Introduction
Patients of all ages can be troubled by hearing loss in one or both ears. This can be frustrating and debilitating. All patients with hearing loss need a thorough workup and management plan. There is good evidence to support early intervention for hearing loss as it may have a better long-term outcome for the patient.
Causes
The causes of hearing loss are quite different in children and adults. Losses may be conductive, where sounds can’t reach the hearing organs, or sensorineural (nerve deafness), where sounds aren’t transmitted properly from the inner ear to the brain.
Young children are prone to Eustachian tube (the tube connecting the ear to the nose) dysfunction which results in fluid (effusions) collecting behind the tympanic membrane (eardrum) causing a conductive loss. This fluid would normally drain down the Eustachian tube if it is functioning normally. If an effusion is present, it like trying to hear under water. In appropriate patients, grommets may indicated to remove the fluid and prevent it reaccumulating. Genetic causes of hearing loss can present early in life or more rarely in adulthood. These can often be picked up after analysing the audiogram (hearing test).
Hearing loss in adults is commonly be due to repeated noise exposure or old age. Wax impaction – buildup of wax can cause decreased hearing if the ear canals are completely occluded. Outer and middle ear infections can cause a reversible hearing loss. Other causes include trauma to the ear or head, and certain medications which are toxic to the ears.
Sudden hearing loss is considered an emergency and needs prompt treatment for hearing to be restored.
Symptoms
In children, hearing loss can cause speech delay, learning difficulties and behavioral issues. Adults with hearing loss may also be troubled by tinnitus or ringing in ears. This can be more troublesome for some patients than the hearing loss itself. Often addressing the hearing loss results in improvement in associated symptoms also.
Sometimes, hearing loss is not obvious to patients. Relatives may notice subtle changes such as the TV being turned up loudly. People may also avoid noisy environments like restaurants where background noise is present. Some patients can withdraw socially because it may be embarrassing for them in crowded places if they cannot hear conversations.
Diagnosis
The diagnosis is made by examining the ears under a microscope and performing a formal audiogram. This is accompanied by tympanometry (tests the function of the Eustachian tube) and speech discrimination testing (how well you recognise words at different levels of loudness). Our audiologist has expertise in paediatric hearing testing for children of all ages, as well as adult testing and hearing aid fitting.
Sometimes a CT scan or MRI is indicated to rule out certain causes of hearing loss that may not be visible on examination of the ears.
Treatment
Treatment is aimed at the cause of the hearing loss. Sometimes watchful waiting with repeat audiograms is appropriate. Other options include surgery (e.g. grommets) or amplification devices.
Dr Levin will work out the cause of your loss after examining your ears and analysing your audiogram. If a hearing aid is needed, our audiologist can discuss this with you.
Ultimately, nobody should feel that they have to live with the frustration of hearing loss and that nothing can be done about it.