Hearing loss (or hearing loss) means hearing loss: it occurs when a component of the ear or ear system does not work properly.


Types of hearing loss (or hearing loss)

1) Transmission Hearing Loss  – Each problem of the outer ear or middle ear that prevents proper conduction of sound is known as “loss of auditory transmission capacity”.

They are usually mild or moderate, between 25 and 65 decibels, and may also be temporary.

2) Sensorineural hearing loss – born from:

  • A loss or lesion of the ciliated sensory cells of the cochlea,
  • An acoustic nerve injury.

It is usually deep and permanent.

The sound comes as normal to the inner ear, but here the problems mentioned above do not allow the sound information to be sent correctly to the higher nerve centers. 
It is also known as “sensorineural deafness,” and may be:

  • Light,
  • Moderate,
  • Grave,
  • Deep

Often these patients use implantable hearing aids or systems for the middle ear.

3) Perceptual hypoacusia occurs when there is a defect in the apparatus that receives and processes the nervous signals in the brain.

4) Mixed deafness  – Mixed hearing loss is both conductive and sensorineural.


Classification of hearing loss

Hearing loss can also be classified into degrees:

  • Light hearing loss (hearing loss included between 20 and 40 decibels) – The patient with a mild hearing loss perceives most speeches, but soft and light sounds are difficult to hear.
  • Moderate hypoacusis (40-70 db) – The patient with moderate hearing loss has great difficulty understanding a person who is speaking with a normal tone of voice.
  • Severe Hearing Loss (70-90 db) – These patients do not understand what a person with a normal voice level says, they hear only a few loud sounds.
  • Deep hearing loss (> 90 db) – The patient with a profound hearing loss does not notice any speech, but only some very strong sounds.

Hearing loss can be:

  • Unilateral or bilateral
    Hypoacusia is unilateral when it occurs only in the left ear or only in the right ear. 
    Hearing loss is bilateral when it affects both ears.
  • Pre-lingual or post-lingual
    Hypoacusia is called  pre-lingual if it is diagnosed before a person has learned to speak or is called a  post-lingual  if it appears later.
  • Symmetrical or asymmetric
    The hearing loss is identical in both ears or is different in each ear: we speak respectively of symmetrical hearing loss and of asymmetrical hearing loss .
  • Progressive or sudden
    Hypoacusis worsens over time gradually or occurs suddenly, suddenly.
  • Floating or stable
    Hypoacusis has improvement and worsening over time, or always remains stable.
  • With congenital or acquired
    origin Hearing loss is present at birth or appears later in the patient’s life.


Causes of Ear Loss

Old age and loud noises are the most common causes of hearing loss.

The age is a major cause of hearing loss: hearing loss increases as you get older, at the age of 80 years most people have significant hearing problems. 
Hearing loss in the elderly occurs when the hair cells within the cochlea gradually die or become injured again: this type of hearing loss is known as sensorineural hearing loss. 
The first sounds that these patients no longer notice are those in high frequencies (acute), such as the voices of women or children, but it is also more difficult to hear the consonants. 
Low-frequency sounds are picked up more easily.

Another frequent cause of hearing loss is ear injury caused by repeated exposure to loud noises over time: the hair cells within the cochlea are impaired, it is sensorineural hearing loss. 
May occur

  • In people who work with noisy tools (occupational disease).
  • After many nights at the disco.

Neurosensory hearing loss may also be caused by:

    • Genetic Deafness – Some people are born or become deaf over time due to genetic anomaly, even if familiarity does not always exist.
    • Viral infection of the inner ear – for example mumps or measles virus.
    • Auditory nerve infection– caused by mumps virus or rubella virus.
    • Rhino-tubal deafness – results from inflammation of the upper respiratory tract (nose and throat), in children occurs along with  tonsillitis or swelling of the adenoids.
    • Ménière Syndrome – a person suffers from dizziness , tinnitus ( ringing in the ears) and has the sensation of a swollen and clogged ear, while hearing loss tends to vary over time.
    • Usher Syndrome – is a genetic disorder that causes deafness, loss of visionand in some cases, serious problems of balance.
  • Acoustic neurinoma – is a benign tumor of the lining of the acoustic nerve.
  • Meningitis – is an infection of the protective membranes around the brain and spinal cord.
  • Labirintite – is an inflammation of the labyrinth and semicircular canals of the ear, causes vertigo, hearing loss, tinnitus, nausea and vomiting .
  • Encephalitis – is an inflammation of the brain.
  • Multiple sclerosis – is a neurological disease that affects the central nervous system.
  • Stroke – The blood supply to the brain is disrupted, this can affect the primary sensitive areas of hearing. Obstruction of the internal auditory artery may cause mild zonal hearing loss or ischemia of the labyrinth that causes deafness.

The most common causes of transmission hearing loss are mechanical obstruction of the ear canal (eg, excessive wax ), fluid buildup, or middle ear infection.

There are other more rare causes of hearing loss:

  • Perforated eardrum – the eardrum is impaired or has a hole.
  • Otosclerosis – is an abnormal growth of the bones of the middle ear that causes a hypomobility of the stirrup and a consequent less effectiveness in the transmission of sounds.
  • Damage to the ossicular chain caused by head trauma (for example, a slap), rupture of the tympanic membrane, or a cholesteatoma , ie an abnormal mass of epithelial cells within the middle ear, is very rare .
  • Prolonged use of the headset is a youthful problem that is appearing. 
    In recent years there has been an alarming increase in hearing loss among young people, the problem seems to have been exacerbated by the increasing and continuous use of headphones to listen to music.

Generally, transmission hearing loss is temporary and is treated with medications or with minor surgery.

Temporary hearing loss

There are several causes that cause temporary hearing loss: most are reversible after proper treatment. 
Some of the most common are:

Wax build-up Wax
production in the ear is a natural process, but sometimes the wax builds up in the ear canal and prevents sound waves from reaching the eardrum.

Middle Ear Infections
Most likely to occur if the patient is suffering from a cold or has a fever : under these conditions it is easier for the phlegm to accumulate and invade the Eustachian tube that connects the ear and throat. 
The consequence is an otitis media  in which even a tear or rupture of the eardrum can occur, the patient feels pain and may have loss of blood or ear pus.

Pressure change
Traveling by plane, some people suffer from temporary hearing loss due to the difference in pressure between the middle ear and atmospheric pressure that is not effectively counterbalanced by the Eustachian tube.

Exposure to loud sounds

Injuries . For example, a head or ear injury.

Other causes:

  • Narrowing of the auditory canal
  • Surgical complications
  • Foreign bodies or ear tumors
  • Congenital defects.


Unilateral deafness

Hearing loss in one ear or “unilateral deafness” is a hearing disorder in which a person is able to hear normally with one ear, but hears nothing with the other ear. 
The deafness of only one ear can be sudden, for example, a person will sleep with a normal hearing function and wake up the next morning with a complete loss of hearing in one ear.

There is no single cause for this pathology: some children are born with unilateral deafness, while in others it is caused by complications that occur during pregnancy . 
In adolescence, this disease is caused by:

In some cases it looks like a hereditary disease, while in adults the most common causes are:

  • Severe infections,
  • plug of wax in the ear canal,
  • A trauma.


Hypoacusis in children

Childhood hearing loss may be:

  • Neurosensory : due to congenital factors such as toxoplasmosis, rubella, CMV, herpes or syphilis , genetic factors, specific syndromes, low birth weight, noise or ototoxic drugs.
  • Conductive : is caused by abnormalities in the formation of the external ear, the eardrum, the ossicular chain or the middle ear.
  • Acquired : It is most often caused by an excess of wax in the ear canal, a foreign object in the ear, cancer, problems with the Eustachian tube, acute and / or chronic otitis and tympanic perforation.


Symptoms of hearing loss

The earliest signs of hearing loss are:

  • Difficulty in clearly hearing what others say
  • The patient often asks people to repeat what they say
  • Listen to music or watch high volume television
  • Difficulty hearing the telephone or the house bell
  • Patients often feel tired or stressed because they concentrate excessively to listen to other people.

Treatment for hearing loss or hearing loss

First of all it is a consultation with an otolaryngologist who performs some tests (for example, the audiometric exam) to find out the cause and define the most appropriate treatment. 
The treatment depends on the type of hearing loss that the patient has:

  • * Surgery improves hearing loss caused by otosclerosis or by excessive scarring in the ear,
  • * Ear infections are most often treated with an antibiotic and, in more severe cases, with surgery.
  • * Meniere’s syndrome is cured with a specific diet and medications.

Hypoacusis is also caused by the use of particular medications , in these cases we advise the patient to consult his doctor to choose an alternative drug treatment.

In any case, rapid treatment for sudden hearing loss significantly increases the patient’s chances of recovery. 
In case of sudden hearing loss caused by damage to the nerves of the ear, if the patient does not have contraindications, it can achieve good results with the hyperbaric chamber that increases the concentration of oxygen in the blood.

Patients with permanent hearing loss need to learn how to effectively use residual hearing capacities: most of these patients benefit from a hearing aid , even if it is used only by one person in five. 
Hearing aids are small tools normally used inside or behind the ear, making the sounds louder and clearer for the patient. 
Often the sounds are different when listening through a hearing aid, so it is important to talk to your doctor to set realistic goals for hearing loss recovery.

There are some new technologies that make it possible to improve the perception of the sounds of patients suffering from hearing loss: new auricular devices tune the patient to what he wants to hear, silencing the other superfluous sounds.

There are also devices that make the radio or television audible to the patient without increasing the volume too much, in addition some sound amplification devices have  been designed specifically for the home and cell phones and serve to listen better and more clearly the conversations. 
In the end, cochlear implants are used especially in young children, but are becoming more and more popular among adults with a profound hearing loss.

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