Hearing Impairments

¶ … causes of hearing loss and reduction in people of all ages. Many people think of hearing loss as being either something a person is born with or something he or she experiences with old age, but those are far from the only factors that can result in hearing impairment. Whether the person is completely deaf or only has trouble hearing, there are a variety of causes that must be considered and ruled out before a definite determination as to the exact cause of the impairment can be made.

Additionally, there are several treatments to be considered. Which one of these is best for the person with the hearing impairment will depend on the cause of that impairment and other factors. Not every option will work for every patient, and doctors must consider numerous issues before making a decision regarding which type of treatment may be the right choice. There are some people with hearing impairment for which no treatment options exist, as well.

Since people lose their hearing for various reasons, there are not always ways to help them regain what they have lost or are losing. If the loss is gradual, they may be able to adjust to the change and the impairment. For a loss that comes on suddenly, adjustment can be more difficult.

This paper, then, explores the issues behind various types of hearing loss, in an effort to determine not only why people lose their hearing, but also whether gradual or sudden losses are more significant from a long-term perspective and how valuable different methods of restoring hearing actually are for a large number of people. While all treatments will not work on all people, improvements are being created all the time. Introduction When people experience hearing loss, they have either a complete or partial inability to hear (Robinson & Sutton, 1979).

There are many reasons why this can occur, and several treatments that can be used in order to allow them to hear again. Whether full hearing can be restored is an important consideration, but sometimes even being able to restore partial hearing is significant for the person with the impairment and enough to help that person resume a more normal life (Kral & O'Donoghue, 2010). The level of impairment is measured in decibels, with a special machine that provides tones for the person to hear.

What that person indicates he or she can hear provides the technician with information on the severity of the person's hearing impairment (Kral & O'Donoghue, 2010). Another consideration is that there are strong opinions in the deaf community when it comes to helping people hear and whether it is always in the person's best interest. Not everyone thinks that those who are born deaf should be made to hear, for example, especially if it is done through risky surgery or other methods. (Oishi & Schacht, 2011).

The methods used to help people hear have met with limited success. Hearing aids do not restore completely normal hearing, and they can be cumbersome and expensive. There are other methods, but they are not for everyone (Lieu, 2004). Additionally, some hearing loss cannot be reversed or stopped (Lieu, 2004). It depends on the reason for it, and the kinds of treatment to which the person responds. When a person is not able to have his or her hearing restored, it can be a very unfortunate thing.

However, many people who are born deaf or who lose all or part of their hearing at a later age are able to live normal lives with a few modifications (Lieu, 2004). While new advances can be explored for those who want to hear again, not everyone is so quick to attempt to get their hearing back. Causes Age Age is one of the main causes for hearing loss.

As people age, they are less likely to hear well because of damage that has been done over their lifetime (Kral & O'Donoghue, 2010). High frequencies are often what these people lose first, although some of them have trouble with lower tones, instead (Robinson & Sutton, 1979). The loss of high-frequency hearing is called presbycusis, and actually starts early in adulthood (Lieu, 2004).

Generally, people who have this condition do not notice it until much later in life, because it takes until older age for them to notice that they can no longer hear conversations properly (Robinson & Sutton, 1979). By the time they get to that point, they are significantly older (Lieu, 2004). They may at that point assume that their hearing loss is from "old age," but the groundwork of the impairment was laid much earlier.

While it is common, it does vary based on genetics and is not related to noise, disease, or toxins that could impair hearing (Lieu, 2004). Noise Nearly half of all cases of hearing loss come from noise, and five percent of people across the globe have some degree of problem with their hearing from noise related factors (Kral Oishi & Schacht, 2011). Fortunately, noise is one of the variables that can be avoided to some degree by most of the population.

People who live near airports and freeways are exposed to a high level of noise quite frequently (Lieu, 2004). These people are more at risk of losing their hearing because of the noise to which they are exposed on a daily basis, although noise affects everyone differently (Oishi & Schacht, 2011). Not everyone who lives with a lot of noise in their lives will have their hearing damaged, they are simply at a higher risk of impairment over time (Lieu, 2004).

It is important to consider the decibel level of the noise, as well as the duration of it, when calculating risk. Illness Diseases can cause hearing loss, especially in children and babies (Kral & O'Donoghue, 2010). Measles and Chlamydia both put people at risk, as do mumps and meningitis (Lieu, 2004). Fetal alcohol syndrome also puts babies at risk for hearing loss, and people who have HIV / AIDS frequently find that they have trouble with their hearing (Lieu, 2004).

Being born prematurely, having syphilis, taking chemotherapy drugs, or having a brain tumor can also affect a person's hearing (Lieu, 2004). While it would logically make sense that disease would or could cause difficulties with numerous parts of the body, including the ears and the ability to hear, many people do not think about illness when they consider hearing loss. Instead, they generally think about genetic issues, noise, or old age as the most important factors in whether a person hears well or has impairment.

However, there are many other reasons that have to be considered in order to find proper treatment. Illness is only one of those reasons, but with the number of illnesses that can cause hearing impairment it is well worth considering (Kral & O'Donoghue, 2010; Lieu, 2004). Genetics Nearly 75 to 80% of the cases of hearing loss are inherited through recessive genes (Oishi & Schacht, 2011). Another 20 to 25% come about through dominant genes, and the remaining genetic cases of hearing loss are through mitochondrial inheritance or x-linked patterns (Oishi & Schacht, 2011).

There are two different forms of deafness that are genetic in nature, and these are syndromic and nonsyndromic (Lieu, 2004). The syndromic version takes place when the genetic markers for hearing impairment are coupled with other medical problems in the individual, while the nonsyndromic version comes from finding only hearing impairment in that individual, absent from other medical problems (Lieu, 2004). Gene mapping is helping to find more information about both forms of deafness, but it is still not possible to determine the exact cause in every case.

Chemicals and Medications There are medications that will commonly cause damage to the ear which is irreversible, such as cisplatin and similar chemotherapy drugs (Lieu, 2004). For that reason, they are not used unless they have to be, to avoid permanent hearing damage to as many people as possible. There are other medications that can affect hearing, but they have more reversible affects, and these can include aspirin, NSAIDs, and diuretics (Lieu, 2004).

Women have to be particularly careful about taking NSAIDs and related medications, because they have a greater chance of hearing loss than men (Lieu, 2004). Medications used for erectile dysfunction can cause hearing loss, as well, which may be permanent (Kral & O'Donoghue, 2010). However, medications, both over the counter and prescription, are not the only concern for people who want to avoid hearing impairment. Chemicals can also be problematic when people are exposed to them.

Solvents, lead, gasoline, crude oil, and automobile exhaust are all possible causes for hearing loss, as are asphyxiants and heavy metals (Lieu, 2004). When a person starts losing his or her hearing due to chemicals it begins with the higher frequencies and is not reversible (Robinson & Sutton, 1979). The cochlea is damaged by lesions, and there are central portions of the auditory system that are degraded (Lieu, 2004).

Ototoxic chemicals like styrene can be extremely problematic, making for a higher risk of hearing loss -- especially when coupled with noise, such as in factory work (Lieu, 2004). Trauma There are two separate ways in which trauma can be a problem for people in the context of hearing loss. One is through direct damage to the ear itself, and the other is from damage to the brain that affects how it processes the sensory input from the ears (Kral & O'Donoghue, 2010).

When a person sustains any type of head injury, he or she is very vulnerable to hearing loss. It may be permanent, or it may only be temporary, but it will be likely (Lieu, 2004). Auditory cortex lesions can be a serious problem for hearing impairment, and can result in deafness or other types of problems (Lieu, 2004). Hearing impairment does not necessarily mean a person cannot hear.

It could also mean that a person cannot hear properly, in that things may sound garbled, or there may be ringing or another type of noise in the ears that is so loud as to be difficult to overcome (Lieu, 2004). Many of the auditory lesions cause problems that are not deafness, as they would have to be in the right spot and at the correct size to cause a person to go completely deaf. Neurobiology There are neurobiological reasons for deafness and other hearing impairments.

Either there is something wrong with the actual mechanical workings of the ear, or there is something wrong with the brain in its ability to process the signals it is receiving from the ear (Kral & O'Donoghue, 2010; Lieu, 2004). Sound travels from the ear to the brain, which is a delicate and complex process. The more complex something is, the more opportunity there is for something to go wrong with that process.

Such is the case with hearing, as issues can arise along the pathway from the sound coming into the ear all the way until it reaches the particular part of the brain where it is processed (Lieu, 2004).

One step depends on the step right before it, so if something goes wrong anywhere along the line, it may not be possible for the sound to continue to the area of the brain where it is needed in order for the person to hear the sound correctly -- or at all (Oishi & Schacht, 2011). Management and Treatment Hearing Aids For people who have relatively standard forms of hearing loss, hearing aids can be the best choice.

They help the person to hear sounds more loudly, as they magnify what is coming into the ear (Lieu, 2004). However, they will not restore normal hearing to a person who is losing his or her ability to hear. Nothing can do that, unfortunately, although it is possible that new options will come available in the future. Hearing aids work by amplifying sound, so the person wearing them does not have to ask everyone around them to speak up (Lieu, 2004).

It can become easier in restaurants and other social settings to hear people, as well, making interactions less awkward for the person with the hearing impairment and for the other people around him or her (Kral & O'Donoghue, 2010). Assistive Devices There are a number of assistive devices that can be used by a person who is hearing impaired, in order to handle daily life tasks. One of the most common is the closed captioning system on the television set.

This allows a person who has a hearing impairment to read the words that the characters in the TV show are speaking. While closed captioning is not always 100% accurate and can have delays and other glitches, it is a good, useful tool for a person to enjoy his or her favorite shows, watch the news, and keep up with the world around him or her (Oishi & Schacht, 2011).

Another important option for hearing impaired people is the telephone system that allows them to see the words the person on the other end of the line is speaking (Lieu, 2004). This is an excellent way for them to be able to converse with others, and can help them lead lives that are more normal than they would otherwise be able to accomplish. Even with email and other methods of communication that do not require hearing, there are still times when a telephone conversation may be needed.

Cochlear Implants Perhaps one of the most impressive advances in helping people who have a hearing impairment is the cochlear implant (Oishi & Schacht, 2011). These stimulate the cochlear nerve through an electrical impulse, and are permanently implanted through a surgical procedure (Lieu, 2004). There is also a risk for people with these implants to contract bacterial meningitis, so a vaccine is recommended (Oishi & Schacht, 2011). Studies have shown that these implants can be an excellent choice for very young children who have profound hearing loss (Kral & O'Donoghue, 2010; Oishi & Schacht, 2011).

When they are treated early, they are often able to develop reasonable hearing and language skills as long as they have rehabilitative therapy to go along with the implant (Oishi & Schacht, 2011). While their hearing will not be "normal," they can learn to use it well enough that it will make a significant impact in their lives and the lives of their loved ones. These implants can also be helpful for older people who have lost all or part of their hearing.

The Deaf Community Even though there have been many advances in technology that can reduce.