Hearing loss

A decrease in hearing indicates that the perception of the frequency of sound is weakening.

Hearing is an amazing and rather complex ability of a living organism. Due to the interaction of the auditory system, which consists of the external, middle and inner ear, we can perceive the sound of the environment and communicate with people. In addition, the inner ear is responsible for the vestibular apparatus: if this function is disturbed, we feel lack of confidence in the movements, the whir of the head, we lose the opportunity to walk fully and even stand. The human auditory system is capable of distinguishing sound vibrations up to 20,000 Hz.

[1], [2], [3], [4]

Causes Hearing loss

Age-related hearing impairment is a fairly common phenomenon that can be observed in 35% of people who applied for help at the age of 70, and almost 50% after 75 years. However, age changes are not the only possible cause of hearing loss, there are a lot of such factors known.

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Symptoms Hearing loss

Symptoms of hearing loss may increase gradually, or develop unexpectedly and dramatically. There is a list of common symptoms that, if found, should be addressed to the doctor for examination:

• others often repeat what they have said twice, or even three times;
• it becomes difficult for you to control a conversation with the participation of several interlocutors;
• a feeling is created that those around you deliberately try to speak quietly, so that you do not hear;
• it becomes difficult to distinguish the conversation against the background of ambient noise, or with a large crowd of people (in a cafe, at a meeting, in the subway);
• it is especially difficult to distinguish a speech published by a child or a woman;
• when watching television, you have to make a louder sound, which often causes irritation from family members or neighbors;
• not hearing a phrase, you often ask again, or answer at random;
• in silence, there may be a ringing in your ears;
• during the conversation you follow the lips of the speaker, so as not to be mistaken in what has been said.

Lowering of auditory capabilities is often accompanied by nervousness and irritability:

• you get tired of excessive auditory strain when trying to understand the conversation of others;
• You show discontent with the interlocutor that he speaks too softly to you;
• Avoid contact with strangers, because you are afraid that you will not understand their speech;
• previously rich communication gradually develops into a kind of seclusion, when you deliberately avoid talking.

[8], [9], [10], [11], [12], [13]

Forms

Hearing loss in one ear

Deteriorating hearing to one ear can happen for several reasons:

1. Accumulation of sulfur in the left or right ear canal is the result of the secretory function of the sulfuric glands on the background of insufficient compliance with the rules of hygienic care of the ears. Lowering the hearing can be accompanied by a feeling of foreign object in the ear, increased perception of one's own voice in one ear, or an ear noise. Symptoms may increase gradually, but sometimes suddenly, for example, after water enters the ear.
2. Blood flow disorder in the arterial vessel of the labyrinth is usually a consequence of spasm, thrombus formation or hemorrhage in the brain. The decrease in hearing as a result of vascular pathology is usually characterized by an unexpected and one-sided appearance. It can be accompanied by an involuntary movement of the eyeball from the side of the lesion (nystagmus) and dizziness.
3. Traumatic impact on the hearing organ - can occur due to a mechanical cause (impact in the ear or head region), acoustic (sudden strong sound near one ear) or as a result of electroporation. The disease can be accompanied by pain in the affected ear, dizziness and difficulty with maintaining balance. Sometimes there are disorders of the autonomic nervous system.

Less often, the defeat of one ear is observed as a complication of infectious pathologies (bacterial and viral diseases).

[14], [15]

Perceptual hearing loss

The reason for hearing loss perceptual type may be a violation in the inner ear or along the nerve pathways. And in the first and second cases there is a normal transmission of the sound pulse through the tympanic membrane to the inner ear. In the place of detection of pathology, there are two types of perceptual hearing loss:

• neurosensory impairment (or cochlear) - develops with weakening of the function of ciliated structures in the inner ear. The snail's ability to transform information about a sound signal that comes from the middle ear, into excitation waves that are transmitted to the brain via the auditory nerve, is lost. Sometimes neurosensory hearing loss can be observed only at a certain interval of high sound frequencies: this variant of hearing loss speaks of the defeat of only those ciliated structures that are located at the base of the cochlea;
• Retrocochlear hearing loss - develops due to the abnormality of the auditory nerve, that is, when the function of the inner ear is not disturbed (sound information is processed), but there is no possibility of transmitting an excitation wave along the auditory nerve to the brain.

Factors for the development of perceptual hearing loss may be the physiological age processes in the inner ear, mechanical and acoustic traumatic effects, or some inflammatory pathologies (meningitis, etc.).

The perceptive type of hearing loss is prone to progression and irreversibility, which in time may require the use of a hearing aid, or the operation of installing a cochlear implant.

Hearing loss after otitis

Deterioration of hearing can progress for a long time in the chronic form of otitis, or occur unexpectedly and abruptly, sometimes for several hours, with acute purulent otitis media. After otitis, hearing in both the ear and the two can worsen. Why is this happening? The reasons can be different:

• continuous violation of the integrity of the tympanic membrane (perforation);
• a large number of sulfur or purulent discharge in the ear canal, as well as epithelial tissue scales;
• spread of the inflammatory process to the auditory nerve.

Running purulent otitis can provoke the formation of dense structures of connective tissue, as well as adhesions, accretions, which in the future may require surgical intervention.

Hearing loss after otitis media may be caused by some medications with ototoxic effect: these are usually antibiotics of the aminoglycoside group (gentamicin, neomycin, etc.), streptomycins, salicylates, quinine and some diuretics. If during the treatment by one of the listed agents you have felt a noise in the ear and a worsening of hearing, you should immediately stop using the ototoxic drug and consult a doctor.

Hearing loss in the child

Causes of hearing impairment in a child can be many. Practically 50% of congenital pathologies of hearing are connected with hereditary diseases. 

Hearing loss in old age

The age-related deterioration of hearing initially affects the perception of high-frequency sounds: the patient reacts without change to domestic noise, but begins to hear worse, for example, bird trills. Similarly, the male voice is heard better and more clearly than the female voice.

Rumor does not drop immediately, and for a long time you can not pay attention to it. Noticeable violations are manifested, as a rule, after 60 years of age. Most often this is expressed in the complexity of communication among the general noise: in the supermarket, in the market.

What can cause such age changes? This is a natural process of aging of the auditory organs, which are responsible for receiving audio signals. In the course of time, the resected structures lose sensitivity and cease to fulfill their function. In addition, some changes are also observed in the areas of the brain responsible for the perception of sound information.

His contribution to the development of hearing loss in old age is also contributing diseases:

• atherosclerotic changes in blood vessels;
• heart failure;
• vascular pathologies due to hypertension or diabetes;
• viral and bacterial diseases (acute respiratory viral infection, influenza).

Often the deterioration of hearing in old age is formed in youth: work in a noisy room, in production, near noisy machines and machines. Deterioration increases over several decades, until there is a combination of professional violations with age.

Degrees of hearing loss

Hearing impairment may differ in the degree of severity of the process. This degree is determined by a special audiometric study, the essence of which is as follows:

• with the help of headphones, the patient is given multifrequency signals;
• if the patient hears a sound of up to 25 decibels, then his auditory perception is assessed as normal;
• if the sound has to be amplified to 40 decibels, so that the patient hears it - then there is a slight decrease in hearing;
• a deep decrease in hearing is the amplification of the sound signal up to 90 decibels or more.

With a deep degree of hearing loss, a person will not simply not hear the conversation, but will not even react to the noise of a running engine in a motorcycle.

There are the following degrees of hearing loss:

• the norm is from 0 to 25 decibels;
• I Art. - from 25 to 40 decibels;
• II century. - from 40 to 55 decibels;
• III century. - from 55 to 70 decibels;
• IV century. - from 70 to 90 decibels;
• total deafness - more than 90 decibels.

[16], [17],

Sharp hearing loss

Sharp deterioration of hearing occurs due to damage to sound-conducting, or sound-sensing receptors.

Causes of damage to the sound-conducting system are the accumulation of sulfur secretions, obstruction of the ear canal, traumatic and inflammatory processes of the middle ear.

A sharp decrease in the sound-perceiving function may be caused by damage to the vessels of the cochlea or a viral disease.

The most common factors are the development of a sharp decrease in hearing:

• sulfur plug - represents a gradual accumulation of sulfur secretions in the region of the membranous cartilaginous part of the external auditory canal. In this case, the hearing can be normal until the time when the minimal gap between the body of the cork and the auditory cancool closes. Most often, this closure is accelerated by ingress into the ear passage of water;
• Arterial blood flow disorder of the labyrinth - usually associated with acute cerebrovascular disease of the brain (consequence of spasm, hemorrhage or thrombosis);
• infectious pathology of the anterior-cochlear nerve is a disease provoked by the activity of a viral or bacterial infection. Most often this condition can develop with influenza, SARS, measles, chickenpox, meningitis, etc .;
• traumatic lesion of the pre-door and cochlear organ - develops due to mechanical, acoustic, barometric or electrical effects. Traumatic damage can include the damage to the tympanic membrane, which is most often the result of inaccurate manipulations when cleaning the ear canal. The cause may also be the action of caustic liquids and temperature changes;
• the defeat of the auditory nerve by the action of ototoxic drugs - is most often associated with the use of streptomycin.

Decreased acuity of hearing

The degree of acuity can depend on innate abilities, on the observance of hygienic rules for caring for the ears and for many other reasons. Children's hearing organs do not differ in structure from adults, but the acuity of hearing in a child is somewhat worse. It improves with time, up to 15-18 years of age. But the limit of audibility of sound fluctuations in children is higher than that of an adult.

But the acuteness of the musical ear depends more on the innate abilities and possibilities. If the child is not deprived of a musical ear, then from infancy he can easily distinguish the height of the sounds, and sometimes even determine the tone. Such a rumor is said to be absolute. However, this ability of the child must be maintained and developed.

Deterioration often depends on the observance of hygienic rules for the care of the auditory organs. For example, when the external auditory canal is filled with sulfur secretions (stoppers), the acuity of hearing can be significantly reduced: sound directed to the eardrum is delayed by accumulations of sulfur and weakens, or even does not reach the goal. To prevent this, it is necessary to regularly cleanse the auditory passage from internal secretions.

[18], [19]

Diagnostics Hearing loss

In order to assess the possibility of treatment for hearing restoration, it is necessary to first carry out a diagnosis that will allow us to understand in which specific department of the hearing aid the pathology has arisen, and for what reason.

Most often, the diagnosis of a patient suffering from hearing impairment consists of the following series of procedures: carrying out a tuning fork, impedance and threshold audiogram. Based on the results of the study, appropriate treatment will be prescribed.

1. Camerontal test. The sound of the tuning fork is applied by the doctor to the central part of the patient's head, after which it specifies which side of the sound vibration or vibration is heard better. Such a test provides the physician with information about the side of the lesion and the affected conduction, either by air or by bone.
2. Threshold audiometry. This method indicates an increase in the auditory threshold in the patient, allows one to assess the depth of hearing loss relative to the frequency range.
3. Impedanceometry. A diagnostic study providing an opportunity to assess the condition of the middle ear, responsible for the passage of sound aerial excitations. The method makes it possible to detect the contractile activity of the auditory musculature and to determine the threshold of the acoustic reflex, including the boundary of discomfort, and also to distinguish pathologies of the inner and middle ear, and to monitor the state of the auditory nerve.

Before conducting diagnostic procedures, it is advisable to stay in relative silence for 16 hours before the start of the study. If the procedure is carried out with the use of headphones, it is desirable to remove glasses, massive earrings and other accessories that may interfere with the proper location of the device.

In addition to the above procedures, it is possible to assign vestibular tests that will help to detect problems with the inner ear, affecting balance and coordination of movements.

[20], [21], [22]

Treatment Hearing loss

Treatment of hearing loss is usually medication, depending on the causes that caused the disorder.

Prevention

Prevention of hearing loss carries some rules that will protect your hearing organs from damage.

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Forecast

If there is a sharp decrease in hearing, if the treatment is started in a timely manner, the prognosis is favorable: about 80% of such cases end with recovery, hearing completely, or almost completely restored.

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