Signs of hearing loss can
be varied. In the child it may be
the inability to normally respond to sounds and develop language. In
the adult symptoms may be tinnitus or ear ringing,
fullness in the ear or difficulty understanding speech in a noisy environment.
Search PubMed for Tinnitus
Take a Self
Test On Ear Disease and Hearing Loss !!!!
Diagram of Ear **
The ear processes
two important steps:
The first is the
collection and amplification of the sound, using the external ear, ear
canal, eardrum and the ear bones in the
middle ear. Disease in this
area of the ear will cause a "Conductive Loss" or loss of sound
loudness. Surgery will often restore the hearing to near normal levels
and if the patient is unable to undergo surgery a hearing aid will greatly benefit
the patient. Even an simple auditory amplifier which costs under $50
can return the hearing to normal. This type of hearing loss is most
commonly found in children and presents as an ear infection or ear
fluid. Examples of Conductive Hearing Losses:
The second is the
processing of the sound by the cochlea and converting the sound into nerve
impulses and transmitting them to the brain via the auditory nerve.
The processing of the sound is very complex, parts of the sound are actually
recreated by the
and can be heard by use of a microphone.
This process is the basis for otoacoustic emission testing in
children. Hearing losses involving this process are called
sensorineural. Sensory for losses involving the cochlea and neural for
losses involving the auditory nerve. Sensorineural hearing losses are
most common in the adult. Unfortunately, there is no cure for these
losses but the most common type, noise-induced hearing loss, are
preventable. If the loss is determined to be neuronal in type, a
central lesion, such as a brain tumor, needs to be sought for.
aids will help patients with this type of hearing loss, but usually do
not restore the hearing to normal. Examples of sensorineural hearing loss:
Search PubMed for Noise Induced Hearing Loss
Hearing loss associated with aging.
Search PubMed for Presbycusis
Disease - Hearing loss associated with increased pressure in the
(fluid contained in the cochlea).
Search PubMed for Meniere's Disease
hearing loss comes on quickly, without warning and for no know reason.
These hearing losses are called a " Sudden Sensorineural Hearing Loss ".
All other causes, such as an acoustic neuroma, should be excluded before
this diagnosis is made. There is some evidence that steroids, when given early,
may help some patients.
View Article. The use of
antiviral agents are controversial with some authors having shown them to be ineffective.
View Article Physicians
advocated the use of agents to increase blood flow, such as plasma
expanders and vasodilators but these medications have not been proven to be
Conlin and Parnes (Arch Oto 2007) reviewed the randomized controlled
studies for sudden hearing loss. They concluded that there are no
valid controlled study for sudden hearing loss treatment and systemic
steroids should not be considered the gold standard.
however should include strict limits on heavy lifting
Tumors of the
auditory nerve - Most commonly a slowly growing benign tumor called an
Search PubMed for Acoustic Neuroma
In children a
permanent hearing loss has a hereditary etiology (cause) in 39%,
acquired in 30%, other causes in 7% and an unknown cause in 24%.
acoustic neuroma is a slowly growing benign tumor located on the
auditory nerve. Although benign, it can be fatal if left
untreated. Up to 10% of autopsies on normal patients have been
reported to contain acoustic neuromas. Thus, some small neuromas
in older patients are followed to see if they will grow.
Patients with a hearing loss
that is worse in one ear than the other should be considered at risk for
this disease. Most should undergo a brain stem auditory evoked
response or MRI scan.
The patient shown in the right
MRI scans, had only a 20 dB loss at 2000 Hz and 4000 Hz. He had
100% discrimination (understanding of words) which is not characteristic
of a neuronal hearing loss. The neuroma showed significant growth
over a 3 year period. It was removed using a sub-occipital
This patient is a 35 yr old female
with a condition called neurofibromatosis. Shown in her initial
MRI scan are bilateral acoustic (ear) and orbit (eye) lesions. She
presented with a unilateral hearing loss with poor discrimination.
To learn more about neurofibromatosis, go to the National Neurofibromatosis
Site Map )
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