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Author: admin, 08.07.2014
Last night on Celebrity Apprentice, Donald Trump sent Meat Loaf and Lil John packing, leaving actress Marlee Matlin and country crooner John Rich as the finalists. About 2 – 3 infants out of every 1,000 live births will have some degree of hearing loss at birth. Conductive hearing loss (CHL): results from a problem in the outer or middle ear, such as wax buildup, rupture of the eardrum, or repeated infections.
Mixed hearing loss: hearing loss that results from a combination of conductive and sensorineural problems.
Central hearing loss: results from damage to the auditory nerve itself, or the brain pathways that lead to the nerve.
Older infants, who should be responding to familiar voices, may show no reaction when spoken to.
For more information about hearing disorders, click here to go to the Resounding Health Casebook on the topic. AboutWe are a wife & husband team of physicians who have trained and taught at some of the top medical schools in the country including Harvard, Johns Hopkins and Washington University in St. Our mission is both a journalistic and educational one: by reporting on common diseases affecting uncommon people, and including the medical facts behind the headlines, we provide a dynamic collection of Teachable Moments in Medicineā„¢ to increase health awareness and medical knowledge.
We give you the medical facts behind Hollywood's health headlines plus information that empowers you to achieve your health and wellness goals. A conductive hearing loss occurs when there is a problem with the one or more of the parts of the ear that conduct sound into the inner ear. There are many potential causes of conductive hearing loss, with some causes being easier to treat than others. If you have any questions about conductive hearing loss or hearing loss in general, please contact our practice to speak with an audiologist. The outer ear consists of the auricle (unlabelled), the external auditory canal, and the lateral surface of the tympanic membrane (TM). There are several other audiological tests that are also commonly abnormal in persons with conductive hearing loss.
Tympanometry usually is either flat (as shown below), or shows an abnormally large volume (indicating a perforation). Other tests that may be helpful in confirming conductive hearing loss are OAE testing and temporal bone CT scan.
Causes include a buildup of ear wax, a foreign body in the ear canal, otosclerosis, typanosclerosis (as shown above), superior canal dehiscence (which can also cause a conductive hyperacusis), external or middle ear infections (otitis externa or media), allergy with serous otitis media (fluid in middle ear), trauma to the ossicular chain such as temporal bone fracture, tumors of the middle ear such as a glomus tumor, erosion of the ossicular chain (cholesteatoma) and perforation of the tympanic membrane.
A hole in the ear drum, which is called a tympanic membrane perforation, causes a conductive hearing loss. It is generally attributed to previous ear infections or trauma (such as a tube insertion).
The last step in the chain of signal transmission between sound in the air and movement of fluid in the inner ear is the middle ear. There are three small bones interposed between the large ear drum, and the small hole (oval window) across which sound is transmitted into the inner ear.
Complete ossicular chain discontinuity usuall results in a large, flat conductive hearing loss.
Characteristically, hearing aids work well for conductive hearing loss, and very good hearing results can be obtained.
Surgical treatment is also generally available for conductive hearing loss as it is always due to a mechanical problem.
Most surgical treatments for otosclerosis or middle ear disease involve opening of the middle ear and repair under direct vision.
However, in our opinion (which is not representative of general opinion of ear surgeons), we think it is preferable to use a hearing aid until hearing becomes unservicable, and then move onto an implanted hearing aid, and skip the middle ear surgery part altogether.
Determining the type and causes of hearing loss depends on where the hearing loss takes place in the ear.
Conductive hearing losses (CHL) are identified within NewSound Hearing Aid Centers comprehensive otoscopic examination and audiometic testing.

Comprehensive audiometric testing will ascertain the levels of hearing loss at multiple individual frequencies in each ear resulting in a graph called an Audiogram. Mixed hearing losses contain a combination of conductive and sensorineural loss components. There are many potential causes of hearing loss regardless of the type from which you suffer.
Causes of mixed hearing loss can include any combination of the above SNHL and CHL causes.
The ear canal, ear drum, and the tiny bones in the middle ear make up the conductive system and any hearing loss caused by a problem in one or more of these areas is called a conductive hearing loss.
Malformation of the outer or middle ear structures, a middle ear infection in which fluid accumulates behind the eardrum, abnormal bone growth in the middle ear, a hole in the eardrum, or poor Eustachian tube function may be responsible for conductive hearing loss. Antibiotics or antifungal medications are usually prescribed for ear infections, whereas surgery is usually an option for malformed or abnormal outer or middle ear structures and other physical problems. The middle ear includes the medial surface of the eardrum, the ossicular chain of bones, the eustachian tube. These can be immensely troublesome because their removal can be difficult, and infections are common. It is more accurate to say that there is a hearing reduction, as generally hearing is not greatly affected -- a 10 db drop is typical.
There also seems to be a weak association with increased serum calcium (de Carvalho et al, 2006) .
When these bones are fused (otosclerosis, or ossicular fixation) or broken (ossicular chain discontinuity), a conductive hearing loss is the inevitable result. When combined with a sensorineural hearing loss, this pattern may look superficially like a conductive hearing loss, because there is an air-bone gap. Persons with LVAS may develop hearing loss as well as be unusually vulnerable to inner ear disease associated with head injury. Recently some groups (Kakehata et al, 2006) are using endoscopy for repair of ossicular chain disturbances -- in our opinion, this is still very investigational and somewhat unreasonable -- when working inside a tiny space, one needs as good an exposure as one can manage.
Carhart Notch 2-kHz Bone Conduction Threshold Dip: A Nondefinitive Predictor of Stapes Fixation in Conductive Hearing Loss With Normal Tympanic Membrane. Today, 25 percent of adults age 45-64 and 40 percent of adults age 65 and older suffer from some degree of measurable hearing impairment. In normal hearing, sound enters the ear canal and vibrates the tympanic membrane (TM, also called the ear drum). Equally important, full testing will also indicate a patient’s level of speech comprehension. To determine the type of loss you or a loved one may have, it is best to visit a hearing clinic for a comprehensive otoscopic and audiometric evaluation.
Having lost her hearing at the age of 18 months (probably from a genetically malformed cochlea), Matlin has become an inspiration for many in the hearing, as well as in the deaf communities. Inattention and falling behind in class work may be the result of an undiagnosed hearing loss problem.
Unlike a sensorineural hearing loss a conductive hearing loss occurs because the sound entering the ear is reduced or dampened by the obstruction; there is no damage to the delicate nerves in the inner ear.
Rarely, there may be more serious causes of conductive hearing loss and these conditions, if left unidentified and untreated, may have profound medical consequences.
Hearing aids are often the best answer when surgery is not possible, because they significantly improve hearing and are convenient. These are most easily removed using an examining microscope, but in some instances, surgical removal is needed. It is presently thought that persons taking calcium supplements are not at increased risk, and also that there is no risk from calcium channel blocker medications. The most common ones are cholesteatoma associated with chronic ear infection (it is not a true tumor) and glomus tumors. The movement of the TM is transferred into a chain of three very small bones in the Middle Ear.

Otosclerosis is a largely hereditary condition that occurs more commonly in women and can be connected to pregnancy or menopause.
However, if unrecognized and left untreated, some conductive losses can become extremely serious with permanent impairment to hearing and possibly life-threatening complications. The cochlea is a fluid-filled long tube that is curled like the shell of a snail and lined with thousands of specialized hair cells called cilia. This exposure can be sudden and traumatic, or it can be cumulative over-time and equally damaging to hearing. Hearing loss involves not only the reception of sound but also our brain’s ability to understand speech. There is no reason to continue to suffer the effects of hearing loss and its degradation to one?s quality of life. She is the youngest woman and the only deaf actress to win the Academy Award for Best Actress in a Leading Role, which she won at age 21 for Children of a Lesser God. People with this type of hearing loss may benefit from hearing aids or a cochlear implant. A conductive hearing loss can often be partially or completely reversed with medical intervention.
Though usually not necessary, implantable hearing devices such as a bone-anchored hearing aid are an excellent alternative if neither surgery nor a traditional hearing aid are feasible options. Practically, this is a very uncommon situation, of much more interest to diagnosticians than patients. To understand what causes hearing loss, it is important to appreciate the different types of hearing loss and how they correspond to the physical components of the ear. The bones work on a lever principle, amplifying the energy as it passes to the Inner Ear at the end of the chain. When the stirrup bone of the Middle Ear moves, it sends a hydraulic wave through the cochlea.
Common sources of excessive noise are industrial noise, work-related noise, military service, music, road noise, guns and hunting, or lawn equipment. Over time, if one has a SNHL and it remains untreated without custom-programmed hearing instruments, the brain loses its ability to discriminate speech. At the very least, have a clinician perform an evaluation to establish a base-line for future comparison. She then wowed people for her dancing abilities on Dancing with the Stars, despite the fact that she couldn’t hear the music. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Anything that impedes the reception, flow, or transfer of energy in the Outer or Middle Ear is known as a Conductive Hearing Loss (CHL).
This wave is picked up by the cilia and transposed into electrical impulses sent to the brain. Once a noise-induced hearing loss begins, we often become even more susceptible to further noise-induced damage. Of course, similar to eyesight, many adults develop a level of hearing loss simply due to natural aging called Presbycusis. But Matalin’s real goal is to be seen as an accomplished woman- who also just happens to be deaf. There is a connection between auditory deprivation and the onset of Alzheimer’s disease. A cochlear implant attempts to replace the function of the cilia and is only considered in truly profound cases of SNHL.

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