Who among us has not experienced a feeling of confusion and helplessness when, for some reason, we could not hear the words of our interlocutor? Hearing loss is a serious detriment to a full life, because we receive the vast majority of information about the world around us through our ears. A healthy person is able to recognize over 400,000 different sounds. Hearing loss significantly reduces a person’s quality of life and complicates his speech communication.
In Russia today there are about 13 million people with poor hearing. 14% of the world's inhabitants over the age of 30 begin to experience these problems. After the age of 60, 30% of the adult population of the planet suffers from hearing loss.
1 Audiometry in MedicCity
2 Flushing the ear canals
3 Diagnosis of hearing loss in MedicCity
Degrees of hearing loss
Hearing loss refers to any weakening of hearing. There are 3 degrees of hearing loss:
- mild hearing loss (the hearing threshold rises to 40 decibels, speech differs at a distance of 4-6 meters);
- moderate hearing loss (hearing threshold from 41 to 50 decibels, a person perceives spoken language at a distance of 1 to 4 meters);
- severe hearing loss (hearing threshold up to 70 decibels, spoken speech can be heard from a distance of 1 meter).
Obstructive wax plugs
This is perhaps the safest cause of hearing loss.
As a rule, sulfur can lead to a sharp decrease in hearing in one or two ears after contact with water. As a result, the sulfur masses swell and completely block the external auditory canal.
In this situation, in addition to a sharp decrease in hearing, pain in the ear may occur. It is necessary to contact an ENT doctor as soon as possible, since delay can lead to the development of inflammation, namely external otitis.
Treatment
During the examination, the ENT doctor will immediately determine the presence of sulfur plugs, remove them, and hearing will be instantly restored.
Sensorineural (sensorineural) hearing loss
Sensorineural ( sensorineural ) hearing loss is characterized by damage to sound-receiving organs and the death of hair cells that transform sounds into neuroelectric impulses.
The main symptom of sensorineural hearing loss is hearing loss. Often occurs after an acute respiratory viral infection, psycho-emotional stress, or intoxication. It can affect either one ear or both at the same time. A very common symptom of this disease is noise in the ear: it can be either high-frequency (ringing, squeaking, “buzzer,” “hissing”) or low-frequency (hum). Such phenomena require immediate medical attention. A doctor who suspects sensorineural hearing loss needs to perform tuning fork tests. To verify the diagnosis and accurately determine the degree of hearing loss, a hardware test is performed - pure tone threshold audiometry. Without treatment and prevention, the disease progresses and leads to complete deafness.
Clinical forms of sensorineural (sensorineural) hearing loss
Sudden hearing loss
Sudden hearing loss can produce symptoms of conductive, sensorineural and mixed hearing loss, depending on the cause. If hearing has been impaired as a result of exposure to noise, the person first loses the ability to hear sounds of certain frequencies (about 4000 Hz), and then becomes less and less able to distinguish sounds of all frequencies.
A person can lose their hearing suddenly over a period of hours or even minutes. As a rule, infection is to blame for hearing loss. Patients with this disorder compare their sensations to a broken telephone wire: a sudden onset of silence. As a rule, the disease of this form is unilateral. It is necessary to urgently consult a doctor. When assistance is provided in the first days of the disease, hearing can be restored in more than 90% of cases.
Acute hearing loss
A week has passed since the man lost his hearing. The probability of hearing returning at this stage is 70-90%. If the clinical picture persists for 1-3 months, then we can talk about subacute hearing loss.
With subacute hearing loss, a person feels fullness in the ears, which becomes permanent. Against the background of tinnitus, the patient begins to feel that he is beginning to hear worse and worse. Of course, the time to restore hearing has already been lost a little, but you still need to see a doctor. Otherwise, hearing loss may develop into a chronic form.
Chronic hearing loss
The duration of the disease is more than 3 months. It is characterized by the fact that even with existing hearing loss, a further decrease in hearing occurs, accompanied by tinnitus. Periods of hearing deterioration may alternate with periods of slight remission. The likelihood of complete hearing recovery at this stage is extremely low. However, courses of maintenance vascular therapy can prevent further hearing loss.
There is also senile hearing loss (presbycusis). related hearing loss is characterized by ringing in the ears and an inability to understand speech (ie, speech intelligibility).
1 Diagnosis of hearing loss in MedicCity
2 Diagnosis of hearing loss in MedicCity
3 Diagnosis of hearing loss in MedicCity
Deafness
Deafness is understood as either a complete absence of hearing, or such a pronounced decrease in which a person does not understand spoken speech, and the perception threshold exceeds 91 dB. Absolute deafness is a rare occurrence. More often, such a patient retains the perception of sounds spoken near the auricle, but he is not able to form words from them. It is this feature that makes it possible to distinguish grade 4 hearing loss from deaf-muteness, although audiologists admit that such a boundary is very arbitrary.
The occurrence of deafness before the child begins to speak leads to the development of deaf-muteness.
Conductive hearing loss
Conductive when the middle ear or eardrum is damaged as a result of mechanical trauma or infection.
Conductive hearing loss is a hearing impairment associated with poor perception of sounds, caused by dysfunction of sound conduction from the outer ear and eardrum to the middle ear and from it to the inner ear. That is why this type of hearing loss is called conductive – from the Latin word “to conduct”.
With conductive hearing loss, sound vibrations do not reach the main human receiving organ - the hairs of the epithelium of the organ of Corti located in the inner ear, which transmit signals to the auditory nerve.
Conductive hearing loss is characterized by reduced sensitivity in the perception of sounds, but there is no change in their clarity. It is enough to increase the volume and a patient with this form of hearing loss will hear normally. Typically, a person with conductive hearing loss speaks in a low voice and has normal ability to distinguish sounds, but has difficulty hearing when chewing.
Causes of conductive hearing loss
The causes of conductive hearing loss can be very diverse.
For example, it is often caused by wax plugs in the outer ear. Unfortunately, patients often try to get rid of such a traffic jam on their own, and often such amateur activity leads to serious injuries and inflammations, fraught with irreversible hearing loss.
Meanwhile, an experienced otolaryngologist at the MedicCity clinic can relieve you of cerumen impaction and the hearing loss it causes within a few minutes and without any discomfort.
Another common cause of conductive hearing loss is otitis externa, an inflammation in the outer ear, often accompanied by suppuration.
At the same time, attempts to treat otitis independently with the help of lotions and randomly selected medications can seriously aggravate the situation and dramatically complicate auditory perception, for a long time or even forever.
In addition, conductive hearing loss can be caused by the following eardrum-related causes:
- perforation or damage to the eardrum (may be accompanied by stabbing pain and bleeding);
- tympanosclerosis or sclerosis of the tympanic membrane is a pathological process of inflammation and degradation of the membrane tissue, accompanied by the formation of a purulent mass;
- anatomical anomalies of eardrum deformation.
These membrane conditions can be caused by injuries, thermal effects, infectious viral diseases, etc.
Sudden conductive hearing loss can also be caused by sudden changes in pressure on the eardrum, for example, when going underwater or into a mine, or when taking off on an airplane. In the middle ear, the consequences of acute and chronic otitis media - inflammation of the middle ear, as well as exudative otitis - can act as sound vibration blockers.
Finally, at the level of the inner ear, the causes of conductive hearing loss can be severe forms of otosclerosis and anatomical obstruction.
Auditory (auditory neuropathy)
With auditory neuropathy, the endings of the auditory nerve most often remain intact and can perceive surrounding sounds in full. However, as nerve impulses travel along the auditory nerve to the brain, sound information is decoded and distorted. This is why detecting and correcting this type of hearing loss is so difficult.
More information about the development of auditory neuropathy in children can be found here.
Diagnosis and treatment of hearing loss
In the department of otorhinolaryngology of the multidisciplinary clinic "MedicCity" you will quickly and accurately be diagnosed using special diagnostic procedures and first-class equipment from the world's leading manufacturers.
A special study - audiometry - is aimed at determining the degree of hearing loss. This study also evaluates the effectiveness of treatment for hearing loss. Tuning fork tests and impedance measurements are also carried out .
1 Audiometry in MedicCity
2 Audiometry in MedicCity
3 Audiometry in MedicCity
Depending on the identified factors, one or another type of treatment is prescribed: conservative (taking anti-inflammatory drugs, physiotherapy - electrophoresis, phonophoresis, etc.), surgical (for example, removal of sclerotized tissue or correction of an anatomical defect).
Special procedures are used to clean the ear in case of suppuration, plugs, etc. A very common procedure for cleaning the auditory tube is by blowing it according to Politzer, using a special balloon.
We have also developed comprehensive treatment programs for sensorineural hearing loss.
Help in
in St. Petersburg will help people with acute unilateral hearing loss choose the optimal hearing aid. We offer only proven and reliable designs that are discreet, highly efficient and have a long service life.
Reasons for contacting the center:
- long-term cooperation with the global manufacturer of hearing aids OTICON;
- the ability to conduct audiometry and consult a specialist on the day of treatment to select the best system according to its characteristics;
- adjusting the hearing aid in accordance with the level of hearing loss and the characteristics of everyday life.
Sign up for a consultation by phone or through the feedback form. We are ready to help every client, regardless of the complexity of the situation.
What to do at the first suspicion
There is only one option. With any hearing loss, a person cannot independently figure out what form of hearing loss he has, what causes its occurrence, and there is no need to do this. It is better to immediately go to a doctor - an ENT specialist or an audiologist, in order to eliminate what can be corrected, or at least slow down the pathological process.
The latter is important because the quality of life with degrees I and III of hearing loss differs significantly. For children - critical, because it affects development. The worse a child’s hearing, the less opportunity he has to develop on an equal basis with his peers.
The doctor makes the diagnosis of “mixed hearing loss” (like any other) after a series of studies. This often requires high-tech equipment and the participation of specialized professionals. Compare the capabilities of a therapist in a regular clinic somewhere in a remote area and a clinic in the MasterSlukh network, equipped with the latest technology. If the available diagnostic methods are not enough, any specialist should give directions for better research. Do you have any doubts about something? Demand a second opinion, a more thorough examination. After all, if the diagnosis is incorrect, there may be no effect from treatment or correction.
What does hearing loss lead to if the necessary measures are not taken?
If proper measures are not taken, hearing loss can affect many aspects of a person's life:
Communication and speech
Cognitive functions
Education and work: In developing countries, children suffering from hearing loss and deafness rarely receive any education. Adults with hearing loss have much higher unemployment rates. Compared to the general working population, the percentage of working deaf people in less skilled jobs is higher.
Social isolation, loneliness and stigma
Socio-economic consequences
Years lived with disability (YDL) and disability-adjusted life years (DALYs)
WHO estimates that unaddressed hearing loss costs the world $980 billion annually. This includes health care costs (excluding the cost of hearing aids), educational assistance costs, disability costs, and social costs. Low- and middle-income countries account for 57% of these costs.
Tubootitis
It is characterized by retraction of the eardrum due to a number of reasons:
- a sudden change in atmospheric pressure (for example, during takeoff or landing of an airplane, ascent on a high-speed elevator, diving under water);
- swelling in the nasal cavity due to inflammation or a vascular reaction to changes in blood pressure.
In this condition, the patient may hear a crackling sound in the ears or rustling noise when yawning or swallowing.
If your hearing does not recover on its own, you should contact an ENT doctor.
Treatment
After examination and additional examination, the doctor can perform a number of procedures to restore hearing: blowing the auditory tubes according to Politzer; pneumomassage of the eardrums; will prescribe gymnastics for the auditory tubes and, if necessary, medications. For people who often encounter this problem during air travel, we recommend using a vasoconstrictor spray in the nose 10 minutes before takeoff and 10 minutes before landing (if there are no contraindications).
Eardrum injury
There can be several causes of injury:
- blow to the ear area;
- perforation of the membrane by foreign objects (a cotton swab, a hairpin, a match, the core of a pen and other objects that are so convenient for scratching the ears);
- falling from a height, including into water;
- injury due to a sudden change in atmospheric pressure.
Treatment
During the examination, the ENT doctor will determine the fact of perforation of the eardrum, perform audiometry to exclude the development of auditory neuritis due to injury, and develop a plan for further action. In most cases, the tactic is wait-and-see. The membrane may close on its own. It is imperative to protect the ear from water and avoid air travel.
A month later, if the integrity of the eardrum has not been restored, the issue of myringoplasty (closing the defect of the eardrum surgically) is considered.
Acute serous otitis media
This causes fluid to accumulate in the tympanic cavity (behind the eardrum). A person hears “as if through water.”
The cause of the occurrence is a long course of tubo-otitis.
Treatment
During the examination, the ENT doctor will see the clinical manifestations characteristic of this condition and, if necessary, will conduct further examination. To restore hearing, blowing of the auditory tubes according to Politzer is used; pneumomassage of the eardrums; gymnastics for the auditory tubes is prescribed; catheterization of the auditory tubes and, if necessary; medications. More serious treatment may be required, including hospitalization in the ENT department.
Causes leading to hearing loss
The causes are divided into congenital and acquired. Of these, the most common ones that lead to hearing loss are:
- Injury;
- Foreign body of the ear canal;
- Acute inflammatory diseases of the external and middle ear;
- Viral infection (for example, herpes virus infection, FLU, SARS-CoV-2);
- Protracted acute otitis media (especially in people with chronic diseases: diabetes mellitus, oncology, congenital and acquired immunodeficiencies);
- Long-term pathology of the ENT organs (chronic rhinitis, adenoid vegetations, structural anomalies of the nasal cavity and nasopharynx, with dysfunction of the auditory tube, prolonged and recurrent exudative otitis);
- Genetic and congenital abnormalities of ear development, birth trauma, deep prematurity;
- The influence of ototoxic drugs (drugs that have a toxic effect on the receptor of the inner ear) and childhood infections that directly affect the organ of hearing (measles, scarlet fever, diphtheria, etc.);
- Diseases of the cardiovascular, nervous and endocrine systems and blood diseases;
- Systemic autoimmune pathology and specific infections (syphilis, tuberculosis);
- Working conditions in noise, vibration, at height;
- Long-term use of headphones (according to WHO, more than 1.1 billion young people are at risk of hearing loss due to listening to music at too high a volume level that is dangerous for hearing);
- Aging as a natural cause.
Features of hearing impairment in children
A child receives a significant part of knowledge about the world around him through the organ of hearing, therefore congenital or acquired deafness or severe hearing loss in preschool age has a negative impact on his further development. Speech, thinking, and imagination suffer the most. The child has difficulty remembering and presenting information received orally.
Children who are deaf from birth without special training remain mute; in those who are hard of hearing, speech develops late, with various distortions - inaccurate pronunciation, violation of sentence structure, confusion in the meaning of words. If hearing impairment occurs after mastering speech, its further development is difficult. The speech reserve of such children remains poor, and cognitive activity slows down.
To prevent negative consequences in children, it is necessary to restore hearing as early as possible and correct developmental deviations.
Children who received timely help are no different from their peers and can study in a regular school. Return to list
Acute purulent otitis media
It can be an independent disease or, more often, a complication of acute purulent rhinitis. Acute purulent otitis media is characterized by pain in the ear, including throbbing pain, fever, and headache.
Treatment
Upon examination, the ENT doctor will make a diagnosis and prescribe local or systemic antibacterial therapy, anti-inflammatory treatment, and, if necessary, hospitalization. After relief of inflammation, as a rule, hearing is completely restored.
Prevention
Public health strategies and clinical interventions throughout a person's life can help prevent many of the causes of hearing loss.
Prevention of hearing loss is necessary throughout life – from the prenatal and perinatal periods to old age. In children, nearly 60% of hearing loss is due to causes that can be prevented through public health measures. Likewise, the most common causes of hearing loss in adults, such as exposure to loud noises and ototoxic drugs, can be prevented.
Effective measures to reduce the incidence of hearing loss, taken at different stages of a person's life, include the following:
- immunization;
- effective protection of maternal and child health;
- genetic counseling;
- identification and management of the most common ear diseases;
- programs to protect hearing from exposure to noise and chemicals at work;
- strategies to promote safe listening to reduce exposure to loud noise during entertainment activities; And
- Correct use of medications to prevent hearing loss caused by ototoxic drugs.
