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Otosclerosis —An abnormal overgrowth of one or more bones in the middle ear prevents the small bones from moving normally. Meniere's disease — This typically causes dizziness, hearing loss, ringing in the ears (tinnitus) and a sensation of fullness or stuffiness in one or both ears. Drugs — Many prescription and nonprescription medications can damage the ear and cause hearing loss. If you have sudden, severe hearing loss, you will notice immediately that your ability to hear has decreased dramatically or disappeared totally in the affected ear. Wear protective earplugs or earmuffs if you are often exposed to loud noise at work or during recreational activities.
Drug-induced hearing loss — Stopping the problem medication may reverse hearing loss or prevent it from getting worse. Sudden sensorineural hearing loss — When the cause is unknown, this condition is usually treated with a corticosteroid, such as prednisone.
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Who are our clients with hearing loss and how can we best facilitate effective communication?
What are the characteristics of hearing loss and what are ways of diagnosing and treating people with hearing loss?
How can vocational rehabilitation professionals appropriately prepare to serve consumers with hearing loss? Where can people with hearing loss find current information, long-term support and tools for self-advocacy?
Sensory loss occurs when there is damage to the cochlea, the end organ of hearing that lies deep within the temporal bone.
See healthy stereocilia, from the tops of the outer and inner hair cells through the membrane covering them in photo A. Acoustic trauma refers to damage that occurs to the ear or auditory system from sound waves that are very loud. Most damage from acoustic trauma occurs in the cochlea; the high pitch areas of the cochlea are more susceptible to damage than the low pitch areas.
If immune components such as immunoglobulin get into the inner ear, that exposure can produce localized immune response and possible hearing loss. Physicians may find it difficult to diagnose autoimmune inner ear disease and often have an extensive protocol of tests to determine the underlying pathology. The important idea for VR Counselors is that this hearing loss occurs very quickly with no ‘warning’.
Meniere’s is said to be caused by endolymphatic hydrops, a condition with too much fluid in the inner ear.
These drugs have different levels of ototoxicity, and other factors such as dosage and duration of taking the drug can have effects.
We now know that a genetic change in the mitochondrial DNA, ‘A1555G’, makes the individual very susceptible to hearing loss given even modest amounts of aminoglycosides. Typically labeled ‘hearing loss due to aging’, presbycusis has recently been shown to have a definite genetic component. In the past we thought the environment one lived in was the biggest contributor to presbycusis, but we know now that genetics plays a much larger role than we thought.
The hearing loss configuration most often seen in presbycusis is labeled ‘sloping’; the X’s and O’s will be normal or near-normal in the low pitches and will move down the audiogram (worse hearing) in the mid- and high frequencies.
A fairly new type of hearing loss that has recently been shown to have a genetic basis is auditory neuropathy spectrum disorder (ANSD).
People who suffer from auditory neuropathy report that speech understanding, even in quiet environments, is very hard. Other problems that can exist with the eighth nerve or the central nervous system are tumors, the most common one probably being an acoustic neuroma. There are other medical conditions which might impair function of the eighth nerve, most commonly Multiple Sclerosis (MS). Other demyelinating diseases that may have hearing loss involvement include Charcot-Marie-Tooth syndrome, Devic Disease, Guillain-Barre Syndrome, a group titled Leukodystrophies and Progressive Multifocal Leukoencephalopathy. Tests developed to diagnose APD can generally be used only with people who have normal hearing, which makes APD quite different from all the other hearing loss causes in this module. Treatments for APD are varied and dictated by the specific problems that individuals demonstrate.
HOW DO WE HEAR SOUND?Sound waves move through the outer ear and set up vibrations in the middle ear. We offer education through formalised training, tailored to the individual in regard to noise exposure, its consequences, causes, and solutions, through our comprehensive educational group sessions.
Arguably, the essential part of any 'Hearing Conservation Program' is ensuring the people wearing the hearing protection understand the fundamentals of noise and the risks associated with exposure to it. Even the most conscientious employer who offers a range of Hearing Protection options has an uphill battle if people don't understand why they need to wear it. Cellphone use: A new study suggests that extended cellphone use for more than 60 minutes per day may cause high frequency hearing loss. Treatment: Before treatment can be administered, Your physician will need to test your hearing to find out what type of hearing loss you have and the extent of the damage incurred.
Hearing experts at the University of Southern California’s Keck School of Medicine and several other institutions are conducting an ABI trial aimed at helping children born without a hearing nerve. As previously reported in a July 2010 article in Hearing Review, Dr Eisenberg has had extensive experience working with children and hearing devices, including the first pediatric cochlear implant. Anatomical view showing ABI placement, which bypasses the cochlea or inner ear (photo courtesy of Cochlear Inc). In the United States, the ABI is approved for use only in patients 12 years or older who have neurofibromatosis type II, an inherited disease that causes a non-malignant brain tumor on the hearing nerve.

The scientists report that surgeons outside the United States have been doing ABI surgeries in children for more than 10 years, but there has never been a formal safety or feasibility study under regulatory oversight. According to the Keck School of Medicine, the NIH clinical trial grant covers the costs of the ABI device, procedure, and subsequent testing. More information about the ABI and its benefits can be found in an article by audiologists Margaret Winter, MS, and Steve Otto, MA, that appeared in the Winter 2013 edition of the Hearing Products Review.
The most common reversible causes are severe buildup of earwax in the ear canal and acute infections of the external ear or middle ear. A vibrating tuning fork is placed in the middle of your forehead to help diagnose one-sided hearing loss.
The doctor uses a hand-held device to generate tones of various intensities to find out if you can hear them. Your doctor may recommend a hearing aid or an implant to improve your ability to communicate with others. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
Researchers are learning a lot about cochlear function but there are few medical treatments available at present.
Photos B, C and D show various losses of inner and outer hair cells resulting from some insult to the cochlea. Loss of outer hair cells is thought to be the most common form of cochlear damage and to underlie most cases of sensory hearing loss that range from mild to about moderately severe.
In many cases the individual recalls a single incident that, in all likelihood, caused their hearing loss. However, the hearing evaluation can reveal anything from a mild loss to a profound hearing loss.
The fluids in the IE are protected by tissues that allow only some of the body’s fluids and molecules to enter. This hearing loss is caused by autoimmune inner ear disease, usually occurs in both ears, called bilateral loss, and is progressive but at different rates in each ear. If these problems are present they tend to be episodic and between these episodes the person may exhibit ataxia, walking with a very wide gait to keep from falling down.
If medical treatment is somewhat successful or not successful, these individuals will be functionally impaired almost immediately and obtaining audiologic treatment and VR services as quickly as possible will be important to and for them. The low frequency sensorineural loss in Meniere’s is rare, as most other damage to the cochlea causes high pitched sensorineural hearing loss. This means that symptoms occur, the person experiences hearing loss, dizziness and tinnitus and then those symptoms recede. However, the audiologist will ask about noise exposure activities and medical history to uncover possible causes for the hearing loss. The two largest categories of ototoxic medications are the aminoglycoside family and some members of the platinum chemotherapy drug family. In addition, some drugs will affect the cochlea more while other drugs may affect the vestibular, or balance system more. A person’s genetic makeup interacts with the environments in which they grow up and live (for example, noisy or quiet job, exposed to ototoxic medications or not), that determine when, how fast and how much cochlear hearing loss they will suffer. As of 2011, at least two gene mutations have been identified in individuals with presbycusis, with another four genes thought to contribute.
ANSD is characterized by normal functioning of the outer hair cells, and therefore some hearing tests ( otoacoustic emissions), are normal. It has also been shown that this disorder can result in auditory thresholds that fluctuate over time and for some people thresholds depend on the temperature.
Some people respond well to hearing aids, while for others amplifying the signal is painful and not helpful. Less common but equally devastating would be tumors from a genetic condition called neurofibromatosis type II. However, common symptoms of APD include trouble understanding speech in background noise, sound localization and discriminating timing differences and auditory patterns in speech. Testing an individual for APD should include a typical hearing evaluation as well as a special set of tests designed to measure various auditory capabilities. The vibrations are then transmitted to the inner ear, and the wave motion in the inner ear is sensed by the auditory nerve hairs in the cochlea, which transmits neural messages to the brain.
We are entering a time when the long term effects of exposure to noise will become paramount.
Additionally, they are unable hear higher octaves, like a woman's or a child's voice, or a bird chirping.
In retrospect, two studies, Danish and Japanese, found there was no correlation between cell phone use and brain tumors. The best treatment is the use of a hearing aid, preferably digital, that can be programmed specifically to your needs. The 3-year clinical trial, launched in March 2014, has successfully implanted an auditory brainstem implant (ABI) device in 4 children who previously could not hear. According to Dr Eisenberg and colleagues, hearing loss manifests in various forms, most of which can be partially restored through hearing aids and cochlear implants. To qualify for participation, pediatric patients must show that standard treatment for hearing loss, such as hearing aids and cochlear implants, have been ineffective. Noise-induced hearing loss can happen because of a single brief burst of an extremely loud sound.
Acoustic neuroma often causes dizziness and equilibrium problems in addition to gradual hearing loss. Or it can result from a Q-tip that ruptures the eardrum during an attempt to clean the ear canal. Your doctor will want to know if you have been exposed to loud noises, trauma of the ear or head, or ear infections. He or she will check for middle-ear problems by measuring your eardrum's ability to reflect sounds.

A hearing aid amplifies sounds electronically and is effective for many people with age-related hearing loss.
Researchers hypothesize that severe to profound sensory hearing loss includes loss of outer and inner hair cells. If there is outer ear or middle ear damage it is first and foremost a medical problem which the physician will treat before an audiologist offers any treatment. Antibodies, also known as immunoglobulin, are proteins that the immune system uses to identify and get rid of foreign objects like bacteria and viruses.
Whenever the amount of hearing loss is different in each ear it is called asymmetric hearing loss.
Another symptom commonly reported is roaring tinnitus, something like the roar in the seashell. The individual may have no problems for weeks, months or even years, until another episode occurs.
Often, transient sounds or more on the order of milliseconds or tens of milliseconds (that is, thousandths of a second). Tinnitus, or ringing in the ears, may be the presenting complaint as well as difficulty understanding speech in a noisy background, which is perhaps the most common complaint of everyone who has cochlear hearing loss. At first, frequencies above 4,000 Hz have the better thresholds but as a person ages, these thresholds may become poorer as well. If an individual is in need of any of these drugs hearing loss is often a secondary consideration because their life may be at risk. Audiologic treatment should begin as quickly as possible, and services from vocational rehabilitation will be critical for these individuals to continue to function well day to day. In addition, diet, stress and other systemic conditions such as diabetes, may also add to hearing loss in the ‘presbycusis’ category. With ANSD, the signal becomes ‘corrupted’ when it reaches the inner hair cells and must cross the synapse to the acoustic (eighth) cranial nerve.
A third treatment type lies in making changes to the person’s environment to facilitate their listening capabilities, such as with an amplified telephone or an assistive device called a frequency modulated or FM system. Inability to hear sounds in the high frequency range is a common occurrence in the adult population, and is associated with sensorineural hearing loss. Hearing aids are very effective, particularly digital open-fit hearing aids that leave the ear canal partially open. According to a recent announcement, the research team presented preliminary findings at the American Association for the Advancement of Sciences (AAAS) 2015 Annual Meeting in San Jose, California, on February 14, 2015. However, those devices cannot help a small population of individuals who do not have a cochlear nerve, or hearing nerve, that sends sound signals to the inner ear.
Scientists believe that the ABI would be more effective in younger children, because their brains are more adaptable. Your doctor will want to rule out the possibility that medications may be causing your hearing loss. Hearing aids today are very small, so small that other people often do not notice you are wearing them. Many conditions that occur within the cochlea result in the loss of outer or inner hair cells.
Hearing levels may recover to some extent, but few people regain absolutely normal hearing. Physicians may suggest reducing caffeine and salt, which many people say helps to some extent. In other cases, the person may benefit from the use of an oral interpreter who silently mouths the words so the person with ANSD can use speech-reading to understand.
In that case, amplification on that ear would not be helpful; however, that individual may find the need for a hearing aid set up to pick up environmental sounds on the affected side and send them to the other ear. When we hear, sound is carried from the external ear and funneled through the ear canal to the tympanic membrane (eardrum) where it vibrates against the eardrum. For people without a hearing nerve, there is no way to perceive sound, even with a hearing aid or cochlear implant.
The current clinical trial will attempt to prove that the ABI surgery is safe in young children, and will allow researchers to study how the brain develops over time as it adapts to learning to hear sound and develop speech with the help of the ABI. It is typically harder to hear high-pitched tones (women's voices, violins) than low-pitched ones (men's voices, bass guitar). Photograph A) below shows healthy stereocilia, projection from the tops of the outer and inner hair cells through the membrane covering them. The ABI is considered to be a revolutionary device because it bypasses the inner ear entirely, stimulating neurons directly at the human brainstem. There are also several surgical procedures that might be used in cases of intractable vertigo. Researchers have discovered that workers exposed to noise and some chemical substances (such as toluene and xylene) simultaneously can suffer greater amounts of hearing loss and cochlear damage than if they are exposed noise alone. Vibrating against each other, the bones send signals to the inner ear where the tiny hair cells in the cochlea send electrical impulses through the cochlear nerve to the brain. Factors that will determine the correct aid for you are type of hearing loss and lifestyle. Additionally, the type of hearing aid that you will be comfortable using will make a difference.
Know that there will be a period of adjustment in getting use to wearing a hearing impairment device. You will need to visit with the audiologist for fine tuning to get the best hearing possible, which will serve to enhance your quality of life.

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