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Mark E. Beaugard, M.D., F.A.C.S., Otolaryngologist
The Chester County Hospital
Published: November 26, 2007
Hearing loss is very common. It will affect 25% to 30% of us by the age of 65, and 75% by the age of 75. Genetics and noise exposure are contributing factors. When it occurs, speech and other sounds are muffled. You have difficulty understanding words, especially with background noise and may ask for frequent repeating. There may be a tendency to withdraw from social settings. Hearing loss may be associated with tinnitus, ringing in the ears.
An otolaryngologist's evaluation of hearing loss will consist of a thorough history, physical examination, an audiogram performed by a certified audiologist, and possibly other diagnostic tests or imaging studies. After a diagnosis is made, treatment options will be discussed. Making the right diagnosis early is important. Surgical solutions may include repair of the eardrum, repair or replacement of the tiny bones of the middle ear, and implantable hearing devices.
Sudden loss of hearing is a medical emergency. It could be from earwax impaction, which can be removed in the doctor's office. However, if the ear exam is normal, it may represent a viral inflammation in the inner ear which can result in permanent hearing loss. This can be successfully treated with steroids and possibly anti-infectious medications. It may be related to Lyme's or autoimmune disease.
The exam may reveal fluid in the middle ear from a blocked eustachian (auditory) tube, barotrauma (pressure on the middle ear), or a tumor in the nasopharynx (upper throat). Pain may indicate an outer or middle ear infection. These conditions may be treated with antibiotics and other medications. Fluctuating hearing loss, tinnitus, fullness in the ear and spinning vertigo represent Ménière's disease, treatable with diuretics, dietary changes and possibly steroids. If there is no vertigo with the fluctuation in hearing, it may represent autoimmune hearing loss.
As you mature, presbycusis is the predominant cause of hearing loss. Age-related hearing loss happens from degeneration of the hair cells and nerves in the inner ear. It is readily treatable with hearing amplification devices. There have been many wonderful improvements in hearing aids. Gone are the days of uncomfortable, bulky devices that squeal, require constant adjustments, and are commonly relegated to dresser drawers.
The new hearing devices are very exciting. Best results are obtained by a medical fitting by an audiologist and an otolaryngologist. With digital devices, the amplified sound is processed to enhance speech clarity and suppress background noise. They can seamlessly switch between programs for different listening environments, have automatic volume controls, and preferentially amplify in the direction of speech. The programs are tailored to each patient's desires and can easily be fine tuned. In most circumstances, the ear does not need to be blocked by a tight-fitting mold. The new devices are small and stylish.
Medical causes of hearing loss are common and readily treatable.
This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.
Last Updated: 7/27/2009