Hearing Loss (Otosclerosis, Presbycusis)

Aging is the most common cause of hearing loss, but the degree of deficiency varies greatly from person to person and affects men more than women. Presbycusis, a type of sensory-neural hearing loss that is particularly prevalent in the elderly, is due to deterioration of the tiny hair cells that line the cochlea in the inner ear. These cells send electrical sound impulses to the part of the brain where sounds are received and processed. Accidents and exposure to excessive noise can also damage these cells.

Hearing deficits present at birth may stem from a congenital or hereditary disorder, or to a birth defect caused by drug use or illness, such as rubella, during pregnancy. A doctor will suspect hearing impairment in an infant who fails to respond to sound or does not begin talking by age two. Childhood diseases, especially chronic middle ear infections, and less commonly, complications from chickenpox, mumps, or measles, can cause hearing loss. Untreated childhood hearing disorders may lead to later speech, reading, behavioral, and learning problems.

Gradual hearing loss that begins between the ages of 20 and 40 may be caused by otosclerosis, a degeneration of the stapes bone in the ear. While the above conditions are mostly irreversible, hearing loss from an excessive buildup of earwax or the side effects of some medications, such as aspirin, antibiotics, quinine, and certain diuretics, is usually temporary.

Diagnostic Studies and Procedures

Hearing is tested in a soundproof booth, with the patient wearing special earphones. A variety of tones are broadcast at different pitches through the earphones, and the person signals if he hears them. Hearing comprehension is tested by broadcasting different words through the earphones. After a doctor has assessed the hearing loss, further tests may be performed to determine its cause. These may include X-rays and a CT scan of the head to detect bone loss or deformities.

Medical Treatments

Depending on the extent of the loss, a hearing aid can often partially or completely restore hearing, but about 70 percent of people with hearing impairments do not seek help. If a hearing aid is necessary, a health professional, rather than a salesperson, should select and fit it because the cause of the hearing impairment determines the type of aid. For example, hearing loss that is equally distributed throughout sound frequencies is best treated with a device that magnifies any sound. Presbycusis, which often entails hearing loss in the higher frequencies only, responds better to a hearing aid designed to amplify only the lost sounds.

Audio-logic rehabilitation, including auditory training and lip-reading, is sometimes needed in addition to a hearing aid. Surgery may remedy some cases of otosclerosis. In one procedure, called a stapedectomy, the diseased stapes bone is removed and replaced with a prosthesis that conducts sound vibrations to the inner ear.

When there is severe or total hearing loss, special implants can permit the perception of some sound, although they cannot restore the ability to distinguish ordinary speech sounds.

Alternative Therapies

Nutrition Therapy. Some practitioners believe that certain types of hearing loss from inner ear disease may be caused by atherosclerosis. They advocate the same type of low-fat, low-cholesterol diet -- with plenty of fresh fruits and vegetables and whole grains -- recommended for people with heart disease. If you have a high cholesterol level, and especially if you are overweight and have diabetes, this healthful lifestyle adjustment may not only protect your hearing, but also prevent a heart attack or stroke.

Music Therapy. Through music, children with impaired hearing or speech difficulties have been helped to discover new ways of communicating.

Self-Treatment

If a buildup of earwax is responsible for diminished hearing, you may be able to remove it using a home kit available in most pharmacies. A warm solution, usually glycerol and an antiseptic, is inserted into the ear to soften the wax, which can then be removed with a syringe or flushed out with warm water. If this doesn't work, see a doctor. Never attempt to remove wax with a hairpin or other sharp object. Such tactics are likely to drive the wax in deeper, and can also damage the ear.

If ringing in the ears or any hearing loss develops while you are taking medication, call your doctor to discuss discontinuation or a lower dosage.

Excessive noise is a leading cause of hearing loss. Wear earplugs when you are using noisy equipment. Even a hair dryer, according to some doctors, makes enough noise over time to impair hearing. If you are unavoidably exposed to a loud noise, such as a siren or subway train, press your fingers against the flap of tissue that covers each ear opening until the sound abates. If you work in a noisy environment, such as an airport or a printing shop, ask about occupational protective ear muffs. Remember, any noise that provokes pain can cause hearing loss.

Other Causes of Hearing Loss

Headsets, a popular means of listening to music while drowning out other sounds such as traffic, can themselves be detrimental to your hearing, especially if you turn the volume up high. Meniere's disease, brain tumors, strokes, head injuries, and viral infections may also result in hearing loss.