Hearing Impairment

Hearing Impairment

Hearing impairment is the term for all conditions or diseases that result in disturbances in the hearing process. This condition can be caused by many things, ranging from long-term noise exposure, to disturbances in the auditory nervous system.

The ear  is a hearing organ that plays an important role in transmitting and receiving sound or sound. The ear consists of three parts, namely outer, middle, and inner.

If there is a disorder in those parts of the ear, then there will be a disorder in the listening process. As a result, the voice can sound unclear or even not heard at all.

Causes of Hearing Loss

There are three types of hearing loss, namely conductive hearing loss, sensorineural hearing loss, and mixed hearing loss. The following is an explanation of the types of hearing loss:

Conductive hearing loss

Conductive hearing loss  occurs when the process of sound transmission is interrupted due to a disturbance in the outer and middle ear. Some conditions or diseases that can cause conductive hearing loss are:

  • Accumulation of fluid in the middle ear due to a cold  or rhinitis
  • Middle ear infection or otitis media
  • External ear infection or otitis externa
  • Disorder or damage to the  eustachian tube , which is the channel that connects the ear with the nose and throat
  • Rupture of the eardrum ( perforation of the tympanic membrane )
  • Tumor or abnormal tissue growth in the outer ear and middle ear, such as cholesteatoma
  • Earwax that accumulates and blocks the ear canal ( cerumen prop )
  • Foreign objects stuck in the ear canal, such as pebbles or insects
  • Abnormalities in the shape of the ear, such as microtia , not forming the earlobe, or the presence of abnormality in the shape of the auditory bones
  • Diseases of the hearing bones, such as otosclerosis

Sensorineural hearing loss

Sensorineural hearing disorders occur as a result of damage to the inner ear and disruption of the nerve pathway between the inner ear and the brain. There are several conditions or diseases that can cause sensorineural hearing impairment, namely:

  • Certain diseases, such as Meniere's disease
  • The use of drugs that can cause side effects on the ear (ototoxic), such as aminoglycoside antibiotics , chemotherapy drugs,   high-dose aspirin , and loop diuretics
  • Certain genetic conditions that are passed down in the family
  • Disorders of the formation of the inner ear
  • The aging process, also known as presbycusis
  • Head injury
  • Long-term exposure to loud noises, for example because of working in a factory with high noise

Mixed hearing loss

Mixed hearing loss occurs when conductive hearing loss occurs together with sensorineural hearing loss. This condition can be a sign of damage to the outer, middle, and inner ear, or nerve pathways to the brain.

Risk factors for hearing loss

There are several factors that can increase the risk of hearing impairment, namely:

  • The aging process, which causes changes in the structure of the inner ear
  • Genetic factors, which can cause a person to be more susceptible to some hearing disorders
  • Exposure to loud sounds, such as sounds from explosions, noise pollution , construction or factories, airplanes, jet engines, music, television shows, or firearms
  • Infectious diseases during pregnancy, such as TORCH infection , which increase the risk of congenital abnormalities, including hearing impairment in  babies  born
  • Certain diseases, such as diabetes,  hypertension , heart disorders, strokes, tumors, and brain injuries

Symptoms of Hearing Loss

The ear is divided into the outer part, the middle part, and the inner part. The listening process begins when sound waves enter through the outer ear and cause vibrations in the eardrum. The ear drum and three small bones in the middle ear then multiply the vibrations to the inner ear.

Further, the vibrations enter the fluid in the cochlea's house (cochlea) which contains thin hairs. The vibrations then attach to the nerves of the thin hair and are converted into electrical signals that are sent to the brain. In the brain, electrical signals will be processed into sounds that are heard.

Hearing impairment occurs when the process of sending sound vibrations or receiving sound that has been processed is interrupted. The following are symptoms that can appear as a result of hearing loss:

  • The voice or words are heard softly
  • Always adjust the sound of TV and music with a loud volume
  • Ringing ears ( tinnitus )
  • Difficulty listening to other people's words and mistaking what is meant, especially when in a crowd
  • Difficulty hearing consonants and high-pitched sounds
  • You have to concentrate hard to hear what people are saying
  • Often asks the other person to repeat the conversation, speaking more clearly, slowly, or loudly
  • Often avoids social situations

While in babies and children , the symptoms of hearing impairment are slightly different from adults, among others:

  • Don't be surprised when you hear a loud voice
  • Not turning towards the source of the sound, especially in babies aged 4 months and above
  • Couldn't say a single word when he was around 15 months old
  • Not hearing when his name was called and only realizing someone's presence when he saw
  • Slow when learning to speak or unclear when speaking
  • Often speak loudly or set the TV to a loud volume
  • The child's answer does not match the question
  • The child asks the interlocutor to repeat the word or question

When should you go to the doctor?

Check with a  doctor  if you experience the above symptoms, especially if the symptoms interfere with daily activities. See a doctor immediately if you suddenly cannot hear anything, or when the hearing loss you feel is accompanied by the following complaints:

  • Ears often ring
  • Vertigo often recurs
  • Fluid coming out of the ear
  • Swollen lymph nodes in the neck or behind the ears

Immediately check yourself with a doctor if you feel that your hearing ability is gradually decreasing, especially if you have a history of ear infections, diabetes, hypertension, heart disorders, strokes, and brain injuries.

Ideally, hearing screening should be done every year or at least every 10 years until you are 50 years old. After the age of 50, do a hearing test at least every 3-5 years.

Diagnosis of Hearing Disorders

The doctor will ask about the patient's complaints and health history. The doctor will also ask the patient about the sounds he often hears and the activities he often or recently did before the hearing disorder appeared.

Next, the doctor will perform an examination using an otoscope to examine the outer ear canal and look at the ear drum. From the examination, the doctor will see if there is damage to the ear drum, or blockage, inflammation, and infection in the ear canal.

In addition to the examination, the doctor will ask the patient to undergo a hearing test in the form of:

  • Tuning fork test, to check hearing impairment and detect the location of damage in the ear
  • Speech audiometry test, to find out how soft or how small words can be heard and understood
  •  Pure tone audiometry test  , to find out the range of tones that can be heard
  • Tympanometry test, to measure the pressure in the eardrum and middle ear, as well as detect blockages or abnormalities in the eardrum

Hearing Impairment Treatment

The purpose of hearing impairment treatment is to overcome the cause and prevent the impairment from getting worse. Generally, hearing impairment caused by earwax buildup, outer ear infection, or middle ear infection, can be cured.

Meanwhile, in sensorineural hearing disorders, especially due to the aging process, treatment aims to improve hearing function or help the patient to adapt and be able to communicate in other ways.

Treatment methods that can be performed by doctors to treat hearing impairment and help patients communicate include:

  • Cleaning the pile of dirt in the ear by giving ear drops, ear irrigation, or using a special suction device
  • Perform surgery to treat abnormalities in the ear drum and ear bone
  • Changing the drug or adjusting the dose of the drug suspected of causing hearing loss
  • Treating other diseases that are thought to be causing hearing loss
  • Provide  hearing aids  to assist the voice transmission process
  • Installing  a cochlear implant  to stimulate the auditory nerve, especially for patients whose auditory nerve is normal but cannot be helped by hearing aids
  • Installing a brainstem auditory implant, to send electrical signals directly to the brain for patients with severe hearing impairment
  • Installing an implant in the middle ear, to multiply the sound waves so that they sound clearer and louder, especially for patients whose ears do not fit the shape of the hearing aid
  • Teaching and training the use  of sign language  or lip reading, both by patients and people around them, so that they can communicate with each other
  • Using  assistive listening devices  (ALDs) to help so that the sound of television, music, or telephone from a person can be directly connected to the hearing aid used

Complications of Hearing Loss

Hearing impairment can interfere with the sufferer's activities. Some of the problems that can be experienced by people with hearing impairment are:

  • Obstacles when communicating with others
  • Decreased productivity at work
  • Increased risk of depression, shame, or low self-esteem
  • Decreased thinking ability and memory

In addition, sufferers can also experience body balance disorders if hearing disorders occur due to problems in the inner ear.

Prevention of Hearing Loss

To reduce the risk of hearing impairment, some efforts that can be made are:

  • Protect the ears from loud noises, by using earmuffs , earplugs,  or earmuffs that are shaped like headphones
  • Have a hearing test every year if possible, or at least every 10 years if under 50, or every 3–5 years if over 50
  • Dry the ears after showering or swimming using a soft towel
  • Listen to music or watch television with a volume that is not too loud, especially when using earphones or headphones
  • Do not insert fingers,  cotton buds , tissue, or any other object into the ear
  • Ask the doctor about the effect of the medicine used on hearing
  • Follow the recommendations and treatment given by the doctor if affected by an ear infection or other disease
  • Carry out routine pregnancy examinations , so that the health of the pregnant mother and fetus can be monitored
  • Ensure babies and children get complete immunization
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