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Hearing loss


Hearing loss
Ear, nose and throat
Hearing loss is a recognised medical condition. One in five of all adults and more than 50% of people over 60 suffer from some degree of hearing impairment. It is often a natural part of the ageing process, although many people find it embarrassing or difficult to accept that they are becoming hard of hearing. Hearing loss can also be present at birth or develop during childhood and adulthood.
The natural hearing loss experienced through ageing (presbycusis) is caused by the loss of tiny hair cells in the cochlea, the part of the inner ear that processes sounds for the brain to interpret. As people grow older, the hair cells begin to die and they begin to notice that sounds are not as clear as they used to be.

Another common cause of hearing loss is damage to the ear from loud noises. Working in noisy environments, listening to loud music through headphones can all damage the delicate structures of the inner ear, particularly if exposed to loud noises over prolonged periods.

Other causes of hearing loss include damage to the structures of the ear caused by infections such as meningitis, mumps, measles and rubella, because of illnesses such as rheumatoid arthritis, otosclerosis, multiple sclerosis and stroke, through a trauma or injury, or as the result of side effects of certain medicines.
Signs of age-related hearing loss may first appear between 30-40 years of age, and gradually get worse as the person gets older. For most people it is the high frequency sounds that disappear first. As speech contains high frequency sounds, the first sign that hearing has become less clear than it used to be can be difficulty in understanding what other people are saying. The person affected may think that people are mumbling and may have to ask for things to be repeated several times before understanding what is being spoken. Sometimes hearing loss makes it harder to pick out what people are saying in noisy places such as in bars or at a party, and it can be difficult for them to keep up with conversations when talking together in groups. The person affected may have difficulty hearing people on the telephone, and will turn the volume higher on the television or when listening to music to compensate for the hearing loss.

If hearing loss has occurred as the result of an infection or an injury, it usually develops suddenly rather than gradually, and the degree of hearing loss is greater.
Hearing may be improved by the use of a hearing aid or cochlear implant. A hearing aid acts as a tiny amplifier increasing the sound that enters the ear while at the same time filtering out background noise and so making it easier to hear what people are saying. Hearing aids come in a wide variety of types, some fit behind the ear, others fit in the ear; some are analogue, others are digital. As hearing aids just amplify sounds they will only work if there is mild to moderate hearing impairment. They are not suitable for those whose hearing is very badly impaired.

A cochlear implant is an electrical device, inserted into the ear during an operation, which converts sound into electrical signals that stimulate the auditory nerve to conduct signals to the brain where they are interpreted as sounds. Cochlear implants are recommended for people whose hearing is severely impaired.
When to see your pharmacist
There are no medicines available for the treatment of hearing loss. Ear drops to soften ear wax will only help if hearing is slightly muffled due to a build up of wax in the ear. If you have noticed that your hearing has got worse while taking certain medicines, in particular antibiotics and diuretics, tell your pharmacist as these may be causing your problem.
When to see your doctor
If you are younger than 60 and you think you have developed hearing difficulties, it is very important to see your doctor. It is less likely to be age-related hearing loss and you should have the cause investigated. If the hearing loss is the result of an ear infection, your doctor will be able to diagnose and treat the infection.

If you think that you have age-related hearing loss, the first step is to visit your doctor to have your hearing investigated. It is a good idea to make a note of your reasons for thinking you have a hearing loss before you go. This will help you describe how your hearing impairment affects your day-to-day life. Usually, you will be referred to an audiologist at an audiology clinic or to a specialist in the ear, nose and throat (ENT) department of your local hospital for some hearing tests. If the tests confirm your suspicions, the audiologist will discuss with you what course of action will suit you best.
Living with hearing loss
Although it is not possible to prevent age-related hearing loss, taking some simple precautions will protect the ears from damage caused by loud noises. Always wear ear protection if working in noisy environments or using noisy equipment. Try to avoid loud noises such as standing too close to loudspeakers at music concerts and do not play loud music through headphones.

If you have been advised to try a hearing aid, do not be put off. Modern hearing aids such as open behind the ear hearing aids are quite discreet and can be comfortably worn even with spectacles. In the unlikely event that someone does notice, they will probably think that you are listening to your personal music or mobile telephone. The hearing aid may feel strange at first but persevere, do not give up. Getting used to a hearing aid takes time, as it does alter the sounds you hear, but the difference in your overall hearing can be a great improvement. A hearing aid will not give you back the hearing you have lost but it enables you to hear the phone, listen to conversations and hear normal, everyday sounds.

Hearing aids fitted with a loop (T) setting or infra red systems can help people with hearing loss to hear sounds more clearly by reducing background noise. Information about these products and other products such as smoke alarms, door bells and telephones specifically designed for people with hearing difficulties is available from The Royal National Institute for Deaf People (see Further Information section below).
Advice for carers and family members
It is very easy for someone with hearing loss to feel isolated and left out and to become socially withdraw. So although it may sometimes be tiresome having to repeat what you've said several times to someone who has hearing loss, try to be patient and try not to exclude the person from your conversations.

If the television is too load for your comfort, try using the Teletext subtitle facility on the television, or purchase a hearing aid with a T setting or get an infra-red TV listening system, as it can facilitate the person's viewing pleasure at a volume setting suitable for the rest of the family.
Further information
The Royal National Institute for Deaf People (RNID) is the largest charity working to change the world for the UK's 9 million deaf and hard of hearing people. It helps people identify whether they have a hearing loss, campaigns for change, provides services and training, and actively supports scientific and technological research.

Information Line
Freephone: 0808 808 0123
Textphone: 0808 808 9000