Coping with hearing loss

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VOL 104 / NO 3 / SEPTEMBER 1998 / POSTGRADUATE MEDICINE

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Hearing loss is the second most common physical disability in the United States, right behind low back pain. About 10% of the US population has some degree of hearing loss, including one third of Americans over 65 years of age. The good news is there are many resources available to help overcome hearing loss. The bad news is that many people choose to ignore the problem and risk increased damage before they seek help or information. If you suspect a problem, please read on.

Types of hearing loss

It's not just a problem for old people any- more. These days, hearing loss strikes many youngsters, especially those who crank up the stereo or headset, play in rock bands or other amplified groups, or spend every free moment at the movies, especially the thrillers. Even "normal" hearing loss associated with aging can start as early as age 40--hardly considered old nowadays. However, many problems can be prevented by paying attention to risks.

Hearing loss usually occurs in one of two forms: conductive loss and sensorineural loss. Some people have a combination of these types.

• Conductive hearing loss is usually caused by disruption of the way sound reaches the tiny bones in the middle ear or by obstruction in the ear canal. It often can be corrected surgically or even by something as simple as cleaning out impacted earwax.

• Sensorineural hearing loss occurs because of damage to the inner ear. It can be either congenital or acquired. The most common site of the problem is the cochlea, a snail-like structure filled with tiny hairs and fluid. The cochlea converts sound into electrical impulses that can be transmitted to the brain. Cochlear hair cells and nerves can be damaged by aging, inherited defects or diseases, injuries, tumors, and loud noises. Age-related hearing loss (presbycusis) is by far the most common cause of sensorineural hearing loss.

What should you do?

If you suspect you have a hearing loss, start by seeing your doctor. Problems with the outer or middle ear often can be corrected. Although disorders of the inner ear often cannot be treated medically or surgically, they may be helped by a hearing aid. While a hearing aid will not make the problem go away, it can help you manage much better.

The new generations of hearing aids are compact and powerful. Most people choose in-the-ear aids, although behind-the-ear styles are still common. Even people with severe or profound hearing loss can benefit.

Protect your hearing

Hearing loss caused by exposure to loud or continuous noise is usually irreversible. As a general rule, if you have to shout to make yourself heard, the noise around you can damage your hearing. Under such conditions, it is best to get away from the noise, to wear ear protectors, or to do whatever you can to decrease the noise. Be especially careful to keep earphones and home sound systems at levels that won't destroy normal hearing.

To help save your hearing:

• Wear protective plugs or earmuffs in noisy environments.
• Be aware of recreational risks (snowmobiling or motorcycling, trapshooting, listening to loud music or loud movie soundtracks).
• Have your hearing tested.

This information is not a substitute for medical treatment.

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