Deafness: Symptoms, Causes and Treatment

Overview

Deafness is the condition of lacking the power of hearing or having impaired hearing. It occurs when people cannot understand speech through hearing, even when the sound is amplified. Deafness can affect the quality of life and relationships. Deafness and hearing loss are potential symptoms of some disorders. For example, disorders that involve the inner ear and auditory nerve often cause dizziness and tinnitus. Symptoms of deafness may be mild, moderate, severe, or profound. Hearing loss most often occurs gradually as people age. Hearing loss is the third most common health problem in the U.S, about 48 million Americans have lost some hearing.

Causes

There
are many possible causes that can lead to deafness, including ear infections,
trauma, long-time exposure to loud noise, medications, congenital diseases,
heredity and aging.

Aging
is the most common cause of hearing loss. People at the age of 65-74 have an
increasing risk of having some level of hearing loss. After age 75, about one
out of two people may suffer from hearing loss.

Illnesses
such as heart disease, high blood pressure, and diabetes may interfere with the
ears’ blood supply. For instance, otosclerosis is a bone disease of the middle
ear, and Ménière’s disease affects the inner ear, which can cause hearing loss.

Trauma,
especially a skull fracture or punctured eardrum, can potentially lead to
hearing loss, and even deafness.

Infection
or ear wax can block ear canals and lessen hearing.

Noise can weaken hearing ability, especially when it is loud and continuous. The Centers for Disease Control (CDC) reported that about 22 million American workers are exposed to dangerous noise levels on the job. Those people are at a higher risk of hearing loss.

Many deafness genes exist, but the most common one associated with hearing loss is a mutation in the connexin 26 (Cx26) gene. Cx26 has a carrier rate of 3% and it causes about 20% of childhood deafness.

Symptoms

The
symptoms of deafness or hearing loss depend on the causes. Some people are born
without the ability to hear, while others suddenly may become deaf due to an
accident or illness. For most people, the symptoms progress gradually over
time. Signs and symptoms may include:

  • Muffling of speech and other sounds
  • Difficulty understanding words
  • Delayed speech
  • Trouble hearing consonants
  • Tinnitus or stroke
  • Lack of startle response to noise
  • Lack of response to hand clapping

Diagnosis

To
diagnose deafness or hearing loss, several tests are needed:

  • A physical examination. The doctor will look into the patient’s ears by using an otoscope for possible causes of hearing loss. The otoscope is an instrument with a light at the end.

  • General screening tests. The doctor may adopt “whisper test”, asking the patient to cover one ear at a time to describe how well they hear words spoken at different volumes, and checking sensitivity to other sounds. However, its accuracy may be limited.

  • Tuning fork tests. This is also known as the Rinne test. Tuning forks are the metal instruments with two prongs that produce sounds when they are struck. It can help the doctor detect hearing loss. This test can also reveal where the damage has occurred in your ear.

  • Audiometer test: The patient will wear earphones, and sounds are directed into one ear at a time. Each tone is repeated at faint levels to find the quietest sound that the patient can hear. It is a more-thorough test.

  • App-based hearing tests. Mobile apps are available for the patients to use by themselves on the tablet to screen for moderate hearing loss.

Treatment

Treatment
depends on both the cause and severity of the deafness. Options include:

  • Removing wax blockage. Earwax blockage is a reversible cause of hearing loss. The doctor may remove earwax using suction or a small tool with a loop on the end.

  • Hearing aids. If hearing loss occurs due to damage to the inner ear, a hearing aid can be helpful. Open fit aids are currently the most popular treatment option.

  • Cochlear implants. If the patient has more severe hearing loss and the conventional hearing aids don’t work enough, then a cochlear implant may be recommended. A cochlear implant can bypass damaged or nonworking parts of the inner ear and directly stimulate the hearing nerve.

  • Surgeries. In some cases, hearing loss and deafness can be treated with surgery, including otosclerosis, infection or abnormalities of the ear drum or bones of hearing as the causes. If the patient has repeated infections with persistent fluid, the doctor may insert small tubes that help ears drain.

However, sensorineural hearing loss is incurable. When the hair cells in the cochlea are damaged, they cannot be repaired. The doctor will recommend various treatments and strategies can help improve quality of life.

Keywords: Deafness

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