It is important to educate the public on hearing and hearing loss.

This article will cover a brief overview and understanding on the following topics: ANATOMY AND PHYSIOLOGY OF THE HUMAN EAR, HEARING ASSESSMENT, TYPES AND CAUSES OF HEARING LOSS, TINNITUS, TREATMENT AS WELL AS THE EFFECTS OF UNTREATED HEARING LOSS.

Anatomy :The Human ear consists of 3 parts:

• the outer ear (the pinna)
• the middle ear
• the inner ear

The human ear is an organ of HEARING and BALANCE. Each of the 3 parts that make up the human ear play a very special function that allows us to hear the sounds all around us.

The outer ear, also called the pinna, is made up of ridged cartrilage covered by skin. Sound is picked up by the pinna and is sent down into the external auditory canal (the ear canal). The ear canal ends at the ear drum.

The sound then causes the ear drum and its 3 tiny attached bones to vibrate. The 3 tiny bones in the middle ear amplify the sound and then transfers the sound vibrations to the inner ear.

The inner ear is made up of 3 parts: the COCHLEA, the vestibule and the semicircular canals. The fluid filled cochlea contains the nerves for hearing. The later two parts control our sense of balance. The inner ear contains 15,000 tiny hair cells. Once the sound reaches the inner ear, they are converted into electrical impulses. These tiny hair cells are connected to the auditory nerve which transmits sound information to the hearing centre of the brain.

Hearing connects us with our family and friends, environmental sounds all around us and music. Hearing is important for driving, walking and when we are out in public places. Hearing is also vital for our safety when it comes to hearing phone calls, door bells, alarms and smoke detectors.

Hearing loss is reported as the 3^rd most common health problem in Canada today. Approximately 3 million Canadians suffer from hearing loss (that is about 1 out of 10 people!). Hearing Loss is an INVISIBLE disability that can effect anyone from all ages. It is often ignored until the effects of untreated hearing loss begins to negatively impact the individual and everyone around them.

Some signs of hearing loss include:

• Speaking loudly
• Feeling that people are mumbling
• You can hear but are having difficulty understanding speech
• Asking people to repeat themselves
• Difficulty understanding women and children
• Volume on your TV/ radio is turned up too high
• Difficulty hearing on the phone
• Difficulty following conversations when background noise in present, or when in groups
• Ringing in one or both ears (also known as tinnitus)
• Favouring one ear

Untreated hearing loss can lead to:

• Isolation, depression and irritability
• Family/ Friends suspect you have a hearing loss
• Denial
• Anxiety
• Search for Cure
• Feeling Powerless
• Emotional Detachment
• Isolation
• Withdrawal from social situations

If you feel you or someone you know is experiencing hearing loss, contact us to schedule a hearing test today!

THE HEARING TEST.

What you should know when describing a Hearing Loss: THE BASICS

1. Decibel (dB) = Loudness
2. Frequency =  Pitch
3. Types of Hearing Loss: Sensorineural (nerve), Conductive (middle ear) or Mixed (nerve and middle ear)
4. Severity of Hearing Loss: Slight, Mild, Moderate, Moderately- Severe, Severe, Profound
5. Configuration/ Shape of Hearing Loss: Flat, sloping and Ski- sloping

The hearing test itself can take approximately 30 minutes. The entire hearing test is performed in a sound booth room. You will wear headphones or ear buds and the practitioner will give you a response button. You will be asked to press the button each time you hear a sound or tone. The different tones will be presented numerous times and each time it will get softer and softer until you do not hear it anymore. You will continue to press the button until the tone is no longer audible to you. This portion of the tests is testing to find out how well you hear sounds that are presented directly through the ear canal to the eardrum. (From the outer ear to the middle ear). Each ear is tested separately.

The second part of the test is similar to the first part. Here, the hearing practitioner will place a bone oscillator headband behind your ear on the bone. The oscillator vibrates and sends sound directly into the cochlea (inner ear). Bypassing the outer and middle ear. You will hear a series of tones and you will be asked to press the button again each time you hear the tone. These tests are important because it helps the practitioner determine if the problem is in the outer, middle or inner ear. It helps determine the TYPE of hearing loss the client has.

The practitioner will then move on to conduct speech testing. This part of the test determines your ability to understand speech. Here, you will be asked to repeat the words that you hear through the headphones/ear buds. Some words will be presented at a comfortable volume. (YOUR comfortable volume). Some words will be presented starting at your comfortable volume but then as each word is being presented, the hearing practitioner will reduce the volume until you can no longer hear the words anymore.

Three types of Hearing Loss:

Sensorineural Hearing Loss

The inner ear hair cells or hearing nerve is damaged and cannot send all the signals to the brain

This type of hearing loss can be due to aging, noise exposure and/or hereditary factors

This type of hearing loss cannot be corrected with medicine or surgery.

Hearing Aids are an option

Conductive Hearing Loss

Sounds are being blocked somewhere in the outer ear and/or middle ear

This type of hearing loss can be due to excessive ear wax, a damaged eardrum, and ear infection or fluid in the middle ear or stiffness of the tiny bones found in the middle ear

This type of hearing loss can be most often medically treated with high success

Hearing Aids are very successful if unable to be medically treated

Mixed Hearing Loss

This occurs when there is both a conductive and sensorineural hearing loss present at the same time

Can be one or several causes

• Aging
• Excessive noise exposure
• Heredity
• Injury (trauma to the head)
• Illness (viral infections such as mumps/ measles)
• Ototoxic drugs (medication that causes hearing loss)
• Meningitis
• Diabetes
• Stroke
• High fever
• Meniere’s disease
• Acoustic tumors

TINNITUS

People who experience tinnitus describe it as a ringing, buzzing, humming, hissing, roaring or clicking sound in their ear or ears. It affects 15%- 20% of people. It may be present all the time or it may come and go. It can be soft and gentle or loud and aggressive. It is not a condition, but a SYMPTOM of an underlying condition such as:

• Hearing Loss
• Wax build- up
• Medications
• Sinus infection
• Ear infection
• Noise exposure
• Jaw misalignment

There is no cure for tinnitus, however, it can be managed with the following:

• Hearing Aids – Hearing aids provide the ability to hear more natural environmental sounds which in turn provide a “masking” effect or in other words, covers up the tinnitus by refocusing the brain on other sounds around you rather than the tinnitus. Most hearing aids today also offer a tinnitus therapy feature.
• Maskers – Generate neutral external sounds. Uses white noise to drown out the tinnitus.
• Tinnitus Retraining Therapy – Rehabilitation for learning to cope with it and aims to teach the brain to ignore it. Takes time and patience.

EAR WAX

The wax in our ears is secreted by the glands. Tiny hairs in our ear canals help trap wax, dust and other foreign objects that would otherwise damage the ear drum if any of the dust, wax or foreign objects got too close to the ear drum. Small amounts of wax usually makes its way to the outer opening of the ear where it is washed away or falls out. Some people generate too much wax quickly and the ear canal cannot effectively clear it and thus builds up and blocks ear canal. Earwax blockage commonly occurs when people try to clean their ears out using q-tips, or other items in their ears. This just pushes the wax deeper, rather than removing it. Always have a licensed professional flush out your ears.

TOO MUCH WAX can BLOCK hearing!

EARLY DETECTION IS THE KEY TO SUCCESSFUL TREATMENT OF HEARING LOSS

It is very important to get your hearing tested, especially if you are over 60 years of age.

What can be done???

• Use correctly fitted hearing aids
• Implement good communication strategies
• Surgery may be an option in some cases
• Face people with hearing impairment directly, on same level and in good light
• Do not talk from another room
• Speak clearly, slowly and articulate. Do not shout/yell or exaggerate mouth movements
• Get their attention before beginning a conversations
• Keep your hands away from your face while talking
• Instead of repeating, try rephrasing
• Reduce ambient noise if possible

Hearing Aids:

Range in: Styles, Technology, Flexibility, Effectiveness within a noisy environment, and Cost.

Style: based on degree of hearing loss, anatomy of ear and client’s preference.

Technology and features: based on individual’s lifestyle.

Settings/ Fitting of aid(s): an individual’s “prescription”.

If a hearing loss is present in both ears, then 2 hearing aids are recommended

WHY?

• Better sound quality
• Increases ability to locate sounds (localization)
• Increases ability to UNDERSTAND speech
• A better sense of balance
• The more complex listening environments you are in, the better and more sophisticated hearing aid technology you will require.
• Based on your lifestyle, hearing loss and needs, you and your hearing practitioner, together, will decide which level of hearing aid technology is best suited for you.
• Improved Speech Understanding

Most people with hearing loss have difficulty with HIGH PITCHED sounds such as “s”, “sh”, “f” and “t”.

For Example:

“eee” (see, she, fee and tee ALL SOUND ALIKE)

Very common for people with a hearing loss to feel that they CAN hear but CANNOT This is because they are missing important sounds as a result of their hearing loss.

This person has a hearing loss and can hear the vowels well but not the consonants.

Here is what they hear…

I a _  _oi_ _       _o       _e_       _o_e      _ _ee_ _.

CAN YOU FIGURE OUT WHAT IS BEING SAID???????

This time the person can hear the consonants well but not the vowels

_  _ m  g_ _ ng  t_    g_t    s_ m _    sw_ _ ts.

HAVE YOU FIGURED IT OUT YET???

I  a _   _oi_ _    _o     _e_    _o_e     _ _ee_ _.

_  _ m    g_ _ ng      t_     g_t     s_ m _    sw_ _ ts.

“I AM GOING TO GET SOME SWEETS”

UNTREATED HEARING LOSS can cause social isolation and loneliness, depression, cognitive decline and dementia, falls and cardiovascular disease.

Higher rates of depression are reported in those with untreated hearing loss.

A recent study found rates of depression are more than DOUBLE in those with hearing loss compared to those with normal hearing.

Reduced confidence is also commonly reported by people with untreated hearing loss.

When hearing loss is present, the hearing areas of the brain SHRINK in age – related hearing loss, and the brain then begins to recruit areas of the brain typically used for higher decision-making functions just to hear sounds.

This increases the overall load on the brain and may contribute to cognitive DECLINE

Hearing loss is associated with accelerated cognitive decline in older adults. Seniors with hearing loss are more likely to develop dementia over time than those with normal hearing. As hearing loss increases, so does the incidence of dementia.

Serious negative effects that go far beyond the inability to hear. This is why everyone over the age of 60 should get a baseline hearing test. This can help you and your hearing health care practitioner monitor the changes in your hearing over time and detect problems early.

Research has shown that treating hearing loss early can slow cognitive decline . Research has also shown that early detection and treatment of hearing loss can slow down the progression of hearing loss.

EARLY DETECTION AND TREATMENT IS THE KEY TO MAINTAINING HEARING HEALTH AND BRAIN HEALTH!

• UNAWARE OF HEARING LOSS
• DENIAL/BLAME OTHERS FOR HEARING LOSS
• LACK OF DESIRE TO SOCIALLY INTERACT
• NEGATIVE STORIES ABOUT HEARING AIDS
• VANITY
• PROBLEMS WITH PRIOR HEARING AIDS
• MISINFORMED
• COST $$$
• IMPROVEMENTS IN:
  • Improved communication – positively impacts personal relationships
  • Increased sense of safety and independence
  • Self-esteem
  • Overall health

Final note: GET YOUR HEARING TESTED!