If I had a dollar for every time I said, “What?” when someone speaks to me, I could have retired ten years ago. Of course, I’m older than 40 now, and the great relief is that some loss of hearing is expected once you get to the fourth decade. The official medical term for this is “presbycusis”: presby=old and cusis=hearing. If you are younger than forty and have trouble hearing, there may be something else going on.
How exactly do we hear? Hearing is a matter of fluid, air, ear structures, and nerves all working together to get sounds into our brains so that they can be interpreted and make sense to us. Conduction is the ability of sound waves to travel through the air, into the ear canal, through fluid, and to the acoustic nerve. Between the ear canal and the middle ear is the ear drum. Just like a musical drum is a piece of skin stretched over a circular frame, so is the ear drum. As sound hits it, the ear drum vibrates, tickling three little bones in the middle ear. These bones send sound energy through fluid to the inner ear. There are millions of little hairs that move, sending signals to the acoustic nerve, and that nerve transmits signals to the brain. The brain works like a computer to interpret what the sounds mean, where they are coming from, how loud they are, etc. Pretty amazing stuff, right?!
What are the symptoms of hearing loss? According to the National Institutes of Health, symptoms of hearing loss may include: certain sounds seeming too loud; difficulty following conversations when two or more people are talking; difficulty hearing in noisy areas (background noise); trouble telling high-pitched sounds (such as “s” or “th”) from one another; less trouble hearing men’s voices than women’s voices; hearing voices as mumbled or slurred; ringing or buzzing sound in the ears (tinnitus).
What can cause these hearing loss symptoms? If there is a blockage anywhere along the way, hearing may be diminished. This can happen regardless of age. For example, if you begin to notice over time that your hearing isn’t quite what it used to be, you might have a blockage. Why do they keep selling cotton-tipped ear cleaners when every health care provider in America tells you not to use them? And why do they always tell you that, anyway?
Well, when you insert those little cotton-tipped sticks into the ear canal, two things can happen. One is that the cotton may slip off the end of the stick and stay in your ear canal. Some people don’t realize that has happened and there it stays. The other is that, instead of taking ear wax out, you are actually forcing it to form a lump that is difficult to remove. Over time, it hardens and, meanwhile, you keep cleaning your ears with those little devils. When you finally are seen by a health care provider who looks into your ear with a light, a big old chunk of ear wax is staring back at her/him. The good news is that removal of ear wax is generally easy enough to do and not terribly uncomfortable. And, WOW! What a difference once it’s gone!! You can hear again immediately. So, bottom line – if you must use a cotton-tipped ear cleaner, don’t put it all the way into your ear.
Extra fluid in the middle ear and/or inflammation can also affect the way you hear. This may occur as a result of an ear infection, allergy, or from the common cold. Ear infections are not common in adults, but when they occur they are generally caused by viruses and will clear up on their own. Sometimes that buildup of fluid can cause some pain. Taking some over-the-counter medication for pain can keep you comfortable as your body takes care of fighting off the virus. Antibiotics will not help you when you have a virus. If you are having trouble because you have allergies, make sure to take your antihistamines, but buy the generic. Cetirizine (Zyrtec), fexofenadine (Allegra), or loratadine (Claritin) offer the same effect but cost much less money – and you can buy them without a prescription.
Sensorineural hearing (SNHL) loss occurs when the inner ear or nerve gets damaged. This can be caused by too much noise, certain prescriptions (cisplatin, quinine or the antibiotics streptomycin and gentamicin), over-the-counter drugs, trauma, and, of course, aging. Some drug-induced hearing loss can be temporary, but some is not.
Remember presbycusis from the first paragraph? This is also a type of sensorineural hearing loss. Presbycusis is not curable, but there are things people can do to hear better. If SNHL results from an infection, steroid medications may be used. If a person experiences a sudden loss of hearing, that can be an emergency that should be treated right away, often with steroids, so get it checked. Presbycusis occurs over time and most often is treated with hearing aids.
If you have any concerns about your hearing, visit www.hear-it.org/Sensorineural-hearing-loss and do a simple hearing test. It is not the same as having a full hearing test run by a hearing/speech specialist, but it may give you an idea of whether or not you should make time for such an evaluation.
What can you do to prevent hearing loss? Using ear protection if you work in a noisy environment is crucial. Your employer is required to provide you with such equipment if that’s a standard part of your job. If using ear buds to listen to music, make sure you don’t have it turned up all the way. If other people can hear it while you have your ear buds in, it’s too loud.
You can still drive if you have some hearing loss, as long as you are being treated (hearing aids, for example) and you can hear a forced whisper from five feet away. Hear, hear! Here’s wishing that the only ringing you hear in your ears anytime soon is just the ringing in of the New Year – happy 2016 to everyone out there. Be well.