Conductive hearing loss

Julie Triftshouser was only in her late 20s when time began taking away one of her precious senses. "I loved to go to plays, but I couldn't hear dialogue," she says. "I couldn't tell if they were saying, ,Go fly to the moon, or ,So buy me some balloons., "

Dinner out with friends was often difficult. Background noise made it impossible to follow conversations. "Everybody is laughing and intent, and you don,t know why," she explains. "So you daydream and look off. You just kind of give up."

Julie eventually found help for her problem. Indeed, with today's treatments, most of the 22 million Americans who live with hearing loss could find relief.

Many causes. Though the result is the same, hearing loss has many causes. In conductive deafness, sound is not properly conducted from the outer ear to the inner ear. The culprit may be earwax, a perforated eardrum, or an infection leading to fluid buildup within the ear. Less common are problems with the tiny hearing bones behind the eardrum.

A second type of deafness occurs when hearing nerves fail. Nerve deafness often develops slowly, so individuals may not realize that their hearing is deteriorating. Most people experience some nerve deafness as they age. Too many people are speeding up this aging process by exposing themselves to daily doses of loud noise.

Among doctors, this premature hearing loss is often called rock and roll deafness, but loud music is only one villain. Any regular exposure to loud noises--in factory settings or on construction sites, for example--can lead to nerve deafness. Heredity may also play a role.

Other causes include auditory nerve tumors, a sudden loud noise, medications, viral infections, and Meniere's disease, which causes increased fluid pressure inside the ear. Some babies are born with a damaged auditory nerve, often because the mother had German measles in pregnancy. Jaundice can cause deafness in infants.

Treatments. Relieving conductive deafness can be as simple as getting the wax out of your ears. Have a doctor do it or use a drugstore syringe-and-solution kit. Don,t use a cotton swab, a paper clip, a golf tee, or any other item that will fit in your ear. You might scratch the skin and cause infection, says Edwin M. Monsell, M.D., Ph.D., head of the Division of Otology and Neurology at Henry Ford Hospital in Detroit.

For hearing loss caused by the congestion of colds and flu, try an over-the-counter decongestant. A doctor can prescribe medications if these decongestants don,t help.

In children, repeated bouts with ear infections can lead to permanent hearing loss. If several months of antibiotic treatments fail to clear up infections, your doctor may suggest inserting a tiny tube through the eardrum to drain the blocked area. The tube eventually works out by itself, and the hole heals.

For severe nerve deafness, when even the most powerful hearing aids don,t help, the newest treatment is the cochlear implant. These tiny devices contain electrical wires that perform the sensory function of the damaged hairlike nerves within the cochlea.

Hearing aids. The most common remedy for nerve deafness is a hearing aid. As the nerves gradually lose sound-sensing capabilities, hearing aids compensate by amplifying sound.

Basic hearing aids start at about $500 each. Programmable aids ($2,000 or more) offer better sound quality and can be adjusted for special situations, such as talking on the phone or listening at a business meeting.

You may be tempted to save money by bypassing a doctor and going directly to a hearing aid dispenser. Don,t. A doctor's checkup can rule out such problems as disease. "Hearing loss is a symptom, but you must know what causes the symptom," says Robert A. Goldenberg, M.D., chair of the Department of Otolaryngology at Wright State University School of Medicine.

One last tip on buying hearing aids: Don,t choose vanity over hearing. Get the model that works best for you.

A happy ending. "I was so upset the first day I got my hearing aids that I cried," says Triftshouser. Part of the problem was vanity, she admits, but she also had to adjust to new sounds. And although she was thrilled to hear well again, "the refrigerator and air conditioner noises drove me crazy."

"People will say, |Gosh, I heard the birds for the first time in 20 years, but I also realized my car needs a tuneup and a muffler' " says Leslie C. Hojem, Clinical Audiologist at Kaiser Permanente Medical Group in Hayward, Calif. Hojem warns not to expect perfection. The sound may be tinny at first, but you get used to it. Triftshouser no longer needs special seating at concerts and plays. Plus, her hearing aids allow her to stay active in Englewood, Ohio, teaching English as a second language. "I couldn't teach without hearing aids because my students speak softly and with accents," she says.

Early signs. Here are some early signs of hearing loss, according to Barry C. Baron, M.D., chair of the Department of Otolaryngology at California Pacific Medical Center in San Francisco:

* You have trouble hearing doorbells, telephones, microwave timers, watch alarms, and other high tones.

* Consonants confuse you, especially telling d from b, z, or t, or s from f. Did she say bad or dad?

* You repeatedly ask that the TV be turned up.

* Your spouse says you don,t listen.

* You can,t hear conversations at restaurants or at meetings where background noise is bad. You avoid these social situations. Among infants:

* Babies who can,t hear will cry but won,t babble, imitate sounds, or make other baby noises.

* If your infant doesn't blink or react when someone, standing out of view, claps hands or drops a book. For free pamphlets, "Is My Baby's Hearing Normal?" and "5 Minute Hearing Test" (for seniors), send a SASE (business size) to: AAO--Head and Neck Surgery, Inc., Dept. BHG, One Prince St., Alexandria, VA 22314. Please specify which pamphlet you want.

1. Try to reduce noise. Even moderate levels of noise can, over time, reduce your hearing.

2. Spend only 15 minutes in rooms where you mud raise your voice.

3. Wear fined earplugs when using firearms or working in noisy settings. Expandable wax plugs are good; cotton won,t do.

4. At concerts, sit far back from those booming speakers.

5. Make sure children have the full range of immunization shots, and act promptly on seeing a doctor for earaches.

COPYRIGHT 1994 Meredith Corporation