Hearing Loss

The Common Causes and Effective Management of Hearing Loss

For those of us who are lucky enough to be unaffected by any significant degree of hearing loss, it may be difficult to fully understand the many difficulties which, without the assistance of suitable compensatory technology, might otherwise be experienced on a daily basis by those who are less fortunate. It is perhaps worth noting that in the United States alone, around one person in 8, or about 30 million of those aged 12 years or over now show a measurable level of auditory impairment in both ears, while in the 2% of the adults between 45 and 54 who are affected, the extent of their impairment is sufficient to be disabling.

There are numerous possible causes for hearing loss, and while it can be an inherited or birth-related condition, or associated with diseases such as mumps, measles, and rubella, in the bulk of cases, it is the result of some aspect of a modern lifestyle that could, perhaps, have been avoided. Among the most common causes, particularly in infants and young children, are ear infections.

The gradual build-up of pus in the ear interferes with the conduction of sounds, resulting in varying degrees of temporary deafness that will normally be reversed by the use of an appropriate antibiotic. Where such infections may exhibit a tendency to recur, there is a real danger that the condition could become chronic, and the associated hearing loss irreversible. Somewhat ironically, in a few individuals, the antibiotic chosen to treat these or other bacterial infections may itself be the cause of auditory insufficiency, which could then become permanent if it is not discontinued and an alternative antibiotic administered in time.

In addition to antibiotics, such as streptomycin and gentamicin, a number of other common prescription and OTC medications have also been found to have the potential to negatively affect audition. These include the so-called non-steroidal anti-inflammatory drugs like aspirin and ibuprofen, as well as prescription-only alternatives, such as diclofenac.

In the workplace too, exposure to certain chemicals can lead to hearing loss. Organic solvents like toluene, xylene, benzene, and even white spirit are known to possess strong ototoxic properties and are able to compromise audition in subjects who are repeatedly exposed to them. Also implicated are heavy metals, such as mercury, lead, and cadmium, while common pesticides, such as paraquat and organophosphates are also heavily implicated.

Outstripping the effects of all of these possible culprits and now widely recognised as the leading cause of deafness among people of all ages in the developed world, is prolonged and repeated exposure to loud noise. This is known as noise-induced hearing loss or NIHL. Where the condition was once confined almost exclusively to the workplace and the most common form of industrial injury, almost all of those who reside in urban areas can be considered to be at risk of developing NIHL today. Thanks to car stereos, and the ubiquitous smartphones and iPods with their tightly fitting ear buds, the risk even extends to those living and working beyond the city boundaries.

It is possible that some of those reading this article, although unaware of it, are already experiencing some degree of noise-induced hearing loss. Since the effect of excessive noise is cumulative, it is important to confirm or to eliminate this possibility without a delay that could result in further impairment. For this purpose, they will need to pay a visit to an audiologist. Operating a chain of state-of-the-art audiology clinics across South Africa, Ear Institute will employ cutting-edge technology to identify any anomalies in audition and to provide a suitably effective management solution in the event that one should be required.

Following a physical examination of the ears to detect any medical condition that might be responsible for hearing loss and warrant referral to a physician or ENT surgeon, an audiogram will be performed to identify those frequencies at which difficulty is evident. Both ears will be tested, to determine if the impairment is of conductive or sensorineural origin, or perhaps a mixture of both. Armed with this information, the audiologist is able to test the effectiveness of a suitable hearing aid in managing the loss of audition.

Generally, the chosen unit will provide the required correction but, in extreme cases, a conventional aid may offer little benefit. In such cases, an evaluation by an ENT surgeon may be required to assess the suitability of a cochlear implant.
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