What Causes Age-Related Hearing Loss?

Age-related hearing loss results from wear and tear of the ear over the years. Damage inflicted by noise is usually found in the inner ear. Many doctors and audiologists believe that heredity and persistent exposure to loud noises also contribute to hearing loss to some degree. Additionally, the build-up of ear wax can cause failure of the ear to carry sound as it was designed to do. Although doctors and hearing specialists can help you or a family member cope with hearing loss and improve what you hear, hearing loss itself is irreversible.

What Are The Signs And Symptoms Of Age-Related Hearing Loss?

Hearing loss is rarely a sudden occurrence, unless brought on by trauma. Over time, those who experience age-related hearing loss may see some or all of these signs:
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• Muffled speech
• Difficulty understanding what others are saying
• Difficulty understanding what is being said in a crowded room
• Need to have others to repeat what was said, or to speak with more clarity or volume
• Need to turn up the volume of the radio or television
• Abnormal withdrawal from conversations
• Avoidance of social settings

Understanding Hearing Loss

To understand hearing loss, you must first understand how we hear. The mechanisms that cause hearing are somewhat uncomplicated. Hearing takes place when sound waves travel through the structures inside the ear and are converted to nerve signals that can be recognised by the brain. There are three major areas that make up the ear – the outer ear, middle ear, and inner ear. Sound waves first pass through the outer ear and cause the eardrum to vibrate. The eardrum and the middle ear (which also contains three small bones known as the hammer, the anvil, and the stirrup) cause an amplification of the vibrations from the eardrum on their way to the inner ear. Once the vibrations reach the inner ear, they pass through fluid found in the cochlea, which is a small structure shaped much like a snail inside the inner ear. The cochlea are attached to nerve cells which, in turn, are covered with thousands of miniscule hairs that assist in the translation of the sound vibrations, turning them into electrical signals that are relayed to the brain. Different sounds are transmitted in different ways, allowing the brain to interpret a variety of messages through the ear.

Hearing Loss: Causes

While the buildup of earwax and earwax blockage can cause hearing loss in people of any age, most hearing loss is the result of damage to the delicate cochlea. The cochlea – or more specifically the tiny hairs in the cochlea – become bent or broken over time which can lead to degeneration of the nerve cells attached to the cochlea. When this happens, signals to the brain that normally occur when sound is transmitted may not be relayed as efficiently, which causes the perceived hearing loss.

Are You Or A Family Member At Risk For Hearing Loss?

The risk factors for hearing loss include:
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• Age
• Heredity
• Loud noises
• Medications like NSAIDS, aspirins, and loop diuretics
• Previous illnesses that are accompanied by high fever, such as meningitis

When To See A Doctor

If you are worried that you or a family member may be suffering from presbycusis, consult your family doctor in the first instance. Your hearing may have deteriorated if you are finding that it is difficult to understand parts of a conversation, or if sounds appear to be “muffled”. Your doctor will perform tests to establish if you have hearing loss and recommend a course of treatment which may be as simple as loosening the wax that has built up in your ear using special drops, fitting you with a hearing aid, or even implanting an electronic device known as a cochlear implant.

Preventing Hearing Loss

Loud noises are a significant cause of temporary or permanent hearing loss. Using headphones to listen to music at a consistently high volume, for example, can be extremely detrimental to your hearing. If you are being exposed to loud noises for long periods of time, it is good practise to take a 15 minute “quiet break” every hour or so. These respites allow your ears – as well as your mind – to “reset” themselves. Avoiding hazardous noise environments are also imperative. A good way to measure if an environment is hazardous or not is whether you can hold a conversation without having to raise your voice. If you work in a noisy environment, you should wear any suitable protection that your employer gives you. If none is given, speak to your health and safety department.

If You Are Experiencing Hearing Loss

The first thing you need to do is consult a hearing professional to determine the exact degree of damage to your hearing and decide if and medical remedies should be undertaken. If something in your life is causing potentially repetitive long term damage, such as your work environment or extracurricular activity, you may have to consider some changes in your lifestyle to ensure that you do not cause long term irreversible damage. Coupled with the self inflicted hearing abuse, you can end up deaf or severely hard of hearing in your later years.

Many Individuals Reluctant To Admit Hearing Problems

You also need to be honest when you are consulting a professional about hearing loss. If you are not honest with them, they cannot give you an honest answer and if they cannot accurately identify your problem, they could end up giving you an improper solution. Many people are very reluctant to admit that they are having difficulty hearing or experiencing hearing loss. Putting off testing can only worsen the situation. If you or a loved one are having difficulty hearing, consulting an audiologist or other hearing professional as soon as possible is imperative to improving your hearing so that you can improve the quality of your life.

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What To Look For

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• Ages 0 to 3 months – Pay attention to the way the child responds to loud noises, awakens to a loud sound and even appears comforted to the sound of their parent’s voice. During this age, the child should be able to make cooing noises from the back of their throat.
• Ages 3 to 12 months – Look for actions from the child as they react to sounds. The child should turn their head or eyes towards the parent as they speak to their child, smile when talked to and even make different sounding cries when he or she is hungry or needs their nappy changed.
• Ages 6 to 12 months – The child should be able to respond to their own name, understand a few words and even react to the changes in tone of their parent’s voice.
• Age 12 months – The child should be able to recognise their own name and understand the term, “no”.
• Ages 12 to 18 months – During this age, the child should be able to point to things and have a few vocabulary words such as “mama” and “dada”.
• Ages 18 to 24 months – The child’s vocabulary should be at fifty words or more during these months and should easily respond to “yes” and “no” questions.
• Ages 2 to 3 years – The child’s vocabulary should be on average 270 words. The child at this age should be able to sing terse songs and even make up three to four word sentences.

An ounce of prevention is worth a pound of cure. If a parent or guardian suspects that their child is unable to perform the above mentioned tasks, set an immediate appointment with the child’s paediatrician.

Signs And Causes Of Hearing Loss In Children

There are many causes and signs of hearing loss in children, which is all the more reason to have a child’s hearing tested as soon and as often as needed. A few of the signs and causes for a hearing test include:
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• A lower birth rate less than two pounds
• Severe jaundice after the child has been born
• Maternal sickness during the pregnancy (e.g. rubella)
• Recurring and frequent ear infections
• Crouzon syndrome, Alport syndrome (a form of kidney disease), and Down syndrome
• Hearing loss can be inherited – check the child’s family history
• A delay in speech

By observing your child’s reactions and responses as a newborn to age three as well keeping informed about the various causes and signs of hearing loss. Children can be tested and possibly treated quickly by their paediatrician.

The Hearing Process

Hearing begins when our outer ears pick up sound waves from the external environment and sends them to the middle ear. Here the ear drum begins to vibrate and – working together with three tiny bones – transmits the vibrations to the inner ear where they are converted to nerve impulses that end up in the brain. The brain recognises these impulses as sound. The common terms for the three bones of the middle ear -known collectively as the “ossicles” – are hammer, anvil, and stirrup. The correct medical terms are malleus, incus, and stapes. The inner ear holds the cochlea which is filled with fluid and hair cells. The vibrations received from the middle ear pass through the cochlear fluid and cause the hair cells to begin moving. It is this stimulation and movement that leads to the creation of the electrical nerve impulses that go to the brain. Different external sounds lead to different vibrations which stimulate different sections of the cochlea which results in the transmission of impulses that allow the brain to distinguish among a variety of sounds.

Otosclerosis And Hearing Loss

The abnormal growths or lesions resulting from otosclerosis most often affect the last bone in the middle ear – the stirrup or stapes. The growths affect the bone’s ability to vibrate, progressing to the point where the stapes gets stuck and won’t vibrate at all. This can have a serious impact on sound waves passing through to the inner ear. The change in both the number and the quality of the sound waves transmitted leads to the hearing loss. In rare cases, otosclerosis can impact the nerve fibres and cells within the inner ear.

Causes Of Otosclerosis

Researchers cannot point to a single cause with 100% accuracy but it appears genetics plays a major factor. Otosclerosis runs in families so if both of your parents have or had it you have about a 50% chance of developing it as well. Research also indicates a possible link between otosclerosis and hormonal changes occurring during pregnancy. Viral infections – like measles, influenza, and sinusitis – may also have links to otosclerosis.

Symptoms Of Otosclerosis

Hearing loss and tinnitus are the most common symptoms. Remember that the hearing loss can be gradual and take a long time before it becomes dysfunctional enough to be noticed. Tinnitus is most frequently thought of as “ringing in the ear”, but the sensations experienced may also include hissing, buzzing, or even roaring sounds.

Diagnosing and Treating Otosclerosis

Your doctor will typically refer a patient suffering from hearing loss to an otolaryngologist – an ear, nose, and throat specialist.  These specialists can determine if there are other causes of the hearing loss that could produce similar symptoms. Audiologists are usually involved in the diagnostic process as well. They have a variety of tests and procedures to evaluate the functioning of the middle and inner ear.

Once otosclerosis has been diagnosed there are two treatment options – surgery or hearing aids. The surgical procedure – called a stapedectomy – involves removing the stapes and replacing it with an artificial bone, frequently made of Teflon. In some cases the stapes is left in place and simply bypassed in favour of the implanted prosthetic or artificial device.

Hearing aids can be appropriate where the hearing loss resulting from ostosclerosis is less severe. A hearing aid acts as a sound amplifier. The audiologist who performed the diagnostic tests should be able to outline the types of hearing aids available and which would be most suitable to the needs of the person with the condition.

Research On Otosclerosis

Much of the current research emphasis is on identifying the genetic structure that might carry the disease from parent to child. In addition, laser surgery techniques applicable to stapedectomies are being improved. Researchers are also working on improving the artificial bones used in the process.

Additional Information

As with any medical issue, your doctor needs to be consulted. It is advisable to do some research before seeing medical practitioners so you can know what questions to ask them. University affiliated medical centres in your area can also be excellent sources of information.

Signs Of What To Look For In Your Elderly Loved One Regarding Their Hearing Loss

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• They have worked or are still working in a loud environment such as a machine shop or factory
• They complain of constant buzzing, hissing, or ringing in their ear
• They are having difficulty understanding what friends and family are saying to them
• Their radio or television is turned up to a higher than normal volume

How To Approach Them

While many of the elderly appear stubborn and difficult when they are approached by their gradual hearing loss, it is mainly due to them having a feeling of a loss of independence. You and your elderly loved one needs to find a quiet place to sit down and explain in clear and direct sentences that many people at their age suffer from some sort of hearing loss and that it is nothing to be ashamed of. In many cases, once the elderly person does go to see their doctor and it is discovered that they have hearing damage or loss (also known as Presbycusis), it may well be treatable with the help of a hearing aid.

Here Are Four Simple Steps To Follow To Help Them:

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1. Never make assumptions of their limitations. Just because they are suffering from hearing loss, it does not mean that their entire body is also impaired. No one wants to be treated that way. Simply and calmly tell them what things you will do in a step by step manner.
2. Give them your respect and patience – they do not want to feel helpless just because of their hearing impairment. Everyone prefers care above pity. By showing pity, it will make them feel that their life is now pathetic because of a hearing impairment.
3. Give them their privacy that they want and need. They are their own person, and they do not need to be talked to or treated like a child. Show them some respect by allowing them to have their own alone time.
4. Remember that they have a right to their choices. Simply ask them how you can help them out more often. They will appreciate you even more for doing that to them.

Always remember that untreated or undiagnosed hearing loss may sometimes lead to social isolation and even depression. Explain to your elderly loved one that they are not alone and you will be there for them every step of the way.