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Hearing Loss
Hearing loss tends to seriously change behavior and slowly destroy quality of life.
IMPORTANCE OF HEARING
Hearing helps to understand the surrounding environment and can alert any coming danger around us.
“Each environment has its own signature. Sound tells a story” For as long as people have walked the Earth, everyone has been in a tight relationship with the environment. We need food, water, oxygen, and many other things. Since our relationship with the environment is not secured, we learned to react or withdraw to changes extremely fast.
Our hearing systems help us to monitor background noise: rainfall, road traffic, and the echoes of people in the other room. It also monitors body activities: breath, heartbeat, coughing, laughing, etc. We hear our surroundings and people.
Every place has a signature noise, and Tim Hortons sounds significantly different from that of the Airport.
We are unconsciously tracking background sound to upkeep our feeling of being alive and a part of the living word. When we lose the ability to hear the daily activity of our surroundings, we live in a pantomime world. We know the world cuts us off. We fall into depression, anxiety, sleep disturbance and paranoia.
Hearing is a part of communication.
Poor conversational skills, difficulty to understand others, and perceptual errors are treated by the public as “dull and unsocial”. It imposes embarrassment and self-criticism.
On a social level, hearing is a communication tool used by everyone in their daily life, to convey information and argue with others.
Depending on the degree of hearing loss, you might be able to hear speech in quiet rooms, but it’s almost impossible to talk with a group of three or more people.
Hearing helps to alert us of any dangerous and prohibited actions.
Hearing these signals tell us the direction of where a sound is coming from. We don’t stop because someone said “Fire”, but because we hear the shrill sound of the fire truck’s siren. We need to hear a warning signal like an ambulance siren, a doorbell, or a car when we cross the street.
Losing the ability to hear warning sounds causes a feeling of insecurity and puts us at risk, because our vision can only see distant objects, but sounds can bend around corners and warn us of many things before we see them.
Losing the ability to hear warning sounds causes a feeling of insecurity and puts us in risk, because our vision can only see distant objects, but sounds can bend around corners and warn us of many things before we see them.
It impacts:
- intimacy, friendship, family relationship
- communication in the health care setting (e.g., understanding a therapeutic plan)
- talking to the clerk at a store
- talking in a car
- listening to music
- learning foreign languages
- understanding accents
- employment
- using a phone
- misunderstanding the clients
- communication with colleagues
It causes:
- High level of emotional distress
- Sustained visual and auditory attention for understanding what people are saying.
- Bluffing is a form of lying which is treated by others as lacking interest in what is being said.
Hearing contributes to the aesthetic pleasure of listening to music and sounds of nature.
Music stimulates the brain, mind, body, and sensitivity. It reduces anxiety, high blood pressure, and pain. It also improves sleep, boosts moods, motivation, mental alertness, and memory.
Hearing aids help capture enough of the desired sounds and rhythms to stimulate your imagination, recreate familiar and beloved auditory images from music and the natural world to satisfy your needs.
Hearing loss is the partial or total inability to hear high or low pitch sounds in one or both ears.
Symptoms of hearing loss
You can hear them speaking but can’t make sense of what they were saying.
Some people’s voices are consistently harder to hear than other peoples.
You believe that most people mumble.You understand speech perfectly in one-on-one conversations in a quiet room, but it becomes impossible to follow a conversation when background noise is present, or several people are talking at once. In fact, you’re the only one in the room who is struggling to hear.
You have an on and off ringing sound in your ears.
You are hearing and responding incorrectly more often due to mixing up words such as hot for got, white for wife, pill for pick, snow for throw, book for took, ten for pen, gale for male.
You ask people to repeat themselves more often.
It’s hard to separate speech from noise.
You are smiling and nodding when someone speaks to give the impression you are listening when in fact, you do not understand what was said.
You feel exhausted from the excessively high concentration while listening.
You don’t hear birds chirping anymore.
77% OF PEOPLE WITH HEARING LOSS UNAWARE OF IT
Hearing loss may be less noticeable to younger people because hearing loss is associated with aging people with good health because hearing loss is often associated with declining health people who had never worked in a noisy environment.
https://canadianaudiologist.ca/issue/volume-8-issue-3-2021/unperceived-hearing-loss-among-canadians/
“….deafness cuts us off from people”, H. Keller
How much hearing loss might you have?
light: 15dB-25dB
This level of hearing loss is defined as having a “slight” hearing loss. You should start taking a hearing test annually to monitor your hearing status to be sure your hearing loss is not progressing.
Mild: 25dB-40dB
When you are in the restaurant, speech may sound like it is loud enough, but not clear. You are missing the consonants: s, t, th, and f which make up 25% of speech. It’s become hard to recognize words: thirsty, taste, past, she, almost, and first. You misunderstand a lot of words such as:
“house” sounding like “how”,
“teeth” sounding like “tee”,
“said” sounding like “ad”,
“Nice” sounding like “Eye”
“Beer” sounding like “deer”, “fear” or “near”
The problem is permanently damaged outer hearing cells of cochlea which are responsible not only for detecting soft sounds, but also for distinguishing between frequencies that are close together. It creates difficulty in listening to speech in a noisy environment.
Hearing aids can imitate the amplification provided by outer hearing cells but can not recover frequency perception. To overcome this problem, the only advance technology hearing aids with all possible features can improve the intensity of speech relative to the background, making soft sounds louder than the noise.
Moderate: 41dB-55dB
Soft speech (for example, the sound of their cars’ turn signal) is not audible anymore because outer hearing cells in the cochlea are permanently damaged.
The auditory system has lost its sharpness, as result it allows more noise to pass through the auditory pathway and makes it harder to recognize close-frequency sounds like B/P, T/D, K/G, F/V, and S/Z.
The inner hearing cells of the cochlea are also partially damaged or bent and they cannot transfer the signal to the brain. Hearing aids are now required for conversational speech.
Moderately Severe: 56-70dB
At this level of hearing loss not only are outer hair cells damaged, but inner hair cells as well. You cannot hear any consonants of speech at typical conversational levels without hearing aids. Because vowels have a lot of sound energy, they are always heard. You might hear people talking, but you cannot make any sense of what was said. Proper hearing loss treatment will help to make speech audible.
Severe: 71-90dB
Only very loud sounds can be heard. Hearing aids begin to lose effectiveness to improve speech understanding. Powerful hearing aids are becoming more beneficial to hear environmental sounds rather than speech. Lipreading together with powerful hearing aids is an effective way to supplement speech understanding.
Profound: Greater than 91dB
The world is quiet, no sounds. Hearing aids are generally not effective for speech listening, but often improve lip-reading skills. Hearing aids are also used to hear environmental sounds.
Cochlea implants may become a solution.
A delay to the treatment of hearing loss may harm you.
Hearing tests not only examine your hearing sensitivity but can also determine whether you have an underlying medical issue and refer you to a physician if necessary (Examples: early signs of ear and brain cancers can be found through and otoscopy and hearing tests)
Hearing tests can reveal an auditory processing disorder (APD) which means the nervous system—not the ears—struggles to make sense of the sounds coming in from the ears. An early referral to a physician can avoid a lot of future complications.
The auditory nerve needs to be stimulated. Early treatment will shorten the adjustment period of training your brain towards hearing aids.
Untreated hearing loss can take a toll on relationships. Improvement of marital distress takes much longer due to the complexities of individual life issues and personality attributes1. When relationships are broken, hearing aids will no longer solely be a tool.
A list of profession may cause hearing loss
- Factory workers
- Entertainment venue employees (Casino, Recreation centres)
- Musicians
- Farmers
- Dental workers
- Construction workers
- Coaches and game officials
- School teacher
- Restaurant workers
- Surgeons who use medical drills,
- First responders
- Military personnel
A lifestyle that may cause hearing loss
Don’t underestimate the risk of permanent damage by work in noisy environments or participate in noisy recreational hobbies.
Driving a car with open windows or a roof
- Gas engine cars produce 85 decibels of sound (Ferraris produce over 100 decibels of sound in first gear).
- Passing vehicles expose the driver to 100 decibels of sound.
- The swooshing and whistling sounds of wind moving into the car add another 85 dB.
Smoking due to a heavy-metal cadmium
- Nicotine constricts blood vessels, narrowing passages for blood to be pumped through your body. The hair cells in the cochlea need a lot of oxygen to be able to move very fast. Blood is the main source of oxygen.
Riding a bike on busy streets
- Traffic produces a high amount of noise around 85 dB
Flying sick
- When the pressure inside a plane changes abruptly an infection or allergy affecting your nose/throat makes it difficult to adjust to pressure changes. You are at risk of damaging your hearing.
Being overweight
- Researchers at Brigham and Women’s Hospital in Boston reviewed data revealing that women with a BMI between 30 and 34 had a 17% higher risk of hearing loss compared with those with a BMI under 25
Scuba diving
- A sudden intense change in pressure can damage the inner ear and temporarily or permanently harm your hearing. People who go deep scuba diving and return to the surface too quickly is at the greatest risk.
Listen to music at a volume louder than 60% *
- Rock concerts are usually between 105 dB and 140 dB
- Headphones at maximum volume are approximately 105 dB.
- Fitness centres use volume up to 93 dB
Causes of hearing loss.
Sensori-neural hearing loss – permanent damage of hearing cells in the cochlea
Loud sounds 85 dB and up cause hearing loss. For every 3 dB, safe exposure time is reduced by half.
85 dB – 8 hours of safe time
88 dB – 4 hours
91 dB – 2 hours
94 dB – 1 hour
97 dB – 30 min
100 dB – 15 min (symphony)
121 dB – 7 sec (rock concert)
How loud the common noises?
Work
- 85 dB handsaw
- 95 dB electric drill
- 100 dB factory
- 130 dB jackhammer
- 120 dB pneumatic drill
- 140 dB airplane taking off
Home
- 75 dB washing machine, flush toilet
- 55- 85 dB vacuum cleaner
- 60 – 90 dB hair dryer
- 70- 85dB coffee grinder
- 70 – 90dB food processor
- 75 – 95 dB blender
- 80 dB
Recreation activity & hobbies
- 60-95 dB lawn mower
- 105 dB snow blower
- 110 dB leaves blower
- 75-85 dB traffic
- 75-110 dB car engine
- 95-110 motorcycle
- 115 dB symphony concert
- 70 – 85 dB theater show
- 110 dB stadium game
- 120 dB rock concert
- 150 dB firecracker
- 157 dB balloon pop
- 170 dB shotgun
Heritage passed down by biological parents.
Viral or bacterial diseases (measles, mumps, meningitis, rubella, herpes)
Heart or vascular problems due to poor blood circulation in the cochlea
Kidney disease
Long-standing (chronic) conditions, such as diabetes and high blood pressure
Injuries to the ear
Meniere’s disease – sudden hearing loss.
Age-related hearing loss (some parts of our body weren’t designed last for 85 or so)
Organic liquid chemicals, such as toluene
More than 200 ototoxic medicines (including certain cancer treatment drugs and some pain relievers)
Heavy-metal contaminants such as the low levels of lead in some drinking water
Iron-deficiency anemia when iron levels deplete blood cells
Presbycusis – progressive loss of high frequencies hearing sensitivity associated with aging.
Age causes cardiovascular problems and other physiological problems like degradation of outer hair cells and the stria vascularis, mechanical changes, stiffness of cochlea membranes.
Conductive Hearing Loss – when sound cannot go through the outer and middle ears
- Ear wax blockage
- Perforated ear drum
- Infection in the middle ear
- Issues with mobilities of the three bones in the middle ear
- An abnormal growth of skin cells
- Allergies
- Tumor
- An abnormal growth of bone tissue in the middle ear
- Dysfunction of the Eustachian tube
Auditory Processing Disorders – the hearing nerve doesn’t transfer signal to the brain
- Stroke
- Anoxia
- Developmental disorders
- Head trauma
TEMPORARY HEARING LOSS stops when the causes stop.
- A head cold, allergy, or bacterial or viral infection causes pus and mucus to build up behind the eardrum.
- Some pain relief medication
- Earwax buildup
Hearing Loss in One or Both Ears
Hearing loss can affect one or both ears.
Hearing loss can be approximately the same in each ear, or worse in one ear than the other.
Hearing loss from environmental causes like noise, ototoxic drugs and ageing are generally symmetrical (both ears).
Very often Industrial noise is concentration of the low frequencies and industrial workers spend most of the time in reverberant environment. Our head and body do not work as a shadow for the low frequency noise. So, the noise from right side bounce from the left wall with minimum loss and become the same loud to the left side.
Hearing loss from medical causes like infection, mumps, the tumor is often asymmetrical (one ear)
Drivers usually have a hearing loss in the left ear due to noise exposure from an open window on the left side.
Music contents of significant high frequency energy in non-reverberant environment. Asymmetry of 25 dB is quite common for musicians especially like violin players.
Gun short is performing in non-reverberant environment. Hunters have hearing loss in the ear opposite to their dominant hand.
Tinnitus
The hair cells in the inner ear move with the pressure of sound waves. That movement triggers the cells to release an electrical signal. The signal travels through the auditory nerve and into your brain. Your brain interprets the signal as sound.
When the hair cells inside your inner ear are partially broken or bent, they spontaneously spark electrical impulses to the brain. So, tinnitus is not a disease – it is a symptom.
Roy Bain said, “When you were young, you could hear background noise which masked the tinnitus. With hearing loss, you can no longer hear the soft background noise, and you hear your tinnitus”
Most people reported the onset of tinnitus just before or shortly after beginning to lose hearing.
Tinnitus can be as long as half or whole day, in the right, in the left or in both ears, inside or outside the head.
Outcome
- Affect concentration.
- Disrupt sleep.
- Lead to depression, hysteria, hypochondria.
Degree of tinnitus precent varies from minimal with very few affects on the people, to almost incapacitating levels, where people are unable to complete normal routine.
Causes of mostly high pitch tinnitus
- Exposure to loud sound
- age-related hearing loss,
- earwax buildup (excessive)
- changes within your ear bones.
- a severe head or neck injury
- sinus pressure,
- a serious brain injury.
Causes of mostly low-pitch tinnitus
- cardiovascular disease,
- allergies,
- anemia
- some jaw disorders (where lower jawbone meets the scalp)
- diet,
- stress
- certain medications
- acoustic nerve neuroma
Tinnitus is a constant sound that does NOT pulse with your heartbeat!!!
Tinnitus can not be changed, but our reaction to it can. Changing responses makes it less of a problem. The main goal is to feel better even though the tinnitus does not change.
Methods to change our reactions to tinnitus:
- Sound-based approaches (Tinnitus Masking and Tinnitus Retraining Therapy with hearing aids treatments)
- Education
- Counseling/Psychotherapy (Cognitive-Behavioral Therapy)
- Hearing aids
- reduces the contrast between tinnitus and quiet environments
- make able to hear soothing sounds. Most tinnitus sound therapy that people find relaxing has a high-pitch sound quality
- shift attention away from tinnitus
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