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Hearing loss

A hearing impairment is a decrease in one's ability to hear (i.e. perceive auditory information). While some cases of hearing loss are reversible with medical treatment, many lead to a permanent disability (often called deafness). more...

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If the hearing loss occurs at a young age, it may interfere with the acquisition of spoken language and social development. Hearing aids and cochlear implants may alleviate some of the problems caused by hearing impairment, but are often insufficient. People who have hearing impairments, especially those who develop a hearing problem later in life, often require support and technical adaptations as part of the rehabilitation process.


There are four major causes of hearing loss: genetic, disease processes affecting the ear, medication and physical trauma.


Hearing loss can be inherited. Both dominant and recessive genes exist which can cause mild to profound impairment. If a family has a dominant gene for deafness it will persist across generations because it will manifest itself in the offspring even if it is inherited from only one parent. If a family had genetic hearing impairment caused by a recessive gene it will not always be apparent as it will have to be passed onto offspring from both parents.

Dominant and recessive hearing impairment can be syndromic or nonsyndromic. Recent gene mapping has identified dozens of nonsyndromic dominant (DFNA#) and recessive (DFNB#) forms of deafness.

  • The most common type of congenital hearing impairment in developed countries is DFNB1, also known as Connexin 26 deafness or GJB2-related deafness.
  • The most common dominant syndromic forms of hearing impairment include Stickler syndrome and Waardenburg syndrome.
  • The most common recessive syndromic forms of hearing impairment are Pendred syndrome, Large vestibular aqueduct syndrome and Usher syndrome.

Disease or illness

  • Measles may result in auditory nerve damage
  • Meningitis may damage the auditory nerve or the cochlea
  • Autoimmune disease has only recently been recognised as a potential cause for cochlear damage. Although probably rare, it is possible for autoimmune processes to target the cochlea specifically, without symptoms affecting other organs. Wegener's granulomatosis is one of the autoimmune conditions that may precipiate hearing loss.
  • Presbyacusis is deafness due to loss of perception to high tones, mainly in the elderly. It is considered a degenerative process, and it is poorly understood why some elderly people develop presbyacusis while others do not.
  • Mumps (Epidemic parotitis) may result in profound sensorineural hearing loss (90 dB or more), unilateral (one ear) or bilateral (both ears).
  • Adenoids that do not disappear by adolescence may continue to grow and may obstruct the Eustachian tube, causing conductive hearing impairment and nasal infections that can spread to the middle ear.
  • AIDS and ARC patients frequently experience auditory system anomalies.
  • HIV (and subsequent opportunistic infections) may directly affect the cochlea and central auditory system.
  • Chlamydia may cause hearing loss in newborns to whom the disease has been passed at birth.
  • Fetal alcohol syndrome is reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake.
  • Premature birth results in sensorineural hearing loss approximately 5% of the time.
  • Syphilis is commonly transmitted from pregnant women to their fetuses, and about a third of the infected children will eventually become deaf.
  • Otosclerosis is a hardening of the stapes (or stirrup) in the middle ear and causes conductive hearing loss.


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Hear! Hear! Are you one of the millions headed for premature hearing loss? Here's how to keep your ears open and healthy in this noisy world
From Natural Health, 10/1/04 by Tom Weede

Lawn mowers, hair dryers, movie trailers, car alarms, jet engines, even squeaky toys ... there are so many perpetrators of acoustic turbulence that we barely notice them anymore.

Or is it that we can't notice them? At least 30 million Americans suffer from some degree of hearing loss, and about one-third of the blame can be directed toward noise. And because the environment is getting noisier, audiologists are seeing more--and younger--people with damaged hearing, according to the American Speech-Language-Hearing Association in Rockville, Md.

"People are starting to notice hearing problems earlier in their adult life," says Tina Mullins, ASHA's director for audiology practice and health care. "And there's more than just hearing that's affected by noise: It can reduce your ability to concentrate and learn, and it can result in poor social and emotional behaviors, such as anger, depression and anxiety."

Noise has also been linked to increases in blood pressure, according to the Journal of Occupational Health Psychology. It can even be bad for your waistline: Investigators at Pennsylvania State University found that women exposed to noise stress are significantly more junk food than their less stressed peers.

ear factor

Since the ears have no natural defenses, hearing loss can occur after one short, intense sound, such as an explosion. Typically, though, it happens over time after extended exposure to loud noise. The excessive sound over-stimulates the microscopic hair cells in the cochlea of the inner ear; when these sensory receptors are injured, they stop transmitting sound to the brain via electrical impulses carried by the auditory nerve.

Loud noise has become such a constant that you may not even be aware that a loss is happening. "Audiologists are seeing 20-year-olds with the hearing of 40- and 60-year-olds, because they are so surrounded by noise all the time," says Julee Sylvester, spokeswoman for the Sight & Hearing Association in St. Paul, Minn.

Hearing difficulty typically begins at high pitches. Sounds may seem distorted or muffled, and you may have trouble understanding speech. And when the damage is done, it's usually irreversible. "Unlike our eyes, where we can wear glasses or do LASIK and get 20/20 vision back, our ears are totally different," says Sylvester. "Once you start losing your hearing, you will never get it back."

If you think you may have hearing damage, talk to your doctor. Treatment options include "assistive listening devices" designed to increase the loudness of specific sounds, such as those from radio, television or telephones, and hearing aids, which are now very small and very sophisticated. While older, analog aids amplified every noise, new digital models are programmed and adjusted to the individual. Karen Shatzkin, who has had a hearing loss since childhood, recently purchased a digital aid customized to her impairment in the higher ranges. "It has just changed my life," says the New York attorney. "I don't think I recognized the degree to which I was missing things."

Digital hearing aids can be expensive, but you should never try to save money by buying a mail-order hearing aid, or use a device that hasn't been adjusted for your personal needs; a poorly programmed unit can inflict further damage on your inner ear.

cover your ears

No FDA-approved drugs are currently available to treat noise-induced hearing loss, says Kathleen Campbell, Ph.D., director of audiology research at Southern Illinois School of Medicine in Springfield. But personal choices may count: A high-fat diet and smoking have both been shown to increase the risk of noise-induced hearing loss in humans, she says, while animal studies indicate that vitamins A, C and E, as well as selenium, magnesium and the antioxidants D-methionine and N-acetylcysteine may help in reducing such risk. Still, Campbell cautions that it's too early to recommend specific meals or supplements beyond a healthy lifestyle and diet plan.

The only proven way to prevent hearing loss is to protect your ears from continuously excessive noise. Damage begins at approximately 85 decibels, about the volume level for trucks, lawn mowers and shouting. (See "Measuring Noise," at right.) Alternate loud activities with quiet times, restrict your contact with noisemakers like lawn equipment and power tools, and gradually replace your appliances with ones that produce fewer decibels of sound.

"Appliance noise is cumulative and additive, so all those appliances running at the same time add to the volume of noise you're experiencing; if you're running the dishwasher, don't use the vacuum at the same time," advises Mullins.

"Every effort you can make to reduce the amount of noise your ears are exposed to helps," she adds. So make sure your Walkman or iPod isn't so loud that the person next to you can hear it, and turn down your car radio. If you can't hear a person three feet away, there's too much noise. If you're in a nightclub or other setting, and your ears begin to hurt, throb, ring, buzz or feel full, then leave. For information on ear plugs and other hearing-protection products, visit; another site,, offers "high fidelity" ear plugs designed for musicians.

quiet down

Even if you turn your own volume down, rapid increases in population and urban development guarantee that the collective cacophony will continue to climb. Noise complaints made up almost 83 percent of the calls to a New York Police Department hotline in 2001. In June, New York City Mayor Michael Bloomberg proposed legislation to overhaul the city's noise code, including reducing construction noise and setting new regulations for bars and clubs. Meanwhile, the European Union is requiring member countries to come up with plans to reduce noise exposure.

A few individuals are also carrying the banner for quiet. When Les Blomberg could no longer tolerate the din of the street sweeper coursing past his residence at 4 a.m.--"It was as loud as a NASCAR race car," he says--he waged a successful campaign in his hometown of Montpelier, Vt., to change the cleaning time to a more civilized hour.

"A hundred years ago the major noise sources you hear right now didn't even exist," says Blomberg, who has founded the Noise Pollution Clearinghouse to advocate for noise controls. His list of modern offenders includes snowmobiles, all-terrain vehicles, leaf blowers, boom boxes, car alarms, and gas-powered lawn mowers. "Electric mowers could revolutionize the soundscape of the suburbs," he says. "One hundred and fifty electric mowers could be mowing in your neighborhood and be quieter than one gas-powered mower."

Whether or not Blomberg, Bloomberg and the EU succeed in stemming the noisy tide, you should find a way to fit quiet time into your overall wellness approach. What's the payoff? Just think about when you've been in a power outage, suggests Mullins, when all those humming, buzzing air conditioners and refrigerators were stilled.

"When those sounds are gone, there's a peacefulness," she says. "Your body really does calm down."

measuring noise

Decibels (dB) signify the level of noise. Each 10 dB increase is a doubling of the volume. The louder the sound, the less time you need to be exposed to it for it to cause harm. While the maximum exposure time at 85 dB is eight hours, at 110 dB the limit falls to 1 minute and 29 seconds, according to the National Institute for Occupational Safety and Health. Here are some common noise levels measured in decibels:

0 faintest sound audible

10 breathing

20 background noise in a house

30 whisper in a library

40 quiet office or residential area

50 light traffic at a distance

60 normal conversation sewing machine

70 freeway traffic alarm clock

80 Vacuum coffee grinder doorbell

90 (damage begins) truck traffic lawn mower shouting

100 (pain begins) factory machinery snowmobile

110 baby crying power saw disco

120 rock concert thunderclap ambulance siren

130 jackhammer symphony percussion stock car race

150 firecracker jet taking off

170 shotgun

180 rocket launch

for more information

American Speech-Language-Hearing Association 800-638-8255 League for the Hard of Hearing 917-305-7800

National Institute on Deafness and Other Communication Disorders 800-241-1044

Noise Pollution Clearinghouse 888-200-8332

Sight & Hearing Association 800-992-0424

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group

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