-esteem due to avoidance of social situations and gatherings
Types of Hearing loss
Hearing loss caused due to a mechanical issue in the middle or outer ear or due to excessive build-up of earwax causing a blockage in the ear canal is known as conductive hearing loss.
Excess earwax blocks sound and cause hearing loss. Though it is temporary, it can become permanent. However, it can be treated.
Sensorineural hearing loss is caused due to damage caused to the auditory nerve (it carries sound impulses to the brain that includes pitch, loudness and meaning of sounds) or to the small hair-like cells in the inner ear. It is the most common type of hearing loss and permanent one. Individuals with this type of hearing loss find it difficult to understand speech or sound even if it is loud and clear enough for hearing.
Mixed type of hearing loss results due to the involvement of both conductive and sensorineural hearing loss.
Sudden Hearing Loss
Sudden hearing loss or sudden deafness or sudden sensorineural hearing loss (SSHL) is a sudden loss of hearing that happens unexpectedly. Hearing loss is seen in one ear. It may be sudden or at once or may develop over a few hours or days.
In a nutshell, sudden hearing loss is abrupt or rapidly progressive. The loss is based on time, severity and the loss of audible frequency spectrum (low or high sound frequency loss). Sudden hearing loss is diagnosed as a sensorineural hearing loss of greater than 30 dB within three days period. Hearing loss can occur in the right or left ear. However, bilateral (hearing loss in both the ears) is very rare and sudden bilateral hearing loss is also very rare.
Causes of Sudden Hearing Loss
Hearing loss causes include ear infections, ear trauma, immunological issues, autoimmune diseases such as Cogan’s syndrome, drug toxicity, neurological issues (multiple sclerosis), metabolic causes, inner ear problems including Meniere’s disease, tumours, circulatory diseases, cochlear issues and unknown causes (idiopathic). Hearing loss is attributed to a known cause only in about 15 to 20% of the cases as the majority of the cases do not have any known cause.
Causes of hearing loss in general
- Drugs (ototoxic and some other medicines)
- Exposure to very loud noises for long
- Head injury or trauma
- Genetic causes
- Acoustic trauma – Even if it is only once
- Age (presbycusis is an age-related hearing loss)
- Acoustic nerve tumour or acoustic neuroma
- Autoimmune diseases or otosclerosis, Measles, mumps and Meniere’s disease.
Sudden hearing loss should be treated as a medical emergency. Those who experience it must seek immediate medical care. Majority of the people with this condition avert consulting an ENT specialist as they assume their hearing loss to be due to an infection, allergy, cold or flu and due to excess earwax in their ear canal or may be due to any other condition. Whatever may be the case, delaying seeking medical care may cause a delay in diagnosis and treatment – which, in turn, will affect the treatment outcomes.
This is a miraculous device of the century. When hearing loss is beyond 70 decibels normal hearing aids may not give any benefit. In this scenario, the cochlear implant can give the power of hearing back. Children who are born with profound hearing impairment can immensely benefit from this device. If the implant is fixed at an early age, a child can hear and speak as well like any other normal child.
Dr. Sampurna Ghosh
MBBS, MS (ENT)
Consultant ENT Head and Neck Surgeon
Specialist in Cochlear Implant
Endoscopic Sinus Surgery Consultant