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Home >> Hearing Loss  

 Hearing Loss

Some hearing loss is a natural part of aging. The eardrum stiffens with age, reducing its ability to vibrate. Age related changes to the bones in the middle ear, such as degeneration of joints and calcium deposits in those joints, causes the middle ear system to become stiffer, resulting in less effective transmission of sound. Over time, irreplaceable hair cells in the inner ear are damaged by a combination of aging, noise exposure, medication, decreased blood supply to the ear and infection. And once hair cells are damaged, the auditory nerve becomes less efficient. But most of those changes do not occur until a man is in his late forties and early fifties.

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Normally sound enters your ear canal and strikes the eardrum, a cone shaped elastic membrane stretched across the end of the canal. As the ear drum vibrates, it causes tiny bones in the middle ear to move back and forth. These movements trigger small waves of fluid in the inner ear that ripple through a snail-shaped organ called the cochlea. Inside the cochlea, 30,000 hair-like cells transmit to the auditory nerve, which carries the sound to the brain. There, they are interpreted and then you respond.

If symptoms of hearing loss appear at an earlier age, the cause could be something as simple as excessive earwax or the very rare side effect of medication. It can also be caused by a shattered eardrum, a head injury, high blood pressure, ear infection, meningitis, or a tumor. Some types of hearing loss occurs in families, such as otosclerosis, a disease that causes excessive bone deposits in the middle ear and prevents it from conducting sounds to the inner ear.

The most common cause of hearing loss in adults under age 50 is excessive noise exposure. There are no continuous loud sounds such as rock concerts or jackhammers in nature. Our ears are very sensitive, so our ancestors could hear a twig snap, which might have meant that food or danger was nearby. So when you go into a noisy environment, you are putting yourself into an environment that your ears were simply not designed to handle. It is advisable for high-decibel musicians and fans to turn down the volume and wear earplugs.

Sudden loud noises close to the ear, such as firecrackers or gunshots, can cause immediate hearing loss. But usually, noise-induced hearing loss happens gradually, over years. In general the longer you expose yourself to sounds louder than 85 decibels, whether it is a rock concert or a leaf blower, the more likely you are to harm the inner ear and damage your hearing.

Hearing loss occurring at younger ages is more prevalent than is generally thought. Overall, about 13 million men have significant hearing impairment, and at least 4.2 million of those men are under the age of 45, according to the American Speech-Language-Hearing-Association. Men seem to develop hearing problems more often than women, and in most cases, those with hearing loss first notice the problem because they keep missing the higher tones of voices or musical instruments. As the auditory nerves deteriorate with age, one ear may be more affected than the other. So an older person may prefer to use one ear more than the other to talk over the telephone. Or he may cock his head, so that he can pick up sounds and voices better with his good ear.

The toll of hearing loss is enormous. It can lead to social isolation, limit your job prospects, complicate your sex life, rob you of your self-esteem and make you feel as if life's parade is passing you by.

  1. An inability to understand conversation that others seem to understand with ease.
  2. A sense that many people are talking with slurred speech or in a mumbling manner.
  3. A need to strain to hear words or sounds because they often seem rather faint.
  4. An inability to hear high notes of musical instruments, or sharp, staccato sounds such as a dripping of a faucet.
  5. The presence of constant ringing or hissing sound in the ears.
  6. An inability to follow what is being said or played in movies, concerts, television presentations, or other cultural or social events.
  7. Recurrent suggestion by friends or relatives that you may have a problem with hearing. If you have encountered any of these situations check it out with your doctor.

These can be graded in one of three general categories:

  1. Presbycusis
  2. Conduction deafness
  3. Central deafness

Most hearing loss that occurs with age results from changes in tissue structure, a deterioration of special cells in the inner ear. This form of deterioration, which is known as presbycusis, makes sounds fainter and may cause older people to have difficulty in understanding speech. Ironically, the condition may also make them more sensitive to loud noises. Most of us begin to lose hearing ability bit by bit after the age of fifty as a result of this deteriorative process. Presbycusis may be aggravated by exposure to loud noises, certain drugs, improper diet, or genetic factors. The hearing loss associated with presbycusis can be worse in those suffering from thyroid disorders, diabetes, atherosclerosis (hardening or clogging of the arteries) and hypertension.

Only your physician or an E.N.T. specialist will be able to sort through all the possible contributing factors to your hearing loss and prescribe appropriate treatment. Some of the possible treatments that have been prescribed for presbycusis have included vasodilators, B-complex vitamins, nicotinic acid (one of the B-complex vitamins) alone, and a variety of drugs and other preparations. But unfortunately, these approaches. usually do not work. In the present time, there is no really effective way to treat presbycusis medically or surgically. The only recognized approach that may help significantly is a hearing aid, a mechanical device that we will be discussing in more detail later.


The problem is that over a period of months or years, wax gets built up in the ears to the extent that it might be as wearing earplugs. Exceptionally hairy external ear canals can naturally prevent wax from falling out of the ears. Irrigation of the ears with lukewarm water is all that is necessary for restoration of hearing. Sometimes, it is not possible to remove the wax build­up with syringe and water because the patient may have a damaged tympanic membrane or eardrum. Also, if there is an infection in the ear, antibiotics and other medications, or even surgery may be required. In addition, some people have bony protrusions in the ear canals that aggravate wax build-up. Manoeuvering around these obstructions may require more complex treatment procedures.


Hearing centres in the brain may be damaged by a mild stroke. Sometimes, the auditory nerves and the hearing centres in the brain can be damaged by infections, lengthy exposure to loud noises, use of certain drugs, head injuries, circulatory problems or tumours. The treatment generally depends on the causative factor.

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