Hearing problems can happen at any age but one common type is age-related hearing loss, which is mainly caused by the deterioration of the nerves that transmit sound signals to the brain. This can happen over time and there are two other types of hearing loss.
In an interview with HT Lifestyle, Dr Fidelis Grace Dass, ENT Consultant at SSM Hospital, shared, “One is called conductive hearing loss, where there’s a problem with the ear’s ability to conduct sound. (the process by which sound waves travel through the ear canal). This could be due to a hole or damage in the eardrum. The second type is mixed hearing loss, which involves a combination of both conductive and sensory-neural hearing loss. This means there could be problems with both the ear’s ability to conduct sound and the nerves transmitting it to the brain.”
Sensorineural Hearing loss
Dr Fidelis Grace Dass explained, “Sensory-neural hearing loss is seen in aged patients mainly due to the degeneration of the nerve/damage to the inner ear. This degeneration occurs in a retrograde fashion. The aged patient might come with a history of tinnitus, a ringing sensation in the ear( also known as cry of the dying nerves). The nerve loses its ability and starts emitting a ringing sound called tinnitus. This is a warning sign for getting required tests to be done. Age-related hearing loss is said to be progressive sense of neural hearing loss. It is progressive because it does not occur suddenly, in due course of time it slowly decreases without the patient’s knowledge. If the patient is less responsive to his peers, watches television with maximum volume, it should be addressed at first followed by audiological evaluation.”
How does this affect the life and well-being of the patient?
Dr Fidelis Grace Dass answered, “When the patients come to know that they are not able to hear properly. Their response to questions and their involvement in a conversation comes down. They respond in a different way. For example the question may be different and the answer would be given in a different manner. Once this starts, they slowly feel distant and are unable to get along with people. This might be a psychological thing also and also at times when they are unable to hear, in their day-to-day lives, might not be able to attend meetings, or give responses in a proper way to their colleagues.”
Preventive measures
Dr Fidelis Grace Dass opined, “It depends on the amount of hearing loss. In the initial stages, if there is a sense of ringing in the ears or if they’re unable to respond properly, a few drugs can be tried out. There’s no surety that tablets will always help. It might prevent neuron degeneration i.e., prevent the further degeneration of the nerves. If the person is not responding and the hearing is more than 50% or mild to moderate hearing loss then to carry out the day to day life without any problem, the patient can go for a hearing aid.”
Treatments
Dr Fidelis Grace Dass suggested, “Hearing aid or cochlear implants can be opted. But for cochlear implants surgery is needed but if there is age related hearing loss then hearing aids can be more than enough.”
Bringing his expertise to the same, Dr Abhishek Khond, Consultant ENT Surgeon at Horizon Prime Hospital in Thane West, revealed, “Age related hearing loss is also known as sensorineural hearing loss since the affected part is the nerve. Aging is a normal phenomenon, we can slow down this process, we cannot stop it. The process of aging is called Presbycusis, where the patient will experience a gradual decline of hearing ability after the age of 60 years.”
He added, “Another commonly heard condition is tinnitus. In this condition, there will be no external sound but the patient will perceive a ringing sound inside the ear. This is usually seen in patients with cochlear nerve weakness. This nerve becomes weak with age and also because of some external stimuli like exposure to a loud noise or exposure to a particular intensity of sound for prolonged periods. The normal speech frequency is 500 to 2000 hertz. If the frequency is higher ie 4000 hertz or 8000 hertz, it can result in impairment of hearing.”
He highlighted the symptoms as –
- Speech discrimination: This is the initial symptom in age related hearing loss, the patient will not be able to differentiate between the two similar words (For example, apple and maple)
- Speech clarity: The first signs for hearing loss
- Tinnitus: Ringing sound inside the ear
- Social inability: The inability to communicate and interact with people because of hearing impairment. This can affect the confidence of the patient.
Factors that may lead to hearing loss
Dr Abhishek Khond explained, “When we talk about slowing down the aging process in terms of hearing ability means reducing the exposure to loud or prolonged sounds for a long period. For example, if the patient is working in a factory or a mill with heavy machinery around, the patient is most likely to have age related hearing loss at an early age. The ears have been exposed to heavy and loud sounds of more than 80 decibels for a prolonged period or a sudden sound of 120 db for a short period is also hazardous.”
He elaborated, “Traffic police have a higher tendency to develop age related hearing loss due to continuous exposure to traffic noise. People working in airports are exposed to the heavy noise of take off and landing noise of the aircrafts. Restaurants or pubs with loud music are another channel for people to develop early hearing loss. In recent times, hearing loss is bound to happen at an early age due to lifestyle. Hearing loss could happen at 50 years of age due to the constant use of mobile phones, earphones, television, etc.”
Treatment
Dr Abhishek Khond recommended, “Pure tone audiometry is a basic behavioral test to measure hearing sensitivity. In this test, different frequency sounds are given to the patient and the graphical representation is jotted down to understand if it is age related sensory hearing loss. There are two types of sensorineural hearing loss- Gradual and Sudden. When a patient suddenly stops hearing overnight, it is considered a medical emergency. The patient must visit an ENT specialist at the earliest. There is a window of 28 – 48 hours where a certain amount of hearing loss can be revived (about 50%).”
He concluded, “The other variant is the gradual decline in hearing. The patient feels the loss of hearing and must undergo an audio message testing. After the test, if the hearing loss is more than 40 to 45 dB, then the patient can use hearing aid devices, or cochlear implant surgery is another option. The use of hearing aids are still seen as a stigma in Indian society. However, we should try to normalize it just like the use of spectacles.”
