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A lot of times an Otolaryngologist won’t be able to pin-point the exact cause of a low frequency hearing loss, but it is usually one of the following. With traditional, high frequency hearing losses, folks tend to have a hard time understanding speech- since most of the clarity of speech comes from high frequency sounds.
One of the most common complaints among those with a reverse slope hearing loss is difficulty hearing on the phone. If you suffer with low frequency hearing loss, you’ve probably realized that the majority of hearing loss information around the web is centered around high frequency hearing loss.
If you want to read a very in-depth analysis on this subject from a PhD who has an extreme low frequency hearing loss, check out this site. If you’d like a free phone consultation with a licensed hearing provider, please feel free to call us at 800-731-6794. Meniere’s Disease, also known as Endolymphatic Hydrops, is an inner ear disorder that is caused by an overproduction or underproduction of endolymphatic fluid found within the cochlea or inner ear. As a result of the pressure changes of the inner ear, fluctuating low frequency hearing loss occurs, which can become permanent and worsen over time.
The exact cause of Meniere’s Disease is unknown, however there several factors that may contribute to it. Gentamycin: A steroid injection applied across the eardrum to the inner ear to help resolve some of the symptoms. Hearing Aids will help to improve audibility and localization of sounds in one’s every day listening situations.
Labyrinthectomy, removal of the inner ear, and a Chemical Labyrinthectomy, a drug used to destroy the vestibular (balance) system, may be recommended however only as a last resort. We have 3 locations in Calgary: North, North West and South and an office in each Okotoks, Cranbrook and Creston, and Invermere, British Columbia. Sensorineural hearing loss (SNHL) is hearing loss due to cochlear (sensory) or VIIIth nerve (neural) auditory dysfunction.
Conductive hearing loss occurs when there is a problem conducting sound waves easily through the outer ear canal, tympanic membrane, or middle ear (ossicles).
The configuration, or shape, of the hearing loss refers to the degree and pattern of hearing loss across frequencies (tones), as illustrated in a graph called an audiogram. In addition, hearing loss may be bilateral or unilateral, symmetrical (degree and configuration of hearing loss are the same in each ear) or asymmetrical, progressive or sudden in onset, and fluctuating or stable. Note: The scope of this content is limited to the diagnosis and management of hearing loss for individuals ages 5 years and older from an audiological perspective. The ASHA Action Center welcomes questions and requests for information from members and non-members. Sensorineural hearing loss is the most common type of hearing loss, occurring in 23% of population older than 65 years of age. Infections, such as meningitis, are a common cause of hearing loss in children where it occurs in approximately 20% of those with streptococcus pneumoniae meningitis (Heckenberg et al 2011). Noise induced hearing loss is a permanent hearing impairment resulting from prolonged exposure to high levels of noise. Children who are born prematurely or contract certain infections in utero are at a higher risk of hearing loss (Hille et al 2007, Roizen 2003). While very unusual, acoustic neuromas or metastatic cancer (particularly breast) can be a source of hearing loss. Sudden hearing loss (SHL) is defined as greater than 30 dB hearing reduction, over at least three contiguous frequencies, occurring over 72 hours or less. Sensory presbyacusis is caused by loss of sensory elements in the basal (high-frequency) end of the cochlea with preservation of neurons.
Cochlear conductive presbyacusis is caused by thickening of the basilar membrane caused by deposition of basophilic substance. Because presbycusis occurs in some individuals as they age but not in others, genetic or environmental factors must also play a role in its development (Liu & Yan 2007). In conductive hearing loss, the second most common form of hearing loss, sound is not transmitted into the inner ear. Images marked as copyright Northwestern University were developed with the support of a National Institutes of Health (NIH) grant to Northwestern University Dept.
The American Hearing Research Foundation is a non-profit foundation that funds research into hearing loss and balance disorders related to the inner ear and is also committed to educating the public about these health issues.
Menieres disease is characterized by a cyclical pattern of sudden hearing loss, tinnitus (ringing in the ears) followed by vertigo. As mentioned under tinnitus the frequency of the noise with Menieres is in the low pitch area. In the beginning of the disease treatment in about 80% of cases is by salt restriction to 1500 mg per day and the use of a potassium sparing diuretic such as Dyazide or Maxzide.
When there is Menieres disease affecting both sides, a treatment with 60 mg of prednisone per day for several weeks with slow tapering is considered a therapeutic trial. If this improves the condition, this is considered to be proof that this type of Menieres disease is due to autoimmune inner ear disease. This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. Audiometry: the Testing of Human HearingPure Tone Audiometry The testing of hearing is most often carried out by establishing the threshold of hearing, the softest sound which can be perceived in a controlled environment.
As an overview, low frequency (or tone) sensorineural hearing loss (LF SNHL or LT SNHL) is unusual, and mainly reported in Meniere's disease as well as related conditions such as low CSF pressure. Le Prell et al (2011) suggested that low frequency hearing loss was detected in 2.7% of normal college student's ears. Oishi et al (2010) suggested that about half of patients with LTSNHL developed high or flat hearing loss within 10 years of onset. The new international criteria for Meniere's disease require observation of a low-tone SNHL.
Gatland et al (1991) reported fluctuation in hearing at low frequencies with dialysis was common, and suggested there might be treatment induced changes in fluid or electrolyte composition of endolymph (e.g. Although OAE's are generally obliterated in patients with hearing loss > 30 dB, for any mechanism other than neural, this is not always the case in the low-tone SNHL associated with Meniere's disease.
The lack of universal correspondence between audios and OAE's in low-tone SNHL in at least some patients with Meniere's, suggests that the mechanism of hearing loss may not always be due to cochlear damage. Of course, in a different clinical context, one might wonder if the patient with the discrepency between OAE and audiogram might be pretending to have hearing loss. Papers are easy to publish about genetic hearing loss conditions, so the literature is somewhat oversupplied with these.
Bespalova et al (2001) reported that low frequency SNHL may be associated with Wolfram syndrome, an autosomal recessive genetic disorder (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness).

Bramhall et al (2008) a reported that "the majority of hereditary LFSNHL is associated with heterozygous mutations in the WFS1 gene (wolframin protein). Eckert et al(2013) suggested that cerebral white matter hyperintensities predict low frequency hearing in older adults. Fukaya et al (1991) suggested that LFSN can be due to microinfarcts in the brainstem during surgery. Ito et al (1998) suggested that bilateral low-frequency SNHL suggested vertebrobasilar insufficiency. Yurtsever et al (2015) reported low and mid-frequency hearing loss in a single patient with Susac syndrome.
There are an immense number of reports of LTSNHL after spinal anesthesia and related conditions with low CSF pressure. Fog et al (1990) reported low frequency hearing loss in patients undergoing spinal anesthesia where a larger needle was used. Waisted et al (1991) suggested that LFSNHL after spinal anesthesia was due to low perilymph pressure. Wang et al reported hearing reduction after prostate surgery with spinal anesthesia (1987). We have encountered a patient, about 50 years old, with a low-tone sensorineural hearing loss that occured in the context of a herpes zoster infection (Ramsay-Hunt).
LTSNHL is generally viewed as either a variant of Meniere's disease or a variant of sudden hearing loss, and the same medications are used.
Sampling audience agendas The prepared materials are subject to improvisational change in response to your special interests and needs. If you have a sharply sloping high frequency loss and hear mostly voice but do not understan d speech… this is what the same passage sounds like to you From C.Berlin, Hair Cells and Hearing Aids, 1996 Singular Publ. If your loss begins at 500 Hz you will hear more of the speech signal but still have difficulty understanding without lip reading From C.Berlin, Hair Cells and Hearing Aids, 1996 Singular Publ. Now even more of the important frequencies become audible but the speech still sounds “tinny”. Now even more natural but still lacking full fidelity From C.Berlin, Hair Cells and Hearing Aids, 1996 Singular Publ. Real Time Demonstration of Speech Acoustics and Analysis Sub question: Are Consonants really “high frequency” and vowels really “low frequency”? These exercises will help us better apply and understand the appearance and… …the nature of frequency response curves in speakers, earphones, and hearing aids. The overall goals of this presentation To review 53 years of mistakes I personally have made in audiological management and how I would prevent them today. To remind us that we are here to serve patients and meet their needs And to do that we have to listen to them, with respect and dignity, and care…deeply…very deeply…about what happens to them and their family-members. The secret lies in The Inner Hair Cell and Its connections to and action with the primary nerve fibers.
What Does This Have to Do With Audiological Management and knowing the validity of your Audiogram? More… Putting hearing aids on someone with normal OAEs can destroy their emissions but still “improve their audiogram sensitivity”. However, if you have a low frequency loss, you may hear the mid and high frequencies just fine, and those will tend to make up for the loss in the lower frequencies (where there is not a lot of speech information). Because the hearing loss occurs more in the low frequencies, it becomes difficult for people to hear low pitched sounds.
However, further testing by an Ear-Nose and Throat (ENT) Specialist is necessary to confirm this diagnosis.
Individuals with hearing loss are sometimes described as deaf or hard of hearing based on the type, degree, and configuration of hearing impairment. For example, a hearing loss that affects only the high tones would be described as a high-frequency loss.
The outer ear includes the auricle, the external auditory canal, and the lateral surface of the tympanic membrane (TM). Postmeningitic hearing loss can be due to lesions of the cochlea, brainstem and higher auditory pathways, but usually is related to suppurative labyrinthitis (cochlear damage). One in 10 Americans has a hearing loss that affects his or her ability to understand normal speech. Much research has focused on the detection of genetic causes of hearing loss, and many of them can now be diagnosed at an early age (Blanchard et al 2012, Dror & Avraham 2009, Kochhar et al 2007, Kokotas et al 2007, Robin et al 2005, Xing et al 2007).
Risk factors that correlate with hearing loss in premature infants include hypoxia, mechanical ventilation, hyperbilirubinemia, very low birth weight, and the use of ototoxic medications. It occurs most frequently in the 30- to 60-year age group and affects males and females equally. These patients have symmetrical, high-frequency sensorineural hearing loss (as shown in Figure 3). Medical conditions that are common in the elderly, such as diabetes and stroke, may also increase the risk of hearing loss with aging (Bainbridge et al 2010, Helzner et al 2005, Maia & Campos 2005, Schreiber et al 2010).
Causes include a buildup of ear wax, a foreign body in the ear canal, otosclerosis, tympanosclerosis (as shown in Figure 4), external or middle ear infections (otitis externa or media), allergy with serous otitis media, trauma to the ossicular chain such as temporal bone fracture, tumors of the middle ear, erosion of the ossicular chain (cholesteatoma) and perforation of the tympanic membrane.
At this point the management of care would be given over to a rheumatologist who likely will consider the use of methotrexate.
It is typical to do this testing with pure tones by providing calibrated tones to a person via earphones, allowing that person to increase the level until it can just be heard. To us, this seems a little overly stringent, compared to the earlier 1995 AAO criteria that just required any kind of hearing loss, but criteria are better than no criteria.
That being said, genetic conditions should not be your first thought when you encounter a patient with LTSNHL. One would think that diabetes insipidus is so rare that hearing loss is probably not the main reason these individuals are seeking attention. These patients are extremely rare because there isn't much microsurgery done close to the brainstem. We are dubious about the conclusion of this paper because it is different than nearly every other paper in the literature. We are dubious that this has any applicability to humans and we have never seen a patient with lithium toxicity with any LFSNHL. We have observed this occasionally ourselves, but of course, the usual pattern is a conductive hyperacusis.
We find this somewhat plausible as pregnancy and delivery might be associated with spinal anesthesia, with changes in collagen, and with gigantic changes in hormonal status. The dot system assumes normal effort speech at roughly 50 dB Hearing Level at 6 feet distance.

Some people may still have trouble in noise and in multiple conversations and locating sound sources. It must be, because we used to fit a hearing aid to it and design educational startegies around it.
About 10% of hearing impaired people have poor audiograms that look manageable but they have normal outer hair cells as evidenced by normal otoacoustic emissions Normal outer hair cells, which are nature’s low level preamplifiers, mitigate AGAINST hearing aid success…there is no need for amplifying faint sounds if the outer hair cells are already doing that job.
For this reason, individuals with low frequency hearing losses can often still understand speech very well. For this reason, hearing on the phone can be very difficult for those with a low frequency loss. In addition, because almost all of the training that hearing providers receive is with regards to flat losses or high frequency losses, how to properly fit a low frequency hearing loss can be mystifying sometimes. The increased pressure can break through the membranes to the inner ear and cause an abnormality in the chemical make-up of the fluid. Presbycusis is a sensorineural hearing loss that occurs gradually, later in life, affecting hearing in both ears over time. Its configuration would show good hearing in the low tones and poor hearing in the high tones. See the permanent childhood hearing loss page for information on hearing loss for children from infancy through age 5. The middle ear includes the medial surface of the TM, the ossicular chain, the eustachian tube, and the tympanic segment of the facial nerve.
These conditions are relatively common in premature infants, and the majority do not go on to develop hearing deficits. Hearing loss in adults surviving pneumococcal meningitis is associated with otitis and pneumococcal serotype. Race and sex differences in age-related hearing loss: the Health, Aging and Body Composition Study. After several hours, at the most 24 hours, this episode is over, only to return in a few weeks again. In about 20% of patients with Menieres disease that is confined to one ear, surgery would be advisable.
Various strategies are used, but pure tone audiometry with tones starting at about 125 Hz and increasing by octaves, half-octaves, or third-octaves to about 8000 Hz is typical.
There is a large literature about genetic causes, mainly in Wolfram's syndrome ( diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), probably because it is relatively easier to publish articles about genetic problems. He defined LTSNH as that the sum of the three low frequencies (125, 250, 500) was more than 100 dB, and the sum of the 3 high frequencies (2, 4, 8) was less than 60 dB.
In other words, Wolfram's is probably not diagnosed mainly by ENT's or audiologists, but rather by renal medicine doctors, as DI is exceedingly rare, while LTSNHL is not so rare in hearing tests. That being said, it is very rare to encounter any substantial change in hearing after pregnancy.
To share techniques to both prevent errors, increase accuracy and validity, speed data collection, and predict success of various management strategies from hearing aids, to Audiory Verbal Therapy, to more visual strategies, etc. Research shows that you don’t need six weeks as an experienced adult to accommodate to a hearing aid.
If not, why do we fit hearing aids and design educational strategies based on pure tone audiograms alone?
It has recently been discovered that a gene mutation, called Wolfram Syndrome may cause low frequency hearing loss.
Due to this, low frequency hearing loss can be harder to detect than a high frequency loss. If you have this problem, you might want to look in to CaptionCall, which is a free service that converts speech to text automatically during phone calls so you can read what the person on the other end of the line is saying. Other symptoms of Meniere’s Disease include roaring tinnitus, sudden and spontaneous vertigo (dizziness), and pressure changes in the ears.
On the other hand, if only the low frequencies were affected, the configuration would show poorer hearing for low tones and better hearing for high tones. The inner ear includes the auditory-vestibular nerve, the cochlea and the vestibular system (semicircular canals). The National Institute of Health reports that about 15 percent of Americans aged 20 to 69 have high frequency hearing loss related to occupational or leisure activities. If the loss is minor, then avoidance of noise and ototoxic medications may be an appropriate treatment. Roughly speaking, the frequency patterns of hearing loss are divided up into: Low-frequency, mid-frequency, high-frequency, notches, and flat.
Other causes of low frequency hearing loss include sudden hearing loss and Meniere’s disease.
Some hearing loss configurations are flat, indicating the same amount of hearing loss for low and high tones. Trauma is more likely to affect hearing in patients who suffer a temporal bone fracture or are older in age (Bergemalm, 2003). Because of occupational risk of noise induced hearing loss, there are government standards regulating allowable noise exposure. Rules and principles as they apply to audiological assessment, hearing aid fitting and educational management.
Many people with a reverse slope loss will report that listening to people with accents sounds like listening to Charlie Brown’s teacher. If you do end up going the hearing aid route (which is often times the only option), make sure you get a hearing aid with at least 6 channels- you’re going to need something good.
People working before the mid 1960s may have been exposed to higher levels of noise where there were no laws mandating use of devices to protect hearing. Occasionally, persons with acquired deafness can be treated surgically with a surgically implanted device, a cochlear implant. The loss of the high frequencies can make it difficult to understand speech, since the intelligible differences in speech sounds are often in the range above 2000 Hz.
Population study of the ability to benefit from amplification and the provision of a hearing aid in 55-74-year-old first-time hearing aid users.
Technology, expectations, and adjustment to hearing loss: predictors of hearing aid outcome. Specific geometries of curves are found to be typical of presbycusis, and a characteristic notch in the hearing curve may be the signature of damage by a sudden loud sound like a gunshot or a firecracker explosion close to the ear.

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Comments Sudden low frequency hearing loss in one ear

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