Are you also experiencing hearing loss? Let's talk about hearing loss!

Do you sometimes feel like someone is mumbling when they are talking? Or do you find it hard to hear what is being said clearly when you are talking on the phone or watching TV? Or do you constantly have to ask other people, "What did they say?"? These could be signs that your hearing is a little weak. Let's talk about this in more detail, because it affects many people.

What is Hearing Loss?

Simply put, hearing loss is the inability to perceive sounds properly when some part of our hearing system is affected. If you have hearing loss, you may have difficulty understanding and participating in conversations. It can be hard to understand when you're talking on the phone, in an online meeting, or when you're watching TV, right? Imagine how frustrating it would be if you were talking to your friends and they were confused.

This condition can affect your job, your relationships, and even your enjoyment of life. Often, it is difficult to completely restore hearing loss. But don't worry! Audiologists - doctors who specialize in diagnosing and treating hearing problems - are here to help. They can recommend treatments that are right for you, such as hearing aids or cochlear implants . These can greatly reduce your hearing loss.

Is this really a common situation?

Yes, indeed. This is something that happens to more people than you might think. Millions of people around the world suffer from some level of hearing loss.

• Some people may have hearing loss in only one ear, which we call unilateral hearing loss .
• Also, as we age - on average, about one in three people over the age of 65, and about one in two over the age of 75 - age-related hearing loss occurs.
• This condition can also be seen in young babies. Roughly speaking, about two in every thousand babies are born with some form of hearing impairment.

What are the types of hearing impairments?

Okay, so are all these hearing impairments the same? No, there are three main types. Let's see what they are.

• Conductive hearing loss: This occurs when there is a blockage in the passage of sound waves through either your outer ear (the eardrum, the ear canal) or your middle ear (the eardrum, the three small bones in the ear). It's like a road being blocked.
• Sensorineural hearing loss: This is when your inner ear (the cochlea, the part of your brain that makes sounds) is damaged over time. However, very rarely, this type of hearing loss can occur suddenly, over a period of days. This is called Sudden Sensorineural Hearing Loss (SSHL) , or sudden deafness .
• Mixed hearing loss: As the name suggests, this can involve both problems with your middle or outer ear (i.e. conductive hearing loss) and problems with your inner ear (i.e. sensorineural hearing loss).

How do I know if I have this condition? (Symptoms)

Most of the time, hearing loss happens gradually. So some people don't even notice it at first. But be aware of these symptoms, because if you have one or more of them, it's a good idea to pay attention to them.

• Do you always have to ask others , "What did you say?" again?
• Do you have difficulty understanding a conversation when you're on a phone call or in a noisy place like a restaurant?
• Do you feel like you're whispering when other people talk?
• Don't you hear high-pitched sounds like birdsong?
• Do you need to turn up the volume on your TV, computer, or tablet?
• Do you hear a ringing or roaring sound (tinnitus) in your ears?
• Do you have an earache ?
• Does your ear feel like it's full of something, like there's fluid inside?
• Do you have balance problems or dizziness ?

How to recognize this condition in young children?

Recognizing this condition in young children is a little different. As parents, we need to be especially vigilant about this.

Characteristics of Babies:

• They may be unresponsive to loud noises (e.g., a door closing, a sudden loud noise).
• Even after 6 months , they may not turn their head in the direction of a sound .
• Even after a year , they may not be able to say single words like "mom" and "dad."
• They may not respond when you call their name.

Characteristics of older children:

• Always asking "Huh?" "What?"
• They start talking later than other children their age.
• The words are not clear when speaking.
• Doesn't follow instructions (maybe because they don't hear them).
• I turn up the volume on the TV and tablet a lot .

Why is hearing loss happening in these ears? (Reasons)

Okay, so why does this hearing loss occur? There could be many reasons. For example, sudden exposure to loud noises - like going to a big music show - can affect your hearing.

Causes of conductive hearing loss:

• The ear is filled with earwax .
• Fluid accumulation in the middle ear due to colds and allergies.
• Middle ear infection (Otitis media) .
• Ear infections caused by water getting into the ear while swimming (Otitis externa) - also called "swimmer's ear".
• Fluid buildup in the middle ear due to problems with the Eustachian tube - the tube that connects the middle ear to the throat.
• Ruptured eardrum .
• Ear tumors (these can be cancerous or benign).
• Something stuck in the ear. For example, your little one could get a small piece of a toy or a piece of candy that you gave them at the dinner table stuck in their ear!
• Some congenital conditions cause a baby's middle or outer ear to not develop properly.

Causes of sensorineural hearing loss:

• Aging (this is the most common cause).
• Diseases such as coronary artery disease , high blood pressure , strokes , and diabetes mellitus .
• Ear damage caused by some medications (ototoxicity) - some antibiotics and anti-cancer drugs are examples of this.
• Some hereditary genetic conditions .
• A hard blow to the head .
• Noise-induced hearing loss . This occurs when working in noisy environments, such as factories and construction sites, for long periods of time, or when using headphones at high volume.
• Infections such as cytomegalovirus (CMV), which is transmitted from mother to child during birth.

Mixed hearing loss:

This is a combination of both the conductive and sensorineural causes mentioned earlier. This means that it affects your outer and middle ear as well as your inner ear. For example, if you are taking a medication that affects your inner ear and accidentally burst your eardrum, then you have a mixed hearing loss.

What complications can this cause?

What are the side effects of hearing loss? In fact, it can make you feel disconnected from the world. It can often lead to feelings of frustration, anger, and resentment . People with severe hearing loss may also experience mental health problems like anxiety or depression . Children with hearing loss may have difficulty concentrating on schoolwork and may have lower grades. Research has also found a link between hearing loss in older people and dementia, a memory loss disease.

How do doctors diagnose this? (Diagnosis)

Well, if you have symptoms like these, how exactly does a doctor diagnose this?

First, your doctor will ask you about your symptoms and do a physical exam. They will check for ear infections and other problems. If you have an injury to your ear or suspect you have something like a tumor in your ear, they may order a CT scan (Computed Tomography scan) or an MRI (Magnetic Resonance Imaging) scan.

Then, your doctor will refer you to an audiologist , or you may see an audiologist directly. An audiologist is the one who performs specialized hearing tests .

Here are some of the most common tests:

• Pure-tone testing: This is the most common test. It measures the lowest pitch you can hear at each pitch. You are exposed to these sounds through headphones or earplugs. Bone conduction testing is also performed by placing a device on your head. By doing both the headphone/plug test and the bone conduction test, the audiologist can tell you exactly what type of hearing loss you have.
• Otoacoustic emissions test (OAE): This tests how well your inner ear is working. It measures the sounds emitted by the tiny cells in the inner ear.
• Tympanometry: This measures how well your eardrum moves. It can detect things like a ruptured eardrum, fluid in the middle ear, and earwax buildup.

What are the levels of hearing loss?

After a hearing test, the audiologist will show you the results and explain what they mean. Often, hearing loss is classified by the 'degree of loss' . This refers to how loud sounds need to be to be heard. According to the American Speech-Language-Hearing Association, these levels are:

• Normal
• Slight
• Mild
• Moderate
• Moderately severe
• Severe
• Very severe (Profound)

What are the treatments for this?

Okay, now let's see what the treatments are for this. Treatments vary depending on the type of hearing loss you have.

Treatment for conductive hearing loss:

• Medications like antibiotics for ear infections.
• Surgery: Tympanoplasty to repair a ruptured eardrum, placement of tubes in the middle ear (called ear tubes), tympanostomy, or surgery to remove earwax .
• Methods for removing earwax or other stuck objects from the ear.

Treatment for sensorineural hearing loss:

• Medications like corticosteroids - These are given to reduce swelling if the delicate hair cells in your cochlea have been damaged by exposure to loud noise.
• Management: Hearing aids and cochlear implants help with sound perception.

Treatment for mixed hearing loss:

• Treatment for this depends on the specific problems affecting your outer, middle, and inner ear. It may be a combination of both of the treatments mentioned above.

Are there any side effects of the treatment?

As with any treatment, there are potential side effects, especially with surgery.

• As a complication of tympanoplasty , sometimes the eardrum may not form properly after surgery (graft failure) .
• Side effects of tympanostomy may include scarring of the eardrum (tympanosclerosis) , recurrent ear infections, or persistent fluid from the ear (otorrhea) .
• Treatment for ear lumps can sometimes cause further hearing loss, balance problems, and weakness on one side of the face.
• Cochlear implant surgery may affect your balance, or even some residual hearing, even if you have severe hearing loss. Very rarely, this surgery can cause nerve damage or cerebrospinal fluid leaks .

Can this be prevented?

Well, then, is there anything we can do to prevent this hearing loss from occurring?

In fact, we can't prevent some types of hearing loss (such as those that come with aging). However, excessive noise is the main cause that can be prevented. So, avoiding situations and environments with high noise levels as much as possible can help you prevent noise-induced hearing loss .

If that's unavoidable, do these things to protect your ears:

• Use earplugs or earmuffs when you are at concerts, riding motorcycles, around loud bands at weddings, or when working with loud machinery.
• Turn down the volume. When listening to music with headphones or earbuds, keep the volume low enough that you can hear people around you talking. Another good rule of thumb is to not listen to music at more than 80% volume for more than 90 minutes a day.
• Do not insert anything into the ear canal. Things like cotton buds, hairpins, and keys can get stuck in the ear or puncture the eardrum.
• Avoid smoking. Smoking impairs blood circulation and can also affect hearing.
• Exercise regularly. It helps prevent diseases that can affect hearing, such as diabetes and high blood pressure.
• Manage your chronic illnesses properly and prevent further damage.

What should I expect? How can I take care of myself?

If you have a hearing loss, what can you expect? How can you take care of yourself?

It really depends on your situation. Some hearing loss is temporary. For example, it can happen when you have a cold, get water in your ear while swimming (swimmer's ear), or get something stuck in your ear. However, sensorineural hearing loss and age-related hearing loss are usually permanent. However, you can regain most of your hearing with hearing aids or cochlear implants.

Living with a hearing loss, even with treatment, can be challenging at times. There may be times when you don't hear as well as you would like. If that happens, it's a good idea to tell others that you have a hearing loss. This will make it easier for them to help you and understand you.

This condition can also affect your mental health . Even with treatment, you may feel depressed or anxious. If you feel this way, talk to a doctor or a friend about it.

When should I see a doctor? What questions should I ask?

If you think your hearing is getting worse, see a doctor right away. You may need a different type of hearing aid.

If your hearing tests confirm that you have a hearing loss, you can ask your doctor these questions:

• What is the cause of my hearing loss?
• What can I do to improve my hearing?
• Will my hearing loss get worse?
• Should I consider cochlear implant surgery ? (For severe hearing loss)

The difference between hearing loss and deafness

Simply put, someone with a hearing loss can still hear enough sounds to understand speech (although perhaps with difficulty). Their hearing can be improved with hearing aids or other treatments.

A deaf person hears very little or nothing. Devices such as hearing aids do not help. A deaf person may use sign language to communicate.

Is hearing loss a disability?

Some countries, for example, have laws like the Americans with Disabilities Act (ADA) . According to those laws, certain medical conditions that significantly affect daily activities are considered disabilities. Hearing loss is one such condition, but whether it is considered a disability or not depends on the degree of hearing loss. Sri Lanka also has laws and policies in this regard.

Hearing loss can be temporary, but many people have permanent hearing loss that is not curable. This can make you feel like you are missing out on a lot of things in life, and can make you feel frustrated, lonely, or depressed. If you think you have a hearing loss, talk to a doctor or audiologist. They can help you decide the best way to improve your hearing.

Finally, things to remember (Take-Home Message)

Finally, I have this to tell you:

Hearing loss is not as uncommon as you might think. If you have any of these symptoms, don't ignore them. It's important to seek medical attention as soon as possible. There are treatments available depending on the cause, and you can also prevent the condition from getting worse.

Remember, your ears are two of the most valuable things in your life. So take care of them. Stay away from loud noises, don't put unnecessary objects in your ears, and follow good hygiene habits.

You are not alone, and there are many people who can help. Don't be afraid, don't hesitate, and get the help you need. Taking care of your hearing health will help improve your overall quality of life.

` Hearing, hearing impairment, deafness, ear disorders, hearing aid, cochlear implant, audiologist, Hearing Loss