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Hearing management

23 May 2018

Are you going deaf or do you just need to unblock your ears?

When faced with hearing loss, it is important to know if the situation is permanent or if it can be reversed.

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Hearing loss can go unnoticed for years and can originate in the ear, in the sound-processing areas of the brain, or a combination of the two.

The situation is often reversible, as for example when the problem is caused by a temporary blockage in the ear canal.

When confronted with hearing loss, one of the first questions asked by patients is whether the situation is permanent or temporary.

Temporary hearing loss: causes and solutions

If hearing loss is temporary, people might want to know how long it will last and if there's anything they can do to help restore their hearing. There are a number of things that can cause temporary hearing loss, including: 

1. Noise-induced hearing loss

Exposure to noise louder than 85dB can temporarily damage your hearing depending on the noise level and proximity to your ear.

  • If the source of the noise cannot be avoided, wearing hearing protection devices (HPDs) such as earplugs or earmuffs may help protect your hearing.

2. Blocked ear canal

If there’s something blocking your ear canal, it will affect your hearing. This may be due to earwax, allergies, a cold or flu, swelling caused by an ear infection, fluid in the middle ear or a physical object in the ear canal.   

  • The role of earwax is to protect the middle and inner ear from germs and other threats. Sometimes, however, it builds up, blocks the ears and impairs hearing. You can try over-the-counter earwax removal drops, or if that doesn't work a doctor can remove the wax with special tools.
  • Colds, flu and allergies can affect hearing, usually in the form of a clogged feeling in the ears. Although annoying, the problem normally resolves itself.
  • According to a Health24 article, middle ear infection (otitis media) is an inflammation or infection of the middle ear. The most common cause is an upper respiratory tract viral infection when viruses travel to the ear. The Eustachian tube becomes so swollen that middle ear ventilation is impaired, the area becomes inflamed, and infected, and pus accumulates behind the eardrum. Otitis media usually resolves spontaneously, but most doctors will attempt to cure middle ear infection by means of an antibiotic such as amoxicillin.
  • Young children may insert objects into their ears, which can interfere with hearing. These objects usually make their own way out of the ear, but if they don't or if there's swelling, bleeding or pain, it is advisable to seek medical assistance. 

3. Otoxic (toxic to the ear) medication

Some medications, like antibiotics and radiation or chemotherapy, can cause temporary hearing loss, tinnitus (ringing in the ear) and balance disorders.

  • These problems may be reversed when medication is discontinued.

Test for severity 

Hearing tests are performed to determine how severe the loss is and where the problem lies.  

According to the World Health Organization:

  • Worldwide 360 million people suffer from disabling hearing loss.
  • There are numerous causes of hearing loss.
  • Half of all cases of hearing loss are avoidable by means of primary prevention.
  • People with hearing loss can be assisted with hearing aids, cochlear implants and other assistive devices; captioning and sign language; and other forms of educational and social support.
  • Current production of hearing aids covers less than 10% of global requirements.

Permanent hearing loss

If the situation cannot be reversed, the foremost question on most patients' minds is if their hearing loss will get worse, and if they will become completely deaf. 

According to the Marin Hearing Center, the six main causes of permanent hearing loss are:

1. Loud noise

A single loud bang may permanently damage your hearing in an instant.

Repeated exposures to loud noise may damage your hearing over an extended period of time, damaging the delicate hair cells in the inner ear. This may lead to permanent hearing loss and tinnitus (ringing in the ears).

2. Ear infection

Otitis media (inflammation of the middle ear) is the most common cause of hearing loss in children and can also affects adults. Damage from an ear infection can cause chronic or permanent hearing loss.

3. Ageing

Presbycusis is the gradual loss of hearing that occurs as people grow older. The loss is usually greatest in the case of high-pitched sounds.

4. Injury to the head or ear

A blow to the head may cause permanent loss of hearing by changing the position of the three bones of the middle ear (ossicular dislocation), a ruptured eardrum, or damage to the delicate nerves in the inner ear or the brain.

5. Birth defects or genetics

Hearing loss is one of the most common birth defectsbut can also develop later in life. Genetic factors are believed to cause about 50% of cases of congenital hearing loss. Illnesses that can cause congenital hearing loss include infections during pregnancy, such as German measles, cytomegalovirus, toxoplasmosis, herpes or syphilis.

6. Reactions to drugs or cancer treatments

Certain medications, like antibiotics, chemo- or radiation therapy, can damage the ear, resulting in hearing loss, tinnitus or balance disorders. There are more than 200 known ototoxic (damaging to hearing) drugs on the market. These problems may be reversed when medication is discontinued, but sometimes the damage is permanent.

When to see your doctor

Hearing loss is permanent when it cannot be corrected by surgery or medication. Permanent hearing loss mostly originates in the inner ear and is called sensory neural hearing loss. The best way to cope with permanent hearing loss is to get a hearing aid.

No matter what the cause, hearing loss should never be ignored. Consult an audiologist as soon as you start to experience any problems with your hearing.

Image credit: iStock

 

Ask the Expert

Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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