Hearing Loss
Definition
Deafness
Loss of the ability to hear may be of three types:
Conductive
Sensorineural
Mixed
Aetiology
Aging (presbycusis)
Noise pollution : carpentry, plumbing, mining, railway drivers, station masters - noise-incuced hearing loss - deafness by the age of 52
Conductive Deafness : external ear disorder: impacted cerumen. middle ear disorder : otitis media, otosclerosis
Sensorineural loss : damage to the cochlea or vestibulocochlear nerve
Functional hearing loss: emotional disturbance.
Risk Factors
Family H/O sensorineural impairment
Congenital malformations of the ear
Low birth weight (<1500 g)
Ototoxic medication (gentamycin loop diuretic)
Recurrent ear infection
Bacterial meninigitis
Chronic exposure to loud noises
Perforation of the tympanic membrane
Clinical Manifestations
tinnitus
increasing inability to hear in groups
need to turn up the volume of the television
Changes in attitude, in the ability to communicate, in the awareness of surroundings and even in the ability to protect oneself.
Disinterested and inattentive student in the classroom
It is not the patient who realizes the loss of hearing first; it is the others who detect it.
Speech deterioration: The person who slurs words or drops word endings, or produces flat-sounding speech. The ears guide the voice, both in loudness and in pronunciation.
Fatigue: If a person tires easily when listening to conversation. or toa speech, fatigue may be the result of straining to hear; may become irritable very easily.
Indifference: Depressed and disinterested in life in general.
Social withdrawal: Not being able to hear withdraws from situations that might prove embarrassing.
Insecurity: Lack of self-confidence and fear of mistakes create a feeling of insecurity
Indecision and procrastination: Due to loss of self-confidence not able to make decisions.
Suspiciousness: hears only part of what is being said, may suspect that others are talking about him or that portions of the conversation are deliberately spoken softly so that he or she will not hear them.
False pride: wants to conceal the hearing loss and thus often pretends to be hearing.
Loneliness and unhappiness: enforced silence is boring and even frightening. People with a hearing loss often feel isolated.
Tendency to dominate the conversation: Many hearing-impaired people tend to dominate the conversation to avoid listening to what others say
Treatment
Treating causes that are amenable to treatment: when not possible rehabilitation
Removal of impacted cerumen
Middle ear infections treated with antibiotics
Otoscelerosis : stapdectomy, imp
Tympanoplsty for large perforation
Myringotomy to let out collections in the middle ear
Aural Rehabilitation
Auditory training
Speech reading
Speech training
Hearing aids
Hearing guide dogs
