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Hearing problems can occur at any age but a common type is age-related hearing loss, which is primarily caused by the deterioration of the nerves that send sound signals to the brain. This can happen over time and there are two other types of hearing loss.
In an interview with HT Lifestyle, Dr. Fidelis Grace Das, ENT consultant at SSM Hospital, shared, “One is called conductive hearing loss, where there is a problem with the ear’s ability to conduct sound. (The process by which sound waves pass through the ear canal). This may be due to a hole or damage to the eardrum. The second type is mixed hearing loss, which includes a combination of both conductive and sensorineural hearing loss. This means that there may be problems with both the ear’s ability to conduct sound and the nerves that transmit it to the brain.
sensorineural hearing loss
Dr. Fidelis Grace Das said, “Sense-neural hearing loss in elderly patients is mainly seen due to nerve degeneration/damage to the inner ear. This degeneration occurs in a regressive manner. Older patients may have a history of tinnitus, a ringing sensation in the ears (also known as the cry of dying nerves). The nerve loses its capacity and starts emitting a ringing sound called tinnitus. This is a warning sign to get necessary testing. Age-related hearing loss is called progressive neural hearing loss. It is progressive because it does not occur suddenly, over time it gradually decreases without the patient’s knowledge. If the patient is less responsive to his/her peers, watches television at maximum volume, this should be noted first and followed by audiological evaluation.
What effect does this have on the patient’s life and well-being?
Dr. Fidelis Grace Das replied, “When patients realize that they are not able to hear properly. Their response to questions and their participation in conversation reduces. They react in different ways. For example the question may be different and the answer will be given differently. Once this starts, they gradually start feeling distant and unable to socialize with people. It can also be a psychological thing and result in times when they are unable to listen, go about their daily lives, participate in meetings, or respond appropriately to their colleagues.
Preventive Measures
Dr. Fidelis Grace Das said, “It depends on the degree of hearing loss. In the early stages, if the ears feel tingling or are unable to respond properly, some medicines may be used. There is no certainty that the pills will always help. It can prevent neuron degeneration i.e., prevent further degeneration of nerves. If the person is not responding and the hearing loss is more than 50% or there is mild to moderate hearing loss, to live daily life without any problem, the patient can take a hearing aid.
treatment
Dr. Fidelis Grace Das suggested, “Hearing aids or cochlear implants can be opted for. But cochlear implants require surgery, but hearing aids may be more than enough if there is age-related hearing loss.
Bringing in his expertise, Dr. Abhishek Khond, consultant ENT surgeon at Horizon Prime Hospital, Thane West, reveals, “Age-related hearing loss is also known as sensorineural hearing loss as the affected part is the nerve. Aging is a normal phenomenon, we can slow down this process but not stop it. The aging process is called presbycusis, where the patient will experience a gradual decline in hearing ability after the age of 60.
He adds, “Another commonly heard condition is tinnitus. In this condition, there will be no external sound but the patient will feel a ringing sound inside the ear. This is commonly seen in patients with cochlear nerve weakness. This nerve weakens with age as well as due to certain external stimuli such as exposure to loud noises or being exposed to a particular intensity of sound for a long period of time. Normal speech frequency is 500 to 2000 Hz. If the frequency is higher i.e. 4000 Hz or 8000 Hz, it may result in hearing loss.”
He highlighted the symptoms –
- speech discrimination: This is an early symptom of age-related hearing loss, the patient will not be able to distinguish between two similar words (for example, apple and maple).
- Speech Clarity: First signs of hearing loss
- Tinnitus: tinnitus
- Social Disability: Inability to communicate and interact with people due to hearing impairment. This may affect the patient’s confidence.
Factors that can cause hearing loss
Dr. Abhishek Khond explains, “When we talk about slowing down the aging process in terms of hearing, it means reducing exposure to loud or prolonged sounds for a long period. For example, if the patient has been working with heavy machinery in a factory or mill, the patient is more likely to develop age-related hearing loss at an early age. It is dangerous to expose the ears to heavy and loud sounds of more than 80 decibels for a long time or even a sudden sound of 120 dB for a short period of time.
He elaborated, “Traffic police have a higher propensity to develop age-related hearing loss due to constant exposure to traffic noise. People working at airports have to face a lot of noise from planes taking off and landing. Restaurants or pubs with loud music are another means for people to quickly develop hearing loss. In recent times, due to lifestyle, it is natural for hearing loss to occur at an early age. Hearing loss may occur at the age of 50 due to continuous use of mobile phones, earphones, television etc.
Treatment
Dr. Abhishek Khond recommends, “Pure tone audiometry is a basic behavioral test to measure hearing sensitivity. In this test, sounds of different frequency are given to the patient and graphical representation is written to understand if it is age-related sensorineural hearing loss. There are two types of sensorineural hearing loss- slowly and suddenly, When a patient suddenly loses hearing overnight, it is considered a medical emergency. The patient should visit an ENT specialist as soon as possible. There is a window of 28–48 hours where a certain amount of hearing loss (about 50%) can be regenerated.
He concluded, “The second type is a gradual decline in hearing ability. The patient experiences hearing loss and has to undergo audio message testing. After testing, if the hearing loss is more than 40 to 45 dB, the patient may use hearing aid devices, or cochlear implant surgery is another option. The use of hearing aids is still seen as a stigma in Indian society. However, we should try to normalize it just like the use of glasses.
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