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For most people, hearing loss is so gradual that it is hardly noticed—and is usually detected first by family, friends, or a hearing test.

You should suspect a hearing loss if you . . .

  • Have been exposed to high noise levels, such as loud music, trucks or tractors, machinery in factories, firearms, or power tools without adequate ear protection.
  • Feel growing nervous tension, irritability, or fatigue from the effort to hear.
  • Are inclined to believe that “everybody mumbles” or “people don’t speak as clearly as they used to.”
  • Find yourself straining to understand conversation in social settings or at work.
  • Frequently misunderstand or need to have things repeated.
  • Find yourself watching people’s faces intently when you are listening.
  • Increase the television or radio volume to a point that others complain of the loudness.
  • Have a family history of hearing loss.
  • Have diabetes, heart, thyroid, or circulation problems.
  • Have been exposed to ototoxic drugs or medications.
  • Have recurring ear infections, constant ringing in the ears, or dizziness.

There are many other clues to possible hearing loss. The list above provides examples of the more frequent indicators.

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How our hearing works:

As sound passes through each ear, it sets off a chain reaction that could be compared to the toppling of dominoes.

First, the outer ear collects pressure (or sound) waves and funnels them through the ear canal. These vibrations strike the eardrum; then the delicate bones of the middle ear conduct the vibrations to the fluid in the inner ear. This stimulates the tiny nerve endings, called hair cells, which transform the vibrations into electrochemical impulses. The impulses travel to the brain where they are deciphered into sounds you recognize.

Sensorineural or “nerve” hearing loss results from damage to the hair cells, nerve fibers, or both in the inner ear. This is the most common type of hearing loss and is often caused by aging or prolonged exposure to noise. It can also be caused by high fever, birth defects, and certain drugs.

People with sensorineural hearing loss can hear speech, but frequently have difficulty understanding it. The problem is usually compounded when background noise is present.

Sensorineural hearing loss is most commonly treated by the use of a hearing instrument and generally cannot be corrected through surgery or medicine.

What is a mixed hearing loss?

Persons with both conductive and sensorineural hearing loss are commonly referred to as having mixed hearing loss. Most of these cases can be helped by either a hearing instrument or surgery.

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Can a one-time exposure to an unexpected, extremely loud, painful noise cause damage?

Yes. This can cause damage at times, but there are also times when it does not. It depends upon the circumstances, how close the loud noise was to the ear, and whether or not it occurred in an open space or in a closed area.

Prevention:

  • Wear earplugs if you are exposed to noise levels that may be harmful to your ears. Cotton balls are not sufficient, as they do not block enough sound; they can also become lodged deep in the ear canal.
  • Do not listen to loud music with earphones.
  • If you are at a concert and the music hurts your ears, put on earplugs or leave immediately. The overamplified sound may cause permanent damage.
  • Educate your children about the danger of loud recreational noise.
  • If you ride a subway, wear earplugs or cover your ears with your hands as the trains pass. The roar of the trains can damage your ears.
  • To lower the risk of infectious diseases that may lead to permanent hearing loss, make sure your children receive all of their immunizations.
  • If your ears tend to get severely blocked with wax frequently, clean them periodically with hydrogen peroxide.
  • Be sure to report any sudden hearing loss to your doctor immediately

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Some 28 million people in the United States have a hearing problem significant enough to interfere with their ability to understand conversations and communicate with others. As many as 2 million cannot hear at all and are considered profoundly deaf. Your chances of having a hearing problem increase dramatically with age. More than one-third of people over the age of 75 experience difficulty hearing, a problem that often leads to frustration and social isolation.

One form of age-related hearing loss—known as presbycusia—usually begins between the ages of 40 and 50 and gets progressively worse. People with presbycusia often have trouble hearing higher frequencies and thus find it particularly difficult to understand women and children, who generally speak at a higher pitch than men do. Presbycusia tends to afflict men more frequently and more severely than women.

Hearing problems are less common in children, but if left untreated, they can have a major impact on how well a child learns and makes friends. About 3 in 1,000 infants have a hearing problem severe enough to interfere with speech and language development.

Doctors divide hearing loss into two main categories:

  1. Conductive hearing loss occurs when something interferes with the transfer of sound waves from the outer to the inner ear, and
  2. Sensorineural hearing loss results from damage to the inner ear or to the nerves that transmit sound impulses from the inner ear to the brain. Sounds may reach the inner ear, but they are not perceived because the necessary messages aren’t sent to the brain correctly.

Sometimes a person has a mixture of both types of hearing loss.

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