How Audiologists Determine and Manage the Needs of the Deaf

In recent years, there has been much debate about the need for political correctness when choosing our words. For example, many of those crippled as the result of a birth defect or an injury now prefer to be described as disabled or physically-disadvantaged. The same can be said of those with an auditory impairment. Some are happy to admit to being hard of hearing or hearing impaired but dislike the use of the term deaf. In sharp contrast, others accept the term as a label to be worn with confidence and which identifies them as a member of a special sub-culture with talents, such as the ability to use sign language and read lips.

While each of these factions has a right to its own views, the fact still remains that, however one may choose to refer to this condition, it is one that, unless identified and suitably managed, is likely to have lifelong consequences. It is fortunate, therefore, that there are now trained healthcare specialists who have the knowledge, the experience, and the necessary tools to perform both the diagnostic and corrective measures. The first step in their investigation is to determine if the hearing loss is due to a treatable medical cause as, in such cases, it might be reversible. Thereafter, other tests must be undertaken on each ear to measure just how deaf the subject actually is, and whether the origin of the impairment is conductive or sensory in nature.

To a degree, progressive hearing loss tends to accompany the ageing process. Known as presbycusis, it is the result of a gradual reduction in the efficiency of the sensory cells in the inner ear that tends to commence in the latter part of the fifth decade in most subjects. Although it is progressive, it is slow and generally tends not to present much of a problem for another decade or so. In recent years, however, the growing number of people affected by hearing loss much earlier in life is causing greater concern.

While chronic ear infections and ototoxic drugs, such as ibuprofen, are known causes and some children may be deaf from birth, noise-induced hearing loss (NIHL) now accounts for the majority of hearing-impaired individuals throughout the world. The dangers of NIHL have long been recognised – mainly due to the high incidence among members of the armed forces returning home after the two world wars. The termination of hostilities in the second conflict coincided with the birth of clinical audiology. This meant that for the first time, there was a reliable means with which to evaluate the auditory efficiency of returning service personnel and others at risk of developing NIHL.

For those with mild to moderate hearing loss, a hearing aid is usually an effective management option. However, for those classified as severely or profoundly deaf due to impaired sensorineural function, an amplification device is most unlikely to be of any benefit. Instead, assisted hearing technology now offers the option of a cochlear implant. Its function is to bypass both the conductive pathway formed by the outer and middle ear and the sensory cells lining the cochlea, and to stimulate the auditory nerves directly, which then relay a modified signal to the sound centres in the brain.

It is the role of the audiologist to identify which audible frequencies are impaired, as well as the type of impairment and its severity. He or she then uses this information either to adjust a suitable hearing aid to match the auditory profile of mild to moderately deaf patients, or to refer those with severe to profound sensorineural hearing loss to an ENT specialist who must then further examine them to see if they are suitable candidates for an implant.

Hearing loss statistics are rising, with more people now at risk of NIHL. Simple precautions and hearing tests can help reduce deaf statistics. If you suspect that you or a loved one may be experiencing some hearing difficulties, waste no time and book an appointment with us as soon as possible. Let us help you in determining the extent of your hearing impairment and the most appropriate solution going forward.
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