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Send Home Our method Usage examples Index Contact StatisticsWe do not evaluate or guarantee the accuracy of any content in this site. Definition: Defining the Meaning of Sensorineural DeafnessThere are two main types of hearing loss - conductive and sensorineural. Comments and Discussion:Have Your Say: Do you agree, disagree, want to discuss or add an opinion on this topic?
Brian Moore, PhD, a Cambridge University researcher in areas of psychoacoustics, has developed a protocol, called the Threshold Equalizing Noise (TEN) test, to clinically identify cochlear dead spots.
Outer and Inner Hair Cell Basics By way of a brief overview, each cochlea contains one row of approximately 3,000 inner hair cells and 3-5 rows of about 12,000 outer hair cells (Figure 1). The jug-shaped inner hair cells send all sound information to the brain; without them we are totally deaf. The outer hair cells work in the opposite direction; that is, they receive messages from the brain and from within the cochlea telling them to rapidly stretch or shrink. Sound hitting the eardrum results in a traveling wave of fluid motion inside the cochlea, thus causing a ripple along the floor upon which the hair cells stand (known as the basilar membrane).
The wave’s peak is even further defined as a result of the action of the outer hair cells. Why WDRC is Often Recommended It can safely be said, therefore, that the most common type of damage to the ear is damage to the outer hair cells. It must be emphasized, however, that no matter how good a hearing aid is, it cannot restore a normal-functioning cochlear traveling wave (Figure 3). Essential Cochlear Concepts Cochlear dead spots occur where there is complete destruction to both the inner and outer hair cells. An important fact to keep in mind is that the traveling wave is asymmetrical in shape (Figures 2-4). When this article was first published in The Hearing Professional, the TEN test puretones and broadband masking noise were all calibrated in dB SPL, not HL. The procedure for Moore’s TEN is to first test for hearing thresholds for the puretones from the TEN CD in quiet, and then to retest for the same thresholds in the presence of ipsilateral masking. For a normal-hearing person, for example, 30 dB of the TEN from the CD should affect most thresholds (Figure 5). For someone with hearing loss, the main idea is to provide enough TEN masking so that the better thresholds are shifted, and determine if the worse thresholds are affected.
Similarly, according to Moore,4 if you masked the worst thresholds by their own minimum masking levels with the TEN, these thresholds should theoretically only be shifted to the level of the TEN used to mask them. Consider someone who has completely dead inner and outer hair cells for the frequencies below 1000 Hz. High-frequency stimulation would have to be quite intense to enable the steep front of the traveling wave to extend into the living, healthy mid-frequency hair cell regions. Reverse and Precipitous High-Frequency SNHL With cochlear dead regions of hair cells, one actually hears by means of remote, living hair cells.
Specifically, in the case of reverse SNHL, the ipsilaterally presented TEN would shift the low-frequency thresholds, even if these thresholds were greater than the intensity of the masking noise. Using conventional thinking, we would consider this impossible because, at these thresholds, the listener should not even be able to hear the masking noise.
Of course, if the hair cells in question are only damaged and not truly dead, the same ipsilateral TEN masking noise would not shift these worst thresholds. Figure 9 shows the thresholds for puretones from the TEN CD, followed by the thresholds found in the presence of 50 dB TEN from the CD.
The TEN test on the CD is not, in my opinion, a required part of any new test battery for our patients.
Not to be forgotten, of course, is the education of ourselves; that is, understanding the TEN test for cochlear dead spots requires an appreciation for the fascinating way in which our cochleae function. McSpaden: Tell me the difference between symmetrical and asymmetrical cochlear dead spots. Symmetrical dead spots occur when the area of completely missing hair cells is located in exactly the same place (or frequency) within both cochleas of the individual. Venema: Cochlear dead spots are not necessarily hereditary, but certainly can be passed from one or both parents. Audiometric thresholds with NIHL improve beyond 6000 Hz precisely because the resonance of the outer ear canal, which gives the extra dose of noise in the first place, drops off one-half octave lower, just beyond 4000 Hz. McSpaden: Speaking of amplification, what kind of hearing instrument would you fit on someone with a high-frequency cochlear dead spot? Consider the person who has dead hair cells in the wide, high-frequency base of the cochlea. Thus, the SNHL thresholds in the severe-to-profound high-frequency range do not really come from the traveling wave peak stimulating the high-frequency hair cells because these are dead. We would use the same kind of technology to fit this type of SNHL as we would to fit any other steeply dropping hearing loss. Another consideration is just how much gain and output one should provide to the severe high-frequency thresholds. If you see a person with a steeply dropping audiogram and severe-to-profound high-frequency thresholds, suspect high-frequency cochlear dead spots. Venema: Fitting a low-frequency rising (or reverse) hearing loss has indeed always been a challenge. If the mid-to-high frequency hearing is normal, even a moderate degree of low-frequency SNHL can be indicative of low-frequency cochlear dead spots. As with the earlier case of the steep high-frequency hearing loss, the thresholds do not come from the hair cells that are supposed to represent these thresholds; instead, they arise from remote, living hair cells in another frequency region. As in the case of high-frequency dead spots, the person with true reverse SNHL will most likely do best with at least a two-channel hearing aid, either analog or digital. McSpaden: How do you achieve binaural balance in a patient with symmetrical dead spots using hearing instruments?
Venema: I presume that symmetrical cochlear dead spots would result in a symmetrical SNHL. McSpaden: How do you achieve binaural balance in a patient with asymmetrical dead spots that you fit with hearing instruments? In the case of asymmetrical SNHL resulting from asymmetrical cochlear dead spots, I’d adjust the frequency crossover between the channels at different positions for each ear. Venema: Cookie-bite SNHL is often a genetic, hereditary type of hearing loss and, yes, it is often due to mid-frequency cochlear dead spots.
Fitting this type of hearing loss is trickier because it requires at least three channels—one for the low frequencies, one for the mid frequencies, and one for the high frequencies. Venema: If the hearing loss is moderate in degree, as is often found in reverse SNHL, I would use WDRC.
Along with considerations of compression, I’d really try to use directional microphones. McSpaden: I can think of a number of patients that had a precipitous SNHL who might well have had a dead spot. Take a look at the audiometric shape to see if you should be suspicious in the first place. It is well documented that there is a relationship between increased hypertension and high level noise exposure hearing loss. Animal studies at the University of Florida (6) showed that ears exposed to noise produced antioxidant enzymes. The protective reaction of the body is to increase the availability of antioxidant enzymes. At the NHCA Hearing Conservation Conference in February, 2003, a presentation from the DOD Spatial Orientation Center, Department of Navy (6) concerned oto-protectants (antioxidants). NAC was determined to prevent hearing loss by substantially reducing outer hair cell damage. The condition of the cardiovascular system can greatly affect hearing loss and can contribute to predisposing the ear synergistically to noise exposure.
Pillsbury HC: Hypertension, hyperlipoproteinemia, chornic noise exposure: Is there synergism in cochlear pathology? Sensorineural hearing loss occurs from damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain.
Just as dead areas of the retina can create holes in one’s field of vision, dead hair cell areas of the cochlea can produce audiometrically useless frequencies.
The most interesting thing about this test is not its clinical utility and how well and consistently it identifies cochlear dead spots. The hairs or stereocilia of the outer hair cells are jammed into the underside of the tectorial membrane, while those of the inner hair cells are not. These test-tube shaped outer hair cells are the active mechanism of the cochlea—the moving parts.
Without the action of the outer hair cells, the traveling wave has a dull and rounded peak. As mentioned earlier, the gain provided by the outer hair cells to very soft input levels is about 50 dB for the low frequencies and about 65 dB for the high frequencies. The CD plays puretones, as well as a single broadband masking noise (noise that includes all audiometric frequencies). When using the test, be sure to go to a level whereby the better thresholds of the person are affected (ie, made worse by the masking). If the decibels on the audiogram were in dB SPL, all thresholds would be elevated or shifted to show a flat 30 dB hearing loss. For example, consider someone with a mild hearing loss for the low frequencies and a moderate hearing loss for the highs.
The ipsilateral masking with 30 dB TEN affects the better low-to-mid frequency thresholds of the sloping SNHL, because the TEN is audible to the person at these frequencies. Consider now that these worst thresholds are caused by cochlear dead spots: in this case, the minimum TEN level would actually shift the worst thresholds at least 10 dB beyond the decibel levels of the TEN itself.
For either type, amplification for the worst thresholds might not be the best course of action. Be suspicious of reverse-sloping SNHL, as it could be indicative of low-frequency dead regions. In this case, intense low-frequency stimulation results in a traveling wave with a peak at the apical (low-frequency) hair cell region of the cochlea. Low-frequency dead spots may reveal only a moderate, low frequency SNHL with a reverse audiogram. The steep slope of the precipitous high-frequency hearing loss thus might reflect the steep front of the traveling wave as it occurs in the cochlea(Figure 8). High-frequency dead spots may reveal an audiogram showing a precipitous, pronounced degree of high-frequency SNHL.
In the case of the precipitous high-frequency SNHL, the TEN would also make the high-frequency thresholds worse, even if they were greater than the intensity of the masking noise. The reason why these thresholds are affected, however, is that, when one has dead hair cell regions at any frequency, one hears tones in these dead areas by means of a small piece of the traveling wave that extends into living hair cell regions.

In the case of the reverse SNHL, a small amount of TEN that was enough to shift the better mid-to-high-frequency thresholds would not affect the poorest thresholds at the low frequencies.
The ipsilateral TEN stimulation of 50 dB SPL should not have any effect on the high-frequency thresholds. The ipsilateral masking with 50 dB TEN affects the low-to-mid frequency thresholds of the sloping SNHL because the TEN is audible to the person at these frequencies. It might be best, in this case, to amplify the low-to-mid frequencies as well as the transition of the audiogram where the thresholds drop. On the other hand, the presence of reverse hearing loss or precipitous high-frequency hearing loss should make dispensing professionals suspicious that cochlear dead spots might exist. Of course, the person’s audiogram would show symmetrical sensorineural hearing loss (SNHL), too. Cochlear dead spots can also be congenital, which simply means they existed at the time of birth.
When someone has a prolonged exposure to noise, NIHL can become so severe that it results in completely dead high-frequency hair cells, which in turn cause a severe-to-profound precipitous high-frequency SNHL. In some cases, ototoxicity can result in complete hair cell destruction in certain frequency regions of the cochlea (cochlear dead spots). If you were to present an intense, high-frequency tone from your audiometer, the peak of the traveling wave would occur in the dead high-frequency area, even though there are no living hair cells there to respond to the tone. Instead, the high-frequency thresholds come indirectly from living mid-frequency hair cells stimulated by the steep front of the traveling wave. Recall that these thresholds may not be real at all, because the high-frequency hair cells are dead! The fact that these reverse hearing losses can sometimes be due to cochlear dead spots in the low-frequency region (apex) of the cochlea, however, can actually help shed some light on the situation. In other words, in the presence of normal mid-to-high frequency hearing, total deafness in the low frequencies can masquerade as a moderate degree of low-frequency SNHL. Now envision presenting a 250 Hz or 500 Hz tone from the audiometer, so that the peak of the traveling wave is made to occur in the dead low-frequency region of the cochlea. In contrast to the case where high-frequency cochlear dead spots cause a steep, precipitous high-frequency hearing loss, low-frequency cochlear dead spots do not have to result in a steeply rising audiogram; reverse SNHL can rise suddenly but it can also rise more gently, like a mirror reflection of the longer, more shallowly sloped tail of the traveling wave.
It is very possible that the person could have a true reverse SNHL due to Meniere’s disease. Due to the asymmetrical shape of the traveling wave, we know that low frequencies mask high frequencies better than highs mask lows. Again, adjust the frequency crossover control so that it is as close to the corner of the audiogram as possible. I’d try to achieve binaural balance by providing similar gain and output at similar frequencies, just like I would with anyone else who had symmetrical hearing loss. Again, I always try to fit difficult hearing loss shapes with multichannel hearing instruments because I can mold the frequency response of the hearing aid to best fit around the corner in the audiogram. I’d adjust the crossover to occur at the specific frequencies where the hearing loss suddenly changed. As we all know, there are people who have a moderate SNHL for the mid frequencies, even though their low- and high-frequency thresholds are normal or near-normal.
If the loss is severe, as in the case of some pronounced precipitous high-frequency hearing losses, I would still use WDRC because I’m not providing tons of gain to fit the severe high-frequency thresholds.
They have been shown again and again to improve speech understanding in background noise. Does the SNHL take a precipitous drop in the mid-to-high frequencies and then bottom out at a severe dB level?
Venema, PhD, is an assistant professor of audiology at the University of Western Ontario, Ontario, and author of the book, Compression for Clinicians (Singular Publishing). Some studies (2) show that elevated cholesterol and triglycerides increase hearing loss in the high frequencies. In one study hearing thresholds (3) have been found to be surprisingly and significantly better in those with raised cholesterol levels. It is also well established that hypertension is associated with a decrease in auditory acuity. Food supplements, vitamin E and foods high in antioxidants as prunes and raisins might be capable of protecting the ear from noise exposure. Conditions as hypertension, mild-to-moderately high cholesterol levels and high triglyceride levels are conditions that can to some extent be affected by diet.
Instead, the best thing about this test is that, in order to understand its rationale and how it works, one is forced to understand how the cochlea works. When soft sounds enter the cochlea, the test-tube shaped outer hair cells shrink, thus pulling the tectorial membrane down, so the stereocilia of the jug-shaped inner hair cells can be bent or sheared. This is what stimulates the hair cells at the cochlea’s wide base (high frequencies) or narrow apex (low frequencies) or at some unique place in between.
This mechanically forces the peak into a sharper point that, in turn, increases our ability to distinguish between frequencies that are close together. For this person, hearing aids should amplify the soft sounds significantly and amplify louder sounds by progressively smaller and smaller increments. The top shows a normal traveling wave envelope, resulting from stimulation of two tones different in frequency. Hearing aids can only amplify and, by so doing, can only enlarge a diminished traveling wave.
Soft, high-frequency stimulation results in a small traveling wave at the base of the cochlea (right), which would easily be overcome or masked by the wave resulting from intense low-frequency stimulation at the apex (left). This broad-band noise is quite different from the narrow bands of noise used in our audiometers. If a client has normal hearing, the thresholds on the typical audiogram will look a bit like a barn roof (Figure 5), with best thresholds showing for the mid frequencies and borderline-to-mild hearing loss appearing for the low frequencies and high frequencies. On the typical audiogram (where dB HL rather than dB SPL is used), the barn-roof shaped thresholds for the normal-hearing person are still affected by the TEN. The puretones played from the CD will show a similar trend; namely, better hearing for the low frequencies than for the high frequencies (Figure 6). The TEN does not, however, affect the high-frequency thresholds because the TEN is not audible to the person at these frequencies. For example, excess high-frequency gain can result in feedback for the person with precipitous hearing loss. It is very possible that the person could be completely deaf in the low frequencies; however, due to the asymmetric shape of the traveling wave, only a moderate reverse hearing loss may be revealed. The long tail of the traveling wave, however, may still extend into the healthy mid-frequency regions (Figure 7). Here, it is possible that the high-frequency thresholds do not truly arise from damaged high-frequency hair cells. In the reverse loss, it would make the good mid-to-high-frequency thresholds worse; in the precipitous high-frequency SNHL, it would make the good low-to-mid frequency thresholds worse. If the TEN masking noise does shift the worst thresholds by 10 dB or more, according to Moore, these thresholds are spurious, and do not actually arise from stimulation of damaged hair cells at these frequencies.4 Instead, in these cases, the worst thresholds arise from indirect stimulation of remote, living hair cells at other frequency regions.
In the case of the precipitous high-frequency SNHL, a small amount of TEN might indeed shift the good low-frequency thresholds, but would not affect the worst high-frequency thresholds by anywhere near 10 dB.
In fact, the high-frequency thresholds are indeed affected because they show a shift of at least 10 dB.
However, the TEN also shifts the high-frequency thresholds by at least 10 dB—even though it is not audible to the person at these frequencies.
Furthermore, it is a good idea to ask these patients what their perceptions of audible tones presented to their worst thresholds are like.
If, on the other hand, the dead regions were located in different locations inside the cochlea, they would be asymmetrical and, accordingly, the person would show SNHL at different frequencies (an asymmetrical audiogram).
It is interesting to note that NIHL occurs at these frequencies because damage due to noise occurs to hair cells that represent frequencies about one-half an octave above the noise that caused it. The cochlea traveling wave has a long, shallow tail and a steeply sloped front as it moves up the cochlea from the base (where high-frequency hair cells are located) to the apex (where low-frequency hair cells are located). The steep slope of that traveling wave front, however, does face the living mid-to-low frequency hair cells, and it will spread slightly into the living mid-frequency hair cells. How do you fit the severe high-frequency thresholds without, at the same time, providing too much gain and output for the good hearing thresholds in the lower frequencies? The dead low-frequency hair cells cannot respond, but the long, shallow tail of the wave still stimulates the healthy mid-frequency hair cells.
For that matter, one could also simply have an honest-to-goodness hereditary moderate degree of low-frequency SNHL. In the case of true reverse SNHL, it might be a good idea to err on the side of less low-frequency amplification. If the rise in thresholds is gentle and there really is no corner, position the crossover so it is at the middle of the rise in thresholds or generally placed at the middle of the change in thresholds.
With multichannel analog or digital hearing aids, I’d adjust the frequency crossover between the channels to the same position.
If the degree of loss was different between ears, of course, one would have to provide different gain and outputs too.
The moderate degree of mid-frequency thresholds can actually indicate cochlear dead spots in the mid frequencies. If the cookie bite SNHL dropped and rose suddenly, making it look like there were two corners in the audiogram, I’d set the two frequency crossovers right at the corners and go from there.
Fitting the slope is the main thing, and the slope is not as severe as the worst degree of the hearing loss. Use common sense, your expertise, and the technology available today to fit people who have cochlear dead spots. He is also an instructor in the Hearing Instrument Specialist program at George Brown College in Toronto. Wanting to get an early jump on the day, I had scheduled my two-year physical first thing in the morning.
Over a period of five years, this study in Finland investigated the relationship between coronary heart disease, high cholesterol levels, intake of saturated fats, and hearing loss. Researchers indicate hyperlipidemia may have a role on the occurrence of sensorineural hearing (SNHL) loss. The longer the noise exposure, the more significant are the changes in both the auditory and cardiovascular systems.
Experiments showed that if increased antioxidants were available, the ear became more resistant to both steady state and intermittent noise. In apoptosis, the hair cell swells two or three times it normal size over a period of four days.
Foods high in antioxidants and low in saturated fats are known to be significantly friendly to the cardiovascular system.
They might experience difficulties with hearing in areas that are noisy, and find it difficult to tell high-pitched sounds such as, 'th,' or, 's,' from one another.

In short, the wave grows (and slows) as it goes up the spiral-shaped cochlea until it reaches peak amplitude and stops.
In someone with outer hair cell damage, the traveling wave peak is dull and rounded, and their ability to distinguish frequencies that are close together is diminished (Figure 2). The sharpening of the peak is accomplished with the action of the outer hair cells, and this increases the ability to distinguish between frequencies that are close together. Wide Dynamic Range Compression (WDRC) hearing aids that accomplish this are specifically intended to imitate what the outer hair cells once did.
They cannot restore one’s original sharp frequency resolution or the ability to separate frequencies that are close together.
The puretones and the masking noise have to be directed toward the same ear, and this can only be done with a two-channel audiometer. The reason for this audiogram shape is that normal-hearing ears are most sensitive to frequencies between 1-4 kHz. The TEN should affect the better thresholds because it is audible to the person at these frequencies. This is due to the calibration of the CD tones in dB SPL, whereas the audiogram is measured in terms of dB hearing loss. Note that in the presence of ipsilaterally presented TEN, at 30 dB the thresholds for the puretones from the CD are tested again. This would indicate a typical high-frequency SNHL that is due to damaged hair cells at these frequencies, but not due to high-frequency cochlear dead spots.
In this case, the person will indicate a response, but it will not truly arise from hearing in the low-frequency hair cell regions.
On the contrary, these thresholds might result from indirect stimulation of low-frequency hair cells. The high-frequency thresholds are not truly indicative of high-frequency sensitivity; rather, they are a result of indirect stimulation of remote living hair cell regions. In this case, the person will indicate a response, but it will not truly arise from high-frequency hair cell regions. If the reverse or precipitous high-frequency hearing loss were due to cochlear dead spots, the TEN would, however, also elevate the thresholds for the worst thresholds, even though the TEN would theoretically be inaudible to the person at these frequencies! These hearing losses would then, respectively, be a true reverse hearing loss and a true precipitous high-frequency hearing loss. This would indicate a high-frequency SNHL that is due to high-frequency cochlear dead spots. It can be found at any frequency, at various decibel levels, and can be symmetrical or asymmetrical. In real-ear measurement, we can see that the resonance of the adult outer ear canal stretches from about 1500 Hz to around 4000 Hz, with a 10-20 dB peak at around 2700 Hz. Some antibiotics known to be toxic to hair cells belong to the family of aminoglycosides.
Usually, in these cases, the only thing we know is that the person experiences a sudden loss of hearing in one ear. In other words, the steep front of the traveling wave faces the apex or pointed low-frequency end of the cochlea.
If the loss dropped and rose gradually, I’d adjust the crossover settings to occur around the centers of each of the two slopes. Soon the physician was informing me that my cholesterol and triglycerides levels were significantly higher and that I was going to have to try to control the problem by diet. It appears that low high-density lipoprotein cholesterol concentration is associated with hearing loss but high cholesterol levels are not. People with SNHL may perceive other people's voices as sounding slurred or mumbled, and find it easier to hear men's voices than women's voices.
By the way, the main reason that the wave actually gets a peak in the first place is because it meets impedance along its travels up the spiral. Is it any wonder that those with sensorineural hearing loss (SNHL) and damaged outer hair cells have difficulty separating speech from background noise? Amplification only increases audibility of sounds, but does not come close to the majesty and wonder of the healthy cochlea. Intense, high-frequency stimulation results in a traveling wave confined to the base of the cochlea (right) and, thus, it would not interfere with the wave resulting from soft low-frequency stimulation (left).
One can separately adjust the intensity of the tones and the masking noise by way of the intensity controls on the audiometer and send both to either the right or left ear. Incidentally, this is why equalizer buttons on some stereo systems are shaped like a smile; we need the artificial boost for the lows and highs in order to hear all of the frequencies at equal loudness levels. The worst thresholds, however, should not be affected because the TEN should not be audible to the person at these frequencies.
Note also, however, that the thresholds masked by 30 dB TEN are only those thresholds that can hear it and not, for example, the worst threshold at 8000 Hz. A shift for the low-frequency thresholds appears, but this does not occur for the high-frequency thresholds. In this case, the person might be “hearing” these low frequencies with their healthy mid-frequency hair cells, and not by means of their dead low-frequency hair cells! It is within this smaller tube that the hair cells grow along the entire inch of cochlea from end to end. Physicians often recommend steroids when patients report SID, but all too often, the hair cell damage is already done by the time treatment is given.
In one hospital, the usual high fat diet was continued and in the other, a low fat diet was instituted. A high cholesterol and high triglyceride diet will predispose hypertensive animals to hearing loss in moderate chronic noise (5).
Most of the damage occurs not at the time of insult, but over a period of four days immediately following the insult.
You begin by testing for thresholds of the puretones from the CD, and then testing the same ear for thresholds while the masking noise is presented into that ear (ie, ipsilateral masking). To be sure, there are some complicated calibration issues that would need to be addressed in order to accurately translate the TEN test results to the typical audiogram with which we are all familiar.
This only makes sense, because the person was not even able to hear the broadband TEN in the high frequencies. For precipitous high-frequency SNHL, should we focus on amplifying the worst high-frequency thresholds or should we concentrate on amplifying the transition or steep slope itself?
Aspirin mainly results in tinnitus, and that side effect tends to disappear when the aspirin consumption is stopped. Many times, the SID results in almost complete deafness in one ear, with only a bit of residual hearing left at perhaps the very low frequencies. As someone who experiences these symptoms due to SNHL, the topic is one that is interesting.The Causes of Sensorineural Hearing LossThe inner portion of a person's ear contains tiny hair cells that are nerve endings. The original traveling wave size or amplitude is restored, but the peaks are still rounded.
This would be a cochlear dead spot covering a very wide area of the cochlea for which hearing amplification is not very successful.
This means that without the noise the loss may not occur and that the amount of loss is greater than expected with either condition alone.
In other words, the ability to separate speech from background noise has not been restored. When the diets were reversed, the results showed the low fat diet reversed the hearing loss and incidence of coronary heart disease.
Sensorineural hearing loss (SNHL) is caused by damage to these cells or nerve fibers in a person's inner ear.
At times, the hearing loss is caused by damage to the nerves that carry signals to the person's brain.Chart showing causes of acquired sensorineural hearing loss (SNHL) - Post to PinterestSNHL may also be present at the time a person is born referred to as, 'congenital,' although it is most often due to genetic syndromes, or infections the person's mother has passed onto their baby while still in the womb such as herpes, rubella, or toxoplasmosis.
The medications are considered to be, 'ototoxic.' At this time there are greater than 200 known ototoxic medications, both over-the-counter and prescription, on the market.
A person's hearing and balance issues caused by these medications might at times be reversed when the medication therapy ends.
The health care professional will discuss the effects with the person and how the side-effects will affect their quality of life.The Effects of Ototoxic MedicationsOne of the first effects people tend to notice related to ototoxic medications and hearing loss involves tinnitus. Dead regions in the cochlea: Diagnosis, perceptual consequences and amplification for the fitting of hearing aids. The hearing loss might go unnoticed until the person's ability to understand speech becomes affected, something this writer has personal experience with. Balance issues might also happen as a result of ototoxic medications; a person may experience a loss of balance and a feeling of being unsteady on their feet. At times these issues are temporary because the person's body may learn to adapt to a reduction in balance control - at other times not.The effects of ototoxic medications have the ability to affect a person's quality of life. An inability to hear conversations, or feeling a bit dizzy, may cause them to cease participation in their usual activities.
The effects kind of sneak up on you and before you know it, there they are.Medications that are OtotoxicChart showing certain ototoxic medications - Post to PinterestMore than 200 medications and chemicals are known to cause hearing and balance issues. It is very important to discuss any effects you experience with your health care professional, as well as the potential for hearing or balance damage related to any medication you are taking. Treatment with a specific medication might provide you with your best hope for curing a life-threatening disease, or ending a life-threatening infection.Medications that are known to cause permanent damage include certain, 'aminoglycoside,' antibiotics such as gentamicin, as well as cancer chemotherapy medications such as carboplatin and cisplatin. Medications that are known to cause temporary damage include, 'salicylate,' pain relievers such as common aspirin, as well as, 'loop diuretics, and quinine.
In some instances, exposure to loud noise while a person is taking certain medications increases their damaging effects.At this time, research is being performed to develop ways to protect people from the ototoxic effects of medications, although there is no approved protective strategy. It is important for you to monitor your hearing and balance before you start treatment with such a medication. Before beginning treatment, a baseline record of your hearing and balance should be recorded by an audiologist. The baseline record should include an audio-logic hearing test that uses high-pitched testing, word recognition, as well as other types of testing if possible. I did not receive these types of testing until it was too late.The information can help you and your health care professional to make any important decisions to change or cease the ototoxic medication therapy before you hearing is permanently damaged. In instances when the medication cannot be changed or stopped, you and your audiologist might take steps to manage the effects of the hearing loss that results. During the course of ototoxic medication treatment, you should have periodic hearing tests as a part of the monitoring process, it will help you to report any hearing changes, balance issues, or ringing in the ears you experience.As for me, I now use hearing aids due to the hearing loss I experience.
Balance issues are a part of life now for me, although a portion of the balance issues may be due to osteoarthritis. It is my belief that a combination of factors led to the hearing loss I experience, such as the use of heavy NSAID's, antibiotics for a life-threatening infection at one point in my life, and age-related factors.

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