HEARING LOSS

8 SIGNS THAT YOU MAY HAVE HEARING LOSS

Have you noticed something different about your conversations lately? Maybe you feel like people are mumbling, or that you are drained after a chat with your buddies? Or perhaps your family has been giving you some ‘not so subtle’ hints that you are missing out on what they are saying? More often than not, our friends and family notice our hearing loss before we do. But here are eight signs you can look out for to catch your hearing loss at the early stages, because with early intervention you may prevent it from getting worse.

1. Your family complains about the TV volume

You may have begun to notice that your family repeatedly asks you to turn the volume down, or that television dialogues are difficult to understand when there is any kind of background music.

2. You can “Hear” but not “Understand”

Sometimes, you may not understand what is being said to you even if it is repeated loudly several times. Difficulty understanding speech is one of the first signs of sensorineural hearing loss. Humans hear a wide range of frequencies, and hearing loss may affect some while leaving others intact. A good Digital hearing aid will help differentially amplify only the sounds (frequencies) that are affected.

3. It’s more difficult to hear in noisy situations

Maybe you are talking to your relatives at a wedding, or to your family at a restaurant, or even to the cashier at your grocery store, and you find that you cannot pick out what they are saying from the background noise.

4. You have difficulty understanding speech in groups

Do you find that you cannot follow when several people are talking at once or when you are in a group, often resulting in you feeling left out of the conversation?

5. It’s harder to understand if you can’t see the person’s face

Is it more difficult for you to understand people if they are turned away from you, or if their mouths are covered (with masks)? You may have been reading lip movements to aid your speech understanding.

6. Phone-calls are more difficult than speaking face to face

Difficulty understanding phone conversations even at the highest volumes, could be a sign of hearing loss, as compensating by lip reading is not possible here.

7. You often misunderstand what is said

It can be a humiliating experience to provide the wrong answer to a question. Hearing loss can lead to you missing out some sounds like “s,” “sh,” “tch,” in words, especially in the early stages.

8. You are drained after a conversation

When one of our senses is impaired, all the other senses have to work twice as hard to compensate, and this can be extremely taxing on your brain, leaving you with less energy for things that you want to do or for spending time with your family.

Some amount of difficulty in conversation is normal and experienced even by those who have no hearing loss. But if you notice that these signs are getting more and more frequent, and that you didn’t have these difficulties before, it may be time for you to get a hearing evaluation. Even more so if you fall in the category of those at risk of hearing loss.

Early intervention is key to minimizing further deterioration in hearing. Leaving hearing loss untreated poses several threats such as cognitive decline in older individuals, and withdrawal from society. Hearing science has progressed very far and there are hearing aids that can cater to every budget and every need. Book an appointment with Hearing Point at the earliest for an evaluation and find the perfect solution to your hearing needs.

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ARE YOU AT RISK OF HEARING LOSS?

Are your earphones/airpods constantly lodged in your ears? Do you frequently ignore that little warning on your phone that says “listening at high Volumes can damage your hearing”? Exposing your ears to loud sounds can lead to a type of hearing loss that is a result of damage to fine structures in the inner ear. And this type of hearing loss is irreversible. These factors put everyone at a danger of damaging their hearing, but the risks are especially high if you.

1. Are exposed to Loud Noise ?

The kind of noise that you may be exposed to at a nightclub or concert is well above 100 dB and listening to noise at this level is only acceptable for a duration of 15 minutes. If you visit places like this, make sure you limit the duration of exposure, or carry ear plugs. Remember to give your ears a break if you listen to music or watch videos on your mobile phones and heed the warning displayed when the volume is too loud

2. Are middle aged or older ?

It has become widely accepted that most people above a certain age will need to use spectacles to manage their weakening vision. Similarly, other parts of the body are affected by ageing too and if you catch yourself asking for several repetitions or if you have trouble understanding people (especially in noisy or group situations).

3. Do any family members have hearing loss?

Genetic factors play a huge role in the types of diseases or disabilities we are susceptible to. And if you have a family member who has hearing loss, there are high chances that you may develop it too.

4. Are exposed to loud noises at work ?

If you work in a field where you are constantly exposed to loud noises, then you are at risk of developing hearing loss. This includes those individuals who work at factories, construction sites, call centers, DJs, bus/auto/tempo drivers, traffic police, priests etc. Make sure you wear ear protective devices and if they are not provided to you at work (at factories), please ask for them. It’s also important to get your hearing evaluated periodically to monitor it.

5. Have hobbies/recreational/activities/ festivities that expose you to loud noise.

Things such as riding motorcycles without silencers, playing loud musical instruments, carpentry, attending lots of bhajans or poojas with loud bells can lead you to develop hearing loss. Even things like bursting crackers, attending weddings where there is a lot of loud music played or during festivities such as Ganesh Chaturthi where there are large gatherings with loud drums can expose you to dangerous levels of noise.

6. Certain Medications

Some drugs like antibiotics (gentamicin), antimalarials (Quinine based medicines) and chemotherapy drugs can lead to hearing loss. High doses of salicylates such as aspirin can cause temporary hearing loss.

7. Certain illnesses.

Some diseases such as Diabetes and Hypertension can increase your risk of hearing loss as they may damage the fine structures of the inner ear. Other fevers such as Mumps (single sided deafness) or meningitis can also damage your hearing. If you are prone to getting ear infections very frequently, this may also result in permanent hearing loss in some cases.

If you face any of the issues mentioned above, book an appointment with Hearing Point at the earliest to get an evaluation.Or contact us to know more.

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Does your baby have hearing loss?

Ideally, every newborn should be screened for hearing loss, and this is the case in several countries where they practice “Universal Newborn Hearing Screening.” Most hospitals in India ensure that babies considered to be at “High Risk” for hearing loss are tested. Early intervention is key for the kids to develop speech and language skills. If they cannot hear, they cannot speak, and will not be able to join school at the appropriate age. Here are few signs which could indicate that your child has hearing loss.

1. Family History of Hearing Loss

The risk for developing hearing loss, whether delayed onset, progressive or congenital is greater if there is a family history.

2. You child was placed in a Neo-Natal ICU

It is important to get your child’s hearing screened if they were placed in an NICU for over 5 days. This also includes cases of hyperbilirubinemia (the child had yellowish skin, and underwent phototherapy)

3. Maternal Infections

There is an increased risk of hearing loss if the mother has had infections during her pregnancy such as CMV, herpes, rubella or syphilis. Even in cases where the mother has high blood pressure during pregnancy or diabetes, the child is at risk of developing hearing loss.

4. Your child had low birth weight or was born premature

Premature babies and those who have low birth weight are at a greater risk of hearing loss, both of the conductive and sensorineural type.

5. Experienced a blow to the head

If the child experienced any serious head trauma, they may have also damaged their hearing.

6. Have parental concern that the child may have hearing loss

Around 70% of hearing loss diagnosed in children is because the parents noticed that their child did not begin speaking at the expected age, or because they notice that the child does not react to sounds in the environment. If you suspect that your child has a delay in language development, please get their hearing evaluated.

7. Your child has been diagnosed with a genetic syndrome

If your child is diagnosed with any syndromes such as Usher’s syndrome, Waardenburg, neurofibromatosis, please ensure that you evaluate their hearing.

If your child has any of these risk factors, book an appointment with us right away so we can detect their hearing loss early and begin intervention as soon as possible, to maximize your child’s chances of developing good speech and language skills.

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Types and Degree of Hearing Loss

Hearing simply described, is the sensation of sound. The organs that help us hear are the Ears

The Ear can be divided into three main parts:

  • Outer
  • Middle
  •  Inner

The outer and middle ear mainly serve as a pathway through which sound travels to the inner ear, which is the main sensory organ for hearing. The inner ear has “Hair cells” that convert the sound into nerve signals that are taken by the auditory nerve to the brain. Any damage to any single one of these organs can cause hearing loss.

What is hearing loss?

Hearing loss refers to the decrease in the sensation of hearing. This can be due to infection, increasing age, nerve problems, exposure to loud noises, birth defects or problems during pregnancy and many other reasons.
Hearing loss has been classified depending on the thresholds obtained during Puretone Audiometry. The classification is called Goodman’s Classification, and it is as follows:

For simplification, hearing loss is classified into three major types based on cause:

  • Conductive
  • Sensorineural
  • Mixed

CONDUCTIVE LOSS:

When hearing loss is caused due to a problem in the outer ear or middle ear. This creates an obstruction in the pathway that takes sound into the inner ear. There are many causes for conductive hearing loss, some of them are: 

  • Ear Infections (Ex: Otitis Media) 
  • Exposure to loud sound/ Being hit on the face or head (Causing ear drum rupture)
  • Excessive hard wax

 These are usually treatable using medication or surgery. However, a loss may remain even after this. Usually, these patients may come to us after being referred to by an ENT doctor. It is important to do an otoscopic examination to ensure that there is no fluid or active discharge in the ear before testing.

Audiogram Pattern:

Conductive hearing loss is reflected in the audiogram by normal Bone conduction thresholds (sound heard directly in the inner ear through skull vibrations) and affected air conduction thresholds (sound travelling to the inner ear through the ear canal using vibrating air molecules). The gap between the two must be more than 10 dB.

 Impedance Findings:

Type B, C, and Cs or in some cases where a long time has passed since the infection, it can be A type or if the infection is in the early stages As.

SENSORINEURAL HEARING LOSS:

This is the type of loss that is a result of damage to the hair cells in the inner ear. This creates an overall reduction in hearing ability and unlike conductive hearing loss, is permanent. The causes of this can be:

  • Old Age 
  • Certain Medication 
  • Exposure to loud Noises, Diseases such as: Mumps, meningitis, multiple sclerosis, Meniere’s disease, diabetes
  • Infections during infancy such as Rubella, low birth weight, complications during pregnancy

Audiogram Pattern:

There is no gap between the bone conduction and air conduction thresholds.

Impedance Findings:

It’s usually a Type A tympanogram.

MIXED HEARING LOSS:

­When an individual has both conductive and sensorineural hearing loss, it is diagnosed under the term mixed hearing loss. For example, this can happen to an individual who has sensorineural hearing loss and also develops an ear infection.

Causes: A combination of the causes for conductive and sensorineural hearing loss.

Audiogram pattern:

Both the air conduction and bone conduction thresholds are affected, and the gap between the two is >10 dB.

FAQs ABOUT NOISE INDUCED HEARING LOSS

When people think about hearing loss, the type that comes to mind most often is loss that one experiences after being exposed to loud sounds. With an increase in the use of earphones for extended periods of time, there is growing concern about what NIHL really is. Here are some of the commonly asked questions about NIHL

What is Noise Induced Hearing Loss (NIHL)?

As suggested by its name, Noise Induced Hearing loss occurs when the individual is exposed to extremely loud noise, or, listens to loud noise for an extended period of time. This is a result of damage to the delicate fine structures inside the ear called Hair cells.

I was exposed to loud noise (at a party/wedding/crackers/gunshot etc.) and I feel like sounds are muffled now, could I have NIHL?

There is a probability that your hearing loss is temporary and that your hair cells may recover on their own in a day or two. But if your loss persists longer than that, please consult us for a hearing evaluation as you may have developed permanent NIHL.

What are its symptoms?

  •  Sudden ringing in the ear after exposure to loud noise.
  •  Feeling that people are mumbling to you.
  •  Others may notice that you are speaking louder or softer than before.
  •  You have pain in your ears after hearing a loud sound.
How to get tested?

If you suspect that you might have NIH, or are worried after being exposed to loud sounds, book a consultation with us. An Audiologist will test your hearing and determine if you have the characteristic NIHL notch at 4 KHz which looks something like this:

What causes Noise Induced hearing Loss?

Our ears are a sophisticated mechanism that enable us to convert the sound vibrations in the air into electrical impulses that can be made sense of by the brain. In order to do this, the sound is collected from the environment by the external ear which acts like a funnel that set the tiny bones in the middle ear into motion. The last bone in this chain, the stirrup shaped stapes, is connected to the snail shaped organ called cochlea that is filled with a gelatinous fluid, which when set into motion by the movement of the footplate of the stapes, disturbs the hair cells located on anelastic membrane that extends through the cochlea. This generates an electrical current that is conducted by the auditory nerve to the brain. When there is an extremely loud noise, the stress on these parts causes some of the hair cells to get damaged, or even die, leading to hearing loss.

How loud is too loud?

Any sound above the level of 85 dB can cause hearing loss depending on the duration of exposure. And since we do not have Sound Level Meters on hand to measure the noise levels (although there are some mobile apps that can measure sound levels for you), we can use this general rule of thumb to determine if the sound is too loud:

  1. You have to shout to be heard over the background Noise.
  2. You cannot hear someone 3 feet away from you.

Could you be more prone to NIHL than others? 

Some factors that can make you more susceptible to NIHL are:

  1. Age
  2. Underlying Health Conditions (Diabetes and Hypertension
Is my job putting me at risk of NIHL?

The most common jobs that can lead to NIHL are jobs at factories, farming (tractors are very noisy), carpentry, construction, call centers (exposed to sound levels of around 70 dB for more that 8 hours a day), Police and Military personnel, Traffic Police, Bus or Auto Drivers (Loud honking of horns), musicians (especially those that play at weddings), pandits (exposed to loud ringing of bells and bhajans) and even Housekeeping (Vacuum cleaners or automatic mops) and Hairdressers (Frequent long duration use of hair dryers).

Is my hobby putting me at risk of NIHL?

Some of your hobbies maybe putting you at risk of developing NIHL:

  • Listening to loud music for extended periods of time.
  • Traveling long distances on motorcycles without silencers.
  • Clubbing and partying with loud music Attending concerts.
Is NIHL preventable?

Yes. Although it may be difficult to control impulse noises (sudden loud sounds such as gunshots, crackers), most other predictable noise exposure can be accounted for and steps can be taken to minimize the level and duration of exposure by following some measures of aural hygiene. 

  • Ear Plugs: Use ear plugs if you are going to be attending an event or area where you may be exposed to loud noise. 
  • Turn Down the volume: Heed the warning flashed on your phone that tells you your music is too loud. 
  • Give your ear breaks: If your job requires you to be exposed to loud noise for extended durations, make sure you give yourself listening breaks every now and then to let your Hair cells recover. 
  • Use the Noise Reduction equipment provided: Most workplaces that put their employees at risk of hearing loss have laws imposed on them to provide ear protective devices such as ear plugs, ear muffs and noise cancelling headphones to their employees. Please make use of these devices exactly as directed for maximum protection. 
I have been diagnosed with NIHL, what do I do?

If you have been tested and have been diagnosed to have hearing loss or have subjectively found that you have NIHL, you will need to be fitted with hearing aid that helps compensate for your hearing loss. There is no other method currently available to reverse the damage done to your ears because of noise exposure. But fortunately, with the advancements in hearing aid technology, you will find a hearing aid that fits right in with your lifestyle and your listening needs to help you hear better.

SUDDEN SENSORINEURAL HEARING LOSS

Sensorineural hearing loss of at least 30 dB within a 72 hour time period, in 3 or more audiometric frequencies is called Sudden Sensorineural Hearing Loss (SSNHL). This type of loss can come out of nowhere and leave the individual feeling extremely scared and confused. Especially because it is usually unilateral. SSNHL is a medical emergency, please do no delay consulting the doctor if you experience any of these symptoms:

  • Rapid onset of unilateral hearing loss (Sensorineural)​
  • Some may report a popping sensation prior to hearing loss​
  • Hearing loss upon waking from sleep​
  • Some may report aural fullness or pressure​
  • Vertigo and tinnitus may also accompany SSHL

SSHL is usually idiopathic (occurs without any discernible cause). ​But some of the possible causes could be:

  • Viral and infectious diseases (Mumps, herpes viruses, rubella, toxoplasmosis)​
  • Autoimmune diseases (Cogan’s Syndrome, AIED, lupus)​
  • Rupture/trauma to the inner ear (Perilymph fistula, barotrauma, temporal bone fracture, ear surgery complications)​
  • Circulatory issues (Vascular spasm, occlusion, rupture, sickle cell disease)​
  • Ingestion of toxic substances
  • Neurologic (Multiple Sclerosis, migraine)​
  • Cancer (acoustic neuroma and other tumors affecting the auditory system)​

SSNHL is a very serious condition and the longer the treatment is delayed, the lower the chances of recovering your hearing. Please provide as many details about the symptoms you are feeling and the circumstances around the onset of your loss including:

  • Ringing, dizziness, and a blocking sensation in your ear. ​
  • When did you notice it, what you ate or drank prior to it, what activity were you engaged in.

Chances of recovery from SSNHL depends upon factors like your age, duration of loss, presence of associated symptoms and degree of hearing loss. You will need to monitor your hearing (even in the unaffected ear) very closely through repeated audiograms. And in case you already have SSNHL that has shown no change over a period of two weeks, the loss is most probably irreversible and it’s in your best interest to use a hearing aid. Please book a consultation with us so that we can fit you with a hearing aid that will allow you to get back to your daily routine, uninterrupted