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Author: admin | 25.01.2014 | Category: Tinnitus Hearing Loss

The ability to hear sounds can be partially or completely impaired, resulting in hearing loss. Hearing-impaired people suffer certain social, psychological and physical problems as a result of their hearing loss.
Although permanent loss of inner ear hair cells results in hearing loss which cannot be reversed, advancement in technology has helped to minimise the resulting disability. Newer hearing aid technologies include those which can be implanted into the middle ear by surgery.
For those who find hearing aids of limited benefit due to the severity of damaged hair cells, cochlear implant may be a viable option.
In general, with a personal experience of more than 500 cochlear implant surgeries performed, I find this technology very effective in suitable patients.
In cell and molecular biology, the regeneration, repair and protection of hearing cells and nerves are exciting rapidly evolving fields.
Associate Professor Low Wong Kein, MBBS, PhD, FRCS Grad Dip (Acupuncture), is a Senior ENT Specialist at Mount Elizabeth Novena Hospital, Singapore. Anyway I was recently asked about digital hearing aids and my experiences after six weeks of sporting them.
I realised that my hearing was poor a long time ago, well over 10 years ago, but I never really did anything about it.
When I first had my hearing tested, the audiologist identified a hearing loss in the middle range and at the high frequencies. I was advised that some hearing aids could cost between ?500 and ?2000 depending on the technology. If you look at the above graphs against the graph below that I nicked from this webpage, you’ll see that the hearing loss is mild to moderate, with high frequencies hurtling towards the severe. I would have paid for the hearing aids, probably making a judgement that around ?1500 is a reasonable price to pay, but I went with my picture to my GP and asked if I could see someone in the NHS.
I saw the GP who took one look at the graph and referred me to the consultant at Ormskirk hospital. He said that NHS hearing aids are decided on a case by case basis and that I should have some, in both ears. About six weeks later, I had an audiology appointment and was issued with some Siemens hearing aids. The aids work as small graphic equalisers, programmed to amplify those frequencies that can’t be heard well. My experience to start with was common with other users – every small sound felt amplifed beyond comfort. Mine are programmed with three modes which can be changed by pressing the button on the back of them.
I find that if they are irritating, I’ll move them around a little which scratches the itch. Today started relatively early, a 0515ish start to try and get some work done before Jude and the children get up at 7. The other reason for getting up early and getting some work done was that I was due at the hospital at 1100 to have some hearing aids fitted.
So actually getting to the day when they were fitted, and then pottering around trying to get used to them has had me get more and more fed up through the day. The outer ear consists of the visible part of the ear (pinna), the ear canal and the ear drum. The middle ear is an air-filled space that contains the three smallest bones in the human body: the malleus, the incus and the stapes. Patients who suffer a severe to profound hearing loss in one ear report no comprehension difficulty in quiet, one-on-one conversations. When a sound occurs toward the deaf ear, the arrival of that sound at the hearing ear is partially blocked by your head, commonly known as the head shadow effect. To your brain, one ear + one ear = three!  A sound that is barely audible at 20 feet away with only one ear is easily audible at 30 feet when two ears are listening. In addition, this neural sharing contributes to an advantage, known as binaural squelch, when listening in background noise. The traditional hearing aid solution for unilateral hearing loss has been the use of a CROS hearing aid. This CROS type aid prevents the head shadow effect but does nothing for localization ability and does not provide binaural summation or squelch. If the hearing loss is in the  severe category, a traditional hearing aid either in a behind-the-ear (BTE) or in-the-ear-style can be fit. A fairly recent surgical solution for single-sided deafness (SSD) is the implantation of a BAHA or Bone-Anchored Hearing Aid. By having someone else voice their view on what you may be missing, we can help pinpoint where we can help the most. Due to each patient’s individual needs, we need to take time to truly understand their situation before making any recommendations. If you must raise your voice to speak with someone only 3 feet away, you are in high (hazardous) noise. The hair cells can be worn out by long periods of loud sounds (or short blasts of extremely loud sounds).
Hearing protectors reduce the wear on the hair cells by blocking noise and reducing it to a safe level, without preventing you from hearing sounds around you. There are four basic types of hearing protection listed below; each offers different advantages and options.
Fit is very important for all types of hearing protectors: no one wants to wear shoes that don't fit well. Custom-molded plugs are made especially for you so are already shaped like your ear (rather than conforming to your ear).

Hearing tests can be arranged where hearing loss can be confirmed and the degree of hearing loss determined.
Yet, in Singapore, almost 70% of the elderly who need hearing aids are not keen on having them. While this may be true for hearing aids of the past, modern digital hearing aids have added features and processing schemes that were previously not possible, making hearing amplification better and more comfortable.
The potential advantages of implantable hearing aids are the elimination of feedback and the occlusion effect, as well as improved fidelity and cosmesis.
Using electrical signals, the cochlear implant stimulates the hearing nerve directly, without the need to rely on viable cochlear-hair cells to work. Gene therapy has been shown to be an effective method of providing long-term support to hearing cells in animals. In adults, untreated hearing loss can lead to anxiety, embarrassment and withdrawal from social contact. Partly I was still expecting someone to say that there was a lot of ear wax and that they just needed washing out. There wasn’t much discussion, only his observation that Specsavers were getting the contract for the NHS hearing tests.
I had another set of tests that came out with the same results and then had a good talk to the consultant. The audiologist uses software that takes the results of the hearing test and programs the aids via a short cable.
These can be then be paired up with multiple bluetooth devices and can also be used for volume control. When Jude and the children would get home from work and school, I would feel like the whole world was a cacophony of noise.
I went to the hospital the following day and they just programmed a new one and I was sent on my way.
On Tuesdays, Wednesdays and Thursdays I pick the children up at 1530 and so to all practical purposes, my day finishes at 1500. My voice is loud and different, my breathing is louder (especially when exercising) and there is a curious resonance when I whistle a single note that makes it sound like a 60’s science fiction special effect.
The children sounded like they were playing at volume 11, and the soreness in the ears all added up to make me feel a bit old, a bit not-working and a bit low.
The cochlea is a snail-shaped bone filled with fluid and thousands of tiny a€?hair cellsa€? that process sound vibrations.
However, understanding conversation in less-than-ideal listening situations is severely compromised.
Your ears individually and collectively gather acoustic information and relay those signals to the auditory reception centers in your brain.
The sounds most easily blocked are the higher pitches, which are absolutely necessary for accurate perception of the voiceless consonant sounds of speech —the s, c, f, t, p, ch, and sh sounds. So someone with hearing in only one ear lacks the instantaneous locating cues of time and intensity. This is called the binaural summation effect and is the result of the two hearing nerves crossing many hundreds of times before the information reaches the cortex.
This squelch provides 3 decibels more signal than noise, also known as the signal-to-noise ratio (SNR). The acronym stands for Contralateral Routing of Sound and employs a unit on the dead ear which contains a microphone to pick up sounds arriving on that dead side. As with all hearing aid fittings, there is an accommodation period during which the patient learns to use the acoustic information from the damaged ear. This surgical implant uses bone conduction to send sounds from the bad ear side to the good ear via an implant with a microprocessor that adheres to a magnet under your scalp. Loss of hearing in one ear is a significant handicap with which many people cope through the use of CROS-type hearing aids, BAHA implant, and positioning themselves  to maximize the best sound reception to the hearing ear. Below are links to sample audiograms showing one example of a normal audiogram, as well as an example of an audiogram demonstrating hearing loss from noise exposure. The tiny hair cells lining the cochlea respond to vibrations (amplified by the ear drum and the middle ear bones) and send signals to the brain, alerting us to sounds. With all of these choices, you need to try different types until you find one that feels comfortable, properly blocks out noise, and works for your activities.
There are three different types of hearing loss, depending on which part of the ear is affected. This is despite the fact that 40% experience negative psycho-social effects as a result of the handicap. With increased advancement in technology, sophisticated features are incorporated in most devices today. There are also bone-anchored hearing aids, where the hearing aid is fitted onto a titanium screw, which bio-integrates with the mastoid bone. The implant consists of an internal portion which is surgically placed under the skin, and an external speech processor that sits behind the ear.
Over the last few years, much progress has been made in the molecular basis of age-related hearing loss, with the aim of preventing hearing loss in the elderly.
The good news is that in the vast majority of patients, modern technology and medical advancement can potentially alleviate the disability resulting from hearing loss. The most fun being a tuning fork placed on my forehead (Weber’s test)- I could sense the note over on one side of the head which confirmed some nerve damage. This echoed the advice from Specsavers, so I’m guessing that it was probably the right diagnosis.
In fact I expected to at least have to sign a receipt or something, but no – I had them fitted and was told to be on my way.
The model that I was issued with was the Siemens Impact Pro L (the link is to the user manual, I couldn’t find a decent single page for them).

If the plugs aren’t in properly, then there is feedback and whistling, but only very quiet and (I think) only I can hear it. The middle ear is also connected to the throat via the Eustachian tube, which makes sure the air pressure is the same on both sides of your eardrum, and allows your ears to a€?popa€? when youa€™re flying in a plane or driving through mountains.
Vibrations enter the cochlea and the fluid is set into motion, like a wave, and the hair cells move in response. With only one ear collecting information, the auditory centers are starved for the complete acoustic picture normally provided by two ears. These consonants allow us to tell the difference between words like teach versus feast and distillery versus facility.
If someone calls your name outdoors, you have to turn your head around to locate the source, and it may take several repetitions to accurately pinpoint the source. This crossing, or decussation, results in the enhancement of sound, so softer sounds become audible. Even though 3 decibels might not seem like much, the decibel is a logarithmic function, much like the Richter scale is for earthquake measurement. The sooner the fitting is done, the more likely the patient will be a successful hearing aid user.
The processor is detachable for showering, etc., and is easily hidden underneath your hair.
Then the cells lay over like wet grass, demonstrating a fairly long exposure to loud sound.
More frequent excessive exposure to noises from leisure-related activities has contributed to an increasing number of children and young adults having noise-induced deafness. These include providing users with enhanced listening in noise and better appreciation of music. This type of hearing aid is useful for patients who are not able to wear a hearing aid in the ear canal, such as those with chronic ear infections or atretic ear canals.
Hearing in both ears offers better hearing in noisy environments as well as more effective localisation of the direction of sounds. However, the progress made so far is still largely experimental and has not been applied in routine clinically use. Friends encouraged me to go, something that in retrospect was a lovely thing to do, and I very much appreciate it. The aids need to be programmed to work with the device, but the hospital will be able to do it.
The second mode is to amplify people directly in front of you, which seems to work brilliantly in restaurants, meetings, etc. Blowing or sucking the end of the hearing aid will usually clear the wax, but it turns out that most people find this gross. Janet, the audiologist, was lovely and showed how she was fitting the amplification to the hearing test graph. When the hair cells move, they send electrical signals along the hearing nerve and toward the brain.
When this information is lacking, a number of things  happen that impair your ability to organize and make sense of speech. This word discrimination ability is compromised by hearing with only one ear because of the head shadow effect. Again, the BAHA does not accomplish true binaural hearing, but it does lessen the head shadow effect, and some recipients do notice improved localization ability after use of the BAHA for some time. D’Alessandro is a Charter Member of the Pennsylvania Academy of Audiology and served on its Board for 9 years.
Because the exposure is so long (relatively), the cells do not bounce back to their normal position, but instead become damaged. A study among National Service conscripts in Singapore revealed a hearing loss prevalence of almost 40 in 1,000, especially those with frequent exposure to loud noise. Besides better functioning, there is a trend towards increasing miniaturisation, which has progressed from body-worn aids, to aids worn behind the ear and in the ear canal. In a process called MAPping, the audiologist uses customised software to set appropriate levels of electrical stimulation to allow audibility of soft sounds and at the same time, ensure uncomfortable loudness sensations are not produced.
Without that encouragement, I’d probably still be pottering around at 60 complaining about everyone muttering. However, my hearing loss is right in the mid-range frequencies and it turns out that there is a *lot* of noise in that range. But how does it apply to hearing loss?Without getting too technical, hearing loss is essentially the break down of hair cells. So three decibels extra is a significant amount and allows for easier understanding in noisy situations.
In the elderly, approximately one in three people between the ages of 65 and 74 has hearing loss. FM systems can be used to enhance the effectiveness of hearing aids, by improving signal-to-noise ratio. It sounds like the person with the microphone is stood right next to you (the priest in this case) and the sensation is unreal.
But eventually the irreversible damage to enough hair cells will cause significant hearing loss.This is where stem cell therapy steps in. My only disappointment was that he didn’t mutter, swear or pass comment on the congregation under his breath. Required fields are marked *CommentName * Email * Website Get personalized tips and information about your hearing.

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