Hearing Loss & Prevention

  • General Overview
  • Signs & Symptoms
  • Types of Hearing Loss
  • Degree of Hearing Loss
  • Audiogram of Sounds
  • Preventing Hearing Loss
  • Do I have hearing loss?
  • Tinnitus
  • Sudden Loss in Hearing
  • Dizziness
  • Conditions Associated with Hearing Loss
  • Hearing vs Understanding

General Overview

Did you know that hearing loss is the third most prevalent chronic health condition in the US? Approximately 48 million Americans have some degree of hearing loss. Aging, noise exposure, medical conditions, and genetics all play a role in hearing loss.

Of individuals with hearing loss, only 20 percent seek treatment. Unfortunately for the majority of individuals with hearing loss, research has shown that untreated hearing loss is linked to fatigue, isolation, and a greater risk of cognitive decline.

Preventing hearing loss can be as simple as knowing when to wear hearing protection. Our audiologists are equipped with a variety of hearing protection options whether your noisy interests are concerts, hunting, riding your motorcycle, music, or sporting events. Keep your body and mind healthy. Schedule an appointment with Professional Hearing Services today. We are here to help you and your loved ones reconnect through better hearing.

Signs & Symptoms

The signs of hearing loss can often go unnoticed for a number of years because hearing loss progresses slowly in most cases. Hearing loss is commonly recognized by family and friends, before you notice you are having difficulty hearing.

You may have a hearing loss if you

  • Ask for repetition or say "what" often
  • Have trouble following conversations in groups or background noise
  • Feel people are speaking softly or mumbling
  • Need the volume on your TV or phone turned up
  • Hear a ringing or buzzing in your ears
  • Need to watch the lips of speakers in order to understand what was said

Warning signs of hearing loss

  • Fatigue after having to focus on conversations
  • Frustration when you misunderstand or fail to hear what someone has said.
  • Withdrawing from social situations that you enjoy because of the trouble hearing
  • Embarrassment when meeting new people
  • Friction between members of your family who point out the troubles you are having

Medical history that can impact hearing

  • Family history of hearing loss not attributed to noise or medical conditions
  • Taking ototoxic medications that can harm your hearing such as chemotherapy treatment or high dose IV antibiotics
  • Have medical conditions such as diabetes, circulation problems, or heart disease
  • Exposure to loud sounds

What to do if I have concerns?

Evaluation of your hearing by an audiologist is important to determine if a hearing loss exists. The audiologist will determine the type and degree of hearing loss and identify if there are medical concerns that require an evaluation by ENT physician.

What is involved in getting my hearing tested

  • Medical History
  • Otoscopy
  • Instructions
  • Puretones and Speech Testing
  • Additional testing if needed
  • Review of Results
  • Recommendations

Types of Hearing Loss

There are three types of hearing loss including: sensorineural hearing loss, conductive hearing loss and mixed hearing loss. Your audiologist will determine the type of hearing loss based upon your hearing evaluation results.

Ear Anatomy

Sensorineural Hearing Loss

Sensorineural hearing loss is the most common type of hearing loss. It occurs when inner ear hair cells or the auditory nerve are damaged. This damage causes a poor transmission of sound signals to the brain. The most common treatment for a sensorineural hearing loss is the use of hearing aids.

Conductive Hearing Loss

Conductive hearing loss is the result of medical issues that affect the outer and/or middle ear. All conductive hearing losses should be evaluated by an Ear, Nose, and Throat physician to determine the cause of loss. Conductive hearing losses can often be treated medically or surgically. If medical treatment is not an option, traditional or bone conduction hearing aids may be considered to improve hearing.

Mixed Hearing Loss

Mixed hearing loss is a combination of sensorineural and conductive hearing loss. Mixed hearing losses should be evaluated by an Ear, Nose, and Throat physician to determine the cause of the loss. Treatment course options will be determined by the physician.

Degree of Hearing Loss

Results of the audiometric evaluation are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. Frequency, from low to high, is plotted from left to right. Hearing loss (HL) is measured in decibels (dB) and is described in general categories. Hearing loss is not measured in percentages. The general hearing loss categories used by most hearing professionals are as follows:

  • Normal hearing (0 to 25 dB HL)
  • Mild hearing loss (26 to 40 dB HL)
  • Moderate hearing loss (41 to 70 dB HL)
  • Severe hearing loss (71 to 90 dB HL)
  • Profound hearing loss (greater than 91 dB HL)

Mild hearing loss: Patients with mild hearing loss may experience trouble hearing soft sounds, increased difficulty in background noise, and struggle to hear things from a distance.

Moderate hearing loss: Patients with moderate degrees of hearing loss may feel like people are mumbling, frequently misunderstand words, and feel that hearing in background noise is extremely difficult.

Severe hearing loss: Patients with severe degrees of hearing loss are frequently not able to folow a conversation without requesting people to speak up or repeat. Typlically environmental sounds like leaves rustling, turn signals, and birds are not heard.

Profound hearing loss: Most sounds of the world are not heard. Loud sound such as fire alrms, telephone rings, and traffic are not heard. Speech is not audible unless someone is shouting. www.starkey.com/hearing-loss-simulator (requested information from Starkey on use of this tool)

Audiogram of Sounds

Audiogram of Sounds

Preventing Hearing Loss

Noise Induced Hearing Loss and How to Prevent It

Noise induced hearing loss (NIHL) is a permanent hearing impairment. NIHL may be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by prolonged exposure to high levels of noise. Excessive noise exposure is one of the most common causes of hearing loss. The National Institute of Health reports that about 15 percent of Americans aged 20 to 69 have high frequency hearing loss due to noise exposure related to occupational or leisure activities. Some of the common occupational and leisure activities that can cause NIHL are: truck drivers, construction and factory workers, military, police officers, musicians, and hunters.

Noise induced hearing loss is the only type of the hearing loss that is preventable. There are many options for preventing NIHL including ear plugs, ear muffs, and custom hearing protection. Doubling up on hearing protection is often recommended. Times when you should wear double hearing protection are at a shooting range or when the noise reduction of the device does not decrease the intensity or volume to a safe listening level. It is important to understand the intensity of the noise that you are exposed to, so the proper hearing protection can be selected.

Understanding Hearing Loss

Do I have hearing loss?

Ten Ways To Recognize Hearing Loss Questionaire

Please circle the response that applies to you

1. Do you have a problem hearing over the telephone?
Yes No
2. Do you have trouble following the conversation when two or more people are talking at the same time?
Yes No
3. Do people complain that you turn the TV volume up too high?
Yes No
4. Do you have to strain to understand conversation?
Yes No
5. Do you have trouble hearing in a noisy background?
Yes No
6. Do you find yourself asking people to repeat themselves?
Yes No
7. Do many people you talk to seem to mumble (or not speak clearly)?
Yes No
8. Do you misunderstand what others are saying and respond inappropriately?
Yes No
9. Do you have trouble understanding the speech of women and children?
Yes No
10. Do people get annoyed because you misunderstand what they say?
Yes No
Enter the code as it is shown: *  
 

Answering "Yes" to three or more questions strongly suggests that a hearing evaluation is warranted.

Contact an audiologist at Professional Hearing Services at 262-549-5150, with locations in Waukesha, New Berlin, and Mukwonago. You can also visit us at www.professionalhearingservices.com.

Patients Survey taken from www.nidcd.nih.gov.

Tinnitus

What is Tinnitus?

Tinnitus is a ringing, roaring, chirping, hissing, or other type of noise that seems to originate in the ear or the head. This is a common problem that affects 1 in 5 people. In many cases, it is not a serious problem, but rather a nuisance that eventually resolves. In some cases, the tinnitus can persist and even change over time. Rarely does tinnitus represent a serious health condition; however, it should be evaluated by an otolaryngologist and audiologist.

Causes

Tinnitus is not a disease but a symptom of an underlying condition. Nearly 36 million Americans suffer from this disorder. In almost all cases, only the patient can hear the noise.

Tinnitus can arise in any of the following areas: the outer ear, the middle ear, the inner ear, or by abnormalities in the brain. Tinnitus can be caused by ear wax, a foreign body in the canal, or anything that blocks the ear canal. Fluid, infection or diseases of the middle ear bones or ear drum can also cause tinnitus.

One of the most common causes of tinnitus is hearing loss or damage to the inner ear. Today, exposure to loud noise is a very common cause of tinnitus and often damages hearing as well.

Some medications (for example, aspirin) and other diseases of the inner ear (Meniere’s disease) can cause tinnitus. Tinnitus can in very rare situations be a symptom of a brain aneurysm or a tumor (Acoustic neuroma). Tinnitus has also been associated with TMJ, sleep disorders, head and neck injury, heart disease and anxiety.

Evaluation

The otolaryngologist will take a thorough medical history and perform a physical examination of your ears. It is helpful to discuss with your physician the tinnitus as well as other symptoms such as fullness, hearing loss, dizziness, or other ear symptoms. In addition, provide the doctor with a description of the tinnitus, onset of the symptom, and medications you are taking. Routinely a hearing evaluation will be ordered by the physician to determine if there is hearing loss. The hearing test should be performed by an audiologist in sound booth. In some cases, additional testing may need to be ordered to further evaluate the auditory system.

Treatment Options

Treatment options include:

  1. Tinnitus Masking: Masking is a treatment where a sound is introduced to cover up or reduce the perceived volume of the tinnitus. A masker can be as simple as turning on a radio, TV, or fan.
  2. Custom Tinnitus Masker: Custom tinnitus maskers, that look like a hearing aid can be worn daily. A custom tinnitus masker typically emits a white or pink noise.
  3. Hearing Aid: Hearing aids are often a first treatment option when hearing loss is found along with the tinnitus.
  4. Lifestyle and Dietary Changes: Decreasing caffeine, stress, exercise, and relaxation techniques can be used as a coping mechanism.
  5. Herbal Treatment: Consult your physician to discuss if herbal treatment may be an option for you. Note: Herbal treatments may interfere with prescription medication so always consult your physician before trying an herbal treatment.
  6. Tinnitus Apps:  Smart phones have made it easy to stream or dock your device to provide accessible free tinnitus maskers.  We recommend trying the following tinnitus apps to determine if there is a sound that helps to mask (cover) your tinnitus.  (Apps can be found at iTunes or Google Play.)

Once you find the right sound, it is recommended that you adjust the volume to below the level to completely cover the tinnitus. Make sure the level is less than 50% of the volume setting in your device to protect your ears from potentially damaging “loud” sounds. Gradually over time, you should be able to decrease the volume of the masker and still manage the tinnitus.

Sudden Loss in Hearing

A sudden loss in hearing is a medical emergency. Individuals who experience a sudden hearing loss should seek medical attention immediately. Delay in treatment of a sudden hearing loss can greatly impact the effectiveness of treatment options.

Sudden sensorineural hearing loss is a rapid change in hearing, typically in one ear occurring at once or over a couple of days. Often times, patients describe associated symptoms of ringing, fullness, and/or dizziness in the ear.

Diagnosis of a sudden hearing loss follows a comprehensive exam of the affected ear by an otolaryngologist (ENT doctor) and completion of a comprehensive hearing evaluation by an audiologist. Additional testing may follow to localize the cause of the sudden hearing loss. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), only about 10-15% of individuals diagnosed with sudden hearing loss have an identifiable cause. Some of the possible causes are infection, trauma, autoimmune diseases, ototoxic medications, circulation problems, tumor, neurologic diseases, and Meniere's disease.

The most common treatment option for sudden sensorineural hearing loss is use of corticosteroids in either pill form or by direct injection into the middle ear. Treatment options will be determined by the otolaryngologist based on the exam and hearing test results.

If you are experiencing a sudden loss in hearing, contact your physician immediately.

Dizziness

A sudden sensation of dizziness can be alarming. Dizziness is a general term used to describe spinning, light headedness, off balance, or falling to name a few. Rest assured that in most cases this is not a sign of a serious health condition. You are not alone; dizziness impacts 20-30% of the population at some times in their lives.

The balance system utilizes information from vision, proprioception, vestibular system, muscles, joints, and the central nervous system. Sometimes signals conflict and it is up to your brain to decide what is true. An example of this is when you are stopped on a train but the train next to you is moving. Your eyes send signals that you are moving but your ear and body signal that you are still. Your brain must pick which is true and this is how your balance is maintained.

What Should You Do?

Do not ignore your symptoms. Schedule an appointment to talk with your healthcare provider. Keep a record of the dates of attacks, if the attacks were prompted by an event, duration of attack, and any other symptoms or concerns.

Common Causes of Dizziness

  1. Vertigo, a sensation that you or the room is spinning, is often caused by an inner ear problem. Common inner ear causes of vertigo include:
    • Benign Paroxysmal Positional Vertigo (BPPV): this occurs when the crystals of the inner ear are dislodged and migrate into a semicircular canal. BPPV is characterized by a brief sensation of spinning that typically lasts less than a minute. This sensation is triggered by specific changes in the position of the head. BPPV is diagnosed and can by treated by a series of simple tests.
    • Infection or Inflammation: sometimes the semicircular canals swell and send incorrect balance signals. This can cause episodes of vertigo that last for hours or days.
    • Meniere's Disease: is a condition in which there is an abundance of fluid in the inner ear that causes increased pressure and swelling. It can affect the hearing and balance systems.
  2. Disequilibrium, a feeling of imbalance without the sensation of spinning, can have many causes including diabetes, anemia, head injury, and aging. There is a chance that the cause will remain unknown.
  3. Syncope, a loss of consciousness or fainting, may be due to a heart or blood pressure problem. If you experience syncope it is pertinent that you consult your physician to rule out serious health conditions.

These are just some of the reasons that vertigo and dizziness occur. It is important to work with your physician to determine the cause of your dizziness.

Conditions Associated with Hearing Loss

Hearing loss is a medical condition that affects people of all ages. Hearing loss is the third most prevalent chronic condition in older Americans behind hypertension and arthritis. Hearing loss can be caused by a number of factors including: age related changes, noise, genetics, medications, lifestyle choices, and medical conditions. Understanding what places you at risk for hearing loss can help you prevent some causes of hearing loss.

Hearing vs Understanding

Imagine that you are not able to hear the sound/s/ in the word sat. Would you be able to distinguish the difference between the word sat, fat, bat and rat? If you were relying on hearing alone, it would be difficult to discriminate the /s/ sound. In order to understand what was said you would have to fill in the gaps by utilizing lip-reading cues, context and previous experiences.

Have you ever asked yourself why can I hear speech but not understand it? Difficulty understanding can be caused by the inability to hear the sounds of speech or a lack of clarity in the auditory system.

Hearing loss is evaluated in two ways. Testing is performed to determine the softest sound that you can hear as well as your ability to understand speech. The sensitivity to sound is assessed through your responses to beeps in the sound booth. The clarity of hearing is evaluated by having you respond to speech in quiet. After both have been evaluated, the audiologist will review the results with you and explain why you may be having trouble understanding words.

If your troubles are due to a loss of sensitivity to sound, a hearing device may be recommended to recover the sounds that you have been missing. A hearing device will increase the volume of the missing sounds with respect to the degree of hearing loss. Amplifying the sound will help improve understanding by allowing you to hear the missing pieces.

If your difficulties are due to reduced sensitivity and lack of clarity, a hearing device may be recommended. Hearing devices can recover the missing sounds but cannot clarify a distorted system. Realistic expectations regarding the limitations of the technology will be discussed. Coping strategies will need to be utilized to reduce background noise, improve communication and optimize listening. In some instances when discrimination has deteriorated substantially, benefit from hearing devices may not be possible and cochlear implants may be recommended.

If you have questions regarding your hearing difficulties and are interested in finding a solution to improve your quality of life and decrease listening effort, consider having your hearing evaluated.