HealthLine: You Talkin' To Me?

When you think your spouse or significant other is ignoring you because you are asking them to take out the garbage, it may actually be true that their hearing is impaired.  Deafness is a medical condition whereby the ability to detect certain frequencies of sound is completely or partially diminished.  In the deaf community, the term “hearing impaired” is not favored and the terms “deaf” and “hard of hearing” are preferred.

In order to understand hearing loss, it is first important to understand how we hear.  Hearing occurs when sound waves reach the inside structures of your ear.  The sound wave vibrations are turned into nerve signals that your brain recognizes as sound. 

The ear has three major parts; outer ear, middle ear and inner ear.  Sound waves travel from the outer ear then vibrate onto the eardrum.  The eardrum and bones of the ear: hammer, anvil and stirrup, make up the middle ear and amplify the vibrations onto the inner ear.  The inner ear consists of a snail shaped structure called a cochlea, which has nerve cells attached to thousands of tiny hairs that translate sound vibrations into electrical signals which are then transmitted to the brain.  It is the differing sound vibrations from these tiny hairs which send various types of nerve signals to your brain that allow you to distinguish one sound from another.

There are three types of hearing loss; conductive, sensorineural and mixed.  Conductive hearing loss occurs when sound is not effectively conducted through the external ear canal to the ear drum and bones of the middle ear.  It involves a reduction in sound level or the ability to hear faint sounds.  It can generally be corrected medically or surgically.  The most common causes of conductive hearing loss are; fluid in the middle ear from a cold, middle ear infection, ear canal infection, allergies, perforated eardrum, benign tumors, impacted ear wax, foreign body of the ear or malformation of the outer ear, external canal or middle ear.

Sensorineural hearing loss occurs when there is damage to the inner ear or the neural pathways that lead from the inner ear to the brain.  Generally sensorineural hearing loss cannot be medically or surgically corrected.  This is the most common type of permanent hearing loss.  It is associated with; certain illnesses - measles, meningitis, fetal alcohol syndrome, drug toxicity, genetic predisposition, aging, head trauma, inner ear malformation or exposure to loud noise.  Mixed hearing loss is classified as such when there are both conductive and sensorineural components contributing to symptoms.

Hearing loss can be quantified by a hearing test, known as an audiogram.  The audiogram measures the decibels or the additional intensity above a nominal threshold that a sound must be before it is detected by the individual.  The higher the decibels, dB, the greater the hearing loss.  Mild impairment occurs at 20-40 dB up to profound, which is 91 dB or greater.

Treatment for hearing loss depends upon the cause and severity of the hearing loss.  Something as simple as ear wax removal by a health care professional may resolve the matter in certain patients.  Hearing aids amplify incoming sound and can be used by both adults and children, but generally provide limited improvement in hearing.  Adults who lost their hearing later in life may choose to be fitted with a cochlear implant which compensates for any damaged or nonworking parts of the inner ear.  Many deaf communities consider cochlear implants in children controversial and feel that parents should be educated on the benefits of sign language before undertaking such an aggressive procedure with its inherent risks and associated loss of the deaf culture.

Hearing loss is more common than people are lead to believe.  12% of children ages 6-19 years have permanent hearing damage from excessive noise exposure.  Presbycusis, gradual loss of hearing of the high pitched frequencies, is mostly seen in the older population.  In the US alone, it is estimated that one-third of people between the ages of 65 and 75, and up to one-half of persons over 75 years of age have some level of hearing loss.

Don’t worry about the garbage.  Drag your husband to the trash can and point, he’ll get the message.

Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest in Women’s Health.  She practices in Enumclaw, 360-825-1389.  Dr. Ballard’s comments are informational only and not to be construed as medical advice.  Consult your personal physician for any medical issues.