Saturday, July 23, 2016

Hearing Loss is Hearing Loss is Hearing Loss, Right? Think Again!


hearingplus.in


  • About 20 percent of Americans, 48 million, report some degree of hearing loss.
  • At age 65, one out of three people has a hearing loss.
  • 60 percent of the people with hearing loss are either in the work force or in educational settings.
  • While people in the workplace with the mildest hearing losses show little or no drop in income compared to their normal hearing peers, as the hearing loss increases, so does the reduction in compensation.
  • About 2-3 of every 1,000 children are hard of hearing or deaf
  • Estimated that 30 school children per 1,000 have a hearing loss.

(http://hearingloss.org/content/basic-facts-about-hearing-loss)

Staggering statistics, if you really think about it. And here is another. According to the CDC in the US, 70% of young adults with hearing loss are employed. That means a 30% unemployment rate for young adults with a hearing loss. (http://www.cdc.gov/ncbddd/hearingloss/data.html)

But is all hearing loss the same? After all, if you can't hear, you can't hear, right? Wrong.
nationalhearingtest.org


Hearing loss is as different as the person with it. To start with, you have different degrees of hearing loss.

The picture above shows what a typical audiogram may look like for a person with hearing loss. The frequencies refer to the pitch. Low frequency, low pitch sounds. High frequency, high pitch sounds.

It also shows the different decibels of hearing loss. In this case, low tones are normal, but as the frequency increases, it falls through mild, to moderate, to severe. This person would not hear women's voices well. Higher pitches would be lost.

But that is only part of the story. It only shows the level of loss, not the kind of loss. Yes, there are different kinds of hearing loss.

Hearing loss comes in three flavors, if you will. They are conductive loss, sensorineural loss, and combined loss.

Conductive loss happens when there is an obstruction in the flow of sound to the inner ear (cochlea). The inner ear is where "hearing" takes place. (Really, it takes place in the brain, but that is another subject.) Some causes of conductive hearing loss include:
  • Fluid in the middle ear from colds
  • Ear infection (otitis media)
  • Allergies (serous otitis media)
  • Poor eustachian tube function
  • Perforated eardrum
  • Benign tumors
  • Impacted earwax (cerumen)
  • Infection in the ear canal (external otitis)
  • Swimmer's Ear (otitis ecxterna)
  • Presence of a foreign body
  • Absence or malformation of the outer ear, ear canal, or middle ear
Hearing aids would probably perform poorly, or not at all, in this type of hearing loss. Making things louder when they can't get into the cochlea is of no use. And chances are, the cochlea may be perfectly healthy.

What needs to happen is for the underlying cause to be fixed, in some of the cases, or for the sound to find another route to the cochlea. This can be done with bone conduction. Some examples are bone conducting headphones and bone anchored hearing aids, but it takes a healthy cochlea to work.

Notice what wasn't on the list of causes of conductive loss? Meniere's disease. That is because that type of hearing loss is the second type, sensorineural.

Sensorineural loss happens when the tiny hairs in the cochlea are damaged or broken. The sound gets to the cochlea, but how it interacts with the hairs is changed. Instead of it flowing across them at an even rate, some are bent or missing, and so are those pitches in hearing. That is why things sound off. The letter T sounds like the letter D, so Tom sounds like Dom, or Dumb. Or it is missing completely and sounds like OM. That is why comprehension of words and conversations become hard. Things sound different or aren't there. In the case of Meniere's, the low pitches go first, so all you may hear is TA instead of Tom. Setaces beco ipossa to udderstad. (Sentences become impossible to understand) See what's missing?

Sensorineural is typical hearing loss. It is the type that happens with aging, as shown in the picture, or noise exposure, or disease, such as Meniere's. The only difference is the slope. With Meniere's, the slope reverses from the picture and is called, surprisingly, reverse slope hearing loss.

This type of loss CAN be helped with hearing aids up to the point of severe or profound loss. After that, the sounds are amplified to such a degree that things are loud, very loud, and likely still not able to be understood. That is where advance solutions, such as cochlear implants come in.

The third type of hearing loss is a combination of conductive and sensorineural. It takes the best (or worst) of both and puts them together. Challenging, but not necessarily impossible to help.

I think it is wise to learn the types and degree of your loss before going out and spending endless money on things that will never help you hear. That only leads to frustration and aggravation.

If your current hearing specialist hasn't or doesn't help you understand these things, find a new one. It's your ears and your hearing. You deserve to have it explained to you in a way you understand and to be helped in a way that does more than line their wallets. Far too many hearing aid dispensers will put a hearing aid on anything to gain a sale. Their goal should be to help people they can actually help and send those they can't to someone who can.

'Til next time

Dennis

Just a guy trying to live with an invisible, potentially debilitating illness

6 comments:

  1. Thank you for this post - I have MD diagnosed last autumn but my hearing difficulties with speech have plagued me for years. This is the clearest article I've read on it all and I thank you for that.

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    1. You are welcome. I tried to make it as clear as possible.

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  2. great information. I have hearing loss from Meniere's. I have cochlear implants in both ears. It's still a challenge. Often people think when you get CI's

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    1. I do very well with my CI's, but it isn't "normal". It takes time to adjust to the CI's and in real life, it takes time to adjust the CI's so you get the best hearing possible.

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  3. My blog is on Wordpress so I couldn't figure out a way to reblog this, but I did post it on my page on Facebook. Picnic With Ants.https://www.facebook.com/picnicwithants/?ref=aymt_homepage_panel

    ReplyDelete