A Brief Explanation Of Hearing Loss
Hearing loss is a decreased ability to hear sound in one or both ears. It can be sudden or gradual and range from mild to profound.
Hearing loss can be caused by many things, including noise exposure, aging, genetics, infections, and certain medications. The most common type of hearing loss is age-related hearing loss, which affects about 1 in 3 people aged 65 and older.
Types of Hearing Loss
There are three types of hearing loss: Sensorineural hearing loss, conductive hearing loss, and mixed hearing loss.
Sensorineural Hearing Loss
- Bilateral Sensorineural Hearing Loss
- Unilateral Sensorineural Hearing Loss
- Asymmetrical Sensorineural Hearing Loss
Conductive Hearing Loss
- Mixed Hearing Loss
Hearing loss isn't a new medical condition. As such, it's expected for scientists and pharmacists to come up with more effective treatment options and methods of managing the condition over time. In this light, we'll extensively discuss the latest treatment procedures and options for hearing loss in this article. Stay tuned!
A brief explanation of hearing loss
Deafness, hearing impairment, and other forms of hearing loss describe a person's degree of difficulty or complete inability to listen to sounds. The severity of the symptoms can range from hardly noticeable to very debilitating. In noisy environments, even a patient with a modest hearing impairment may struggle to comprehend speech; those with intermediate loss may need a hearing aid.
Some people are profoundly deaf and must learn to read lips to communicate. Those severely deaf have no residual hearing and must rely on visual cues such as lip reading and sign language to communicate. 15% of Americans over the age of 18 report having some degree of hearing loss.
To learn more, we also suggest reading Understanding Ear Pressure.
Hearing loss vs. deafness
Various degrees of hearing loss needs to be identified and treated accordingly.
Hearing loss is a common problem that can profoundly impact the quality of life.
While the causes of hearing loss vary, the most common culprit is damage to the inner ear. This can occur due to aging, exposure to loud noise, or certain medical conditions. Hearing loss can make it challenging to follow conversations, enjoy music, and stay connected with loved ones. The good news is that there are several effective treatment options available.
This condition manifests itself when a person's hearing is impaired to the point where they cannot understand uttered speech, even when the volume is raised.
It means that a person has no sense of hearing at all. One who is profoundly deaf has absolutely no auditory perception. The degree of hearing loss is measured by the increase in the volume required for normal speech comprehension.
While some believe that a diagnosis of profound Deafness represents the end of the hearing spectrum, others argue that "profoundly deaf" and "totally deaf" are not mutually exclusive.
Types of hearing loss
Sensorineural hearing loss, conductive hearing loss, and mixed hearing loss are the three categories of hearing loss.
Sensorineural hearing loss
Hearing loss caused by damage to the nerves connecting the inner ear to the brain is known as sensorineural hearing loss. The majority of people with hearing loss have sensorineural hearing loss.
Aging, exposure to loud noises, or other factors may all lead to the destruction of the neurons and inner hair cells, causing this condition. There is currently no medical or surgical treatment for sensorineural hearing loss. However, hearing aids may assist with treatment and improvement.
Depending on the origin, hearing loss due to SNHL may affect both ears or only one. If your SNHL develops slowly over time, you may not notice any changes until you have your hearing tested. Symptoms of sudden onset SNHL often appear within a few days. The onset of SNHL is sometimes so abrupt that it is the first thing patients notice when they open their eyes in the morning.
Some of the consequences of sensorineural hearing loss include the following:
- Discomfort in hearing in noisy environments.
- Having a tough time deciphering female and children voices.
- Vertigo and issues with balance.
- Difficulty in hearing high-frequency noises.
- It seems as if sounds and conversations are muffled.
- Experiencing voices one doesn't recognize or comprehend.
- Tinnitus (ringing in your ears).
Sensorineural hearing loss causes
SNHL may either be present from birth (congenital) or developed later in life (acquired). The following may have a role in SNHL development.
- Congenital Hearing Loss
- Loud Noises
Types of sensorineural hearing loss
Depending on the root cause, sensorineural hearing loss may affect either one or both ears.
- Bilateral Sensorineural Hearing Loss
- Unilateral Sensorineural Hearing Loss
- Asymmetrical Sensorineural Hearing Loss
Sensorineural hearing loss diagnosis
Sensorineural hearing loss is best diagnosed after a series of tests has been performed by a doctor.
- Physical exam
SNHL may be distinguished from conductive hearing loss with a physical examination. The doctor will check for signs of infection, inflammation, eardrum damage, foreign things, and excess fluid or earwax.
- Tuning forks
As a preliminary check, a doctor could do a tuning fork test. Some particular checks are:
- Weber's test
The doctor lightly taps a tuning fork tuned to 512 hertz and positions it in front of your eyebrows. Hearing loss is most likely conductive if the sound is amplified in the unaffected ear. You probably have sensorineural hearing loss if sounds are more robust in your good ear.
- Rinne test
In this procedure, the doctor strikes a tuning fork and presses it on the mastoid bone behind the ear until the patient can no longer hear it. Your doctor will gradually increase the distance between the tuning fork and your ear canal until you no longer detect the sound. If you have SNHL, holding the tuning fork in front of your ear canal rather than against the bone can help you hear it better.
If your doctor suspects you have hearing loss, they will likely refer you to an audiologist for a more thorough hearing exam.
You'll take the exam while wearing headphones in a soundproof booth. Each ear will be subjected to a slightly varying volume and Frequency of tones and speech. An individual's threshold for audible sound and the exact frequencies affected by hearing loss may be determined with this test.
Conductive hearing loss
Obstructions in the outer or middle ear, such as fluid, tumors, earwax, or even ear formation, usually cause conductive hearing loss. This blockage stops sound from reaching the inner ear. Medical and surgical interventions have proven effective in treating conductive hearing loss.
The signs of conductive hearing loss are those that you've probably already thought about. Sound quality is diminished with conductive hearing loss.
A common symptom of conductive hearing loss is trouble understanding speech at normal conversational levels. This may cause people to increase the volume on their stereos, TVs, and other audio equipment.
The following are some other signs of conductive hearing loss:
- Lack of hearing, all of a sudden.
- Consistently deteriorating hearing loss
- Trouble hearing in one or both ears
- Earache or fullness in one or both ears
- Odors emanating from your ear that are unfamiliar or off-putting
- Ear leakage that contains liquid
What are the causes of conductive hearing loss?
In the case of conductive hearing loss, the inner ear simply isn't receiving any sound waves. An issue with the external or middle ear might lead to this condition. Some of the outer-ear issues that might lead to conductive hearing loss are:
- The sensation of having a bug or other small object lodged in one's ear.
- Accumulation of wax in the ear canal.
- A tumor of the ear bone.
- Infections in the ear canal, such as those caused by swimming.
- The ear canal is full of fluid.
- Ear canal abnormalities.
- Shrinkage of the ear canal.
- Middle-ear issues like those listed above may lead to conductive hearing loss.
- Fluid accumulation in the middle ear and related infections.
- Your eardrum has been ruptured.
- A perforation in the ear drum.
- Collapsed eardrum brought on by pressure within the ear.
- Your eardrum has become thicker.
- Excessive skin cell growth in the middle ear.
- Traumatic injury to the ear's middle ear bones.
- Otosclerosis is a hereditary disorder that causes the structure of the middle ear bone to be abnormal.
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How is conductive hearing loss diagnosed?
A doctor specializing in treating the ears, nose, and throat (ENT) can determine the cause of your hearing loss. They will inquire as to your overall health and your hearing loss specifically. You'll be checked out so they can identify your specific kind of hearing loss and investigate possible causes.
An audiogram is one of the first things that must be done when diagnosing hearing loss. A conductive, sensorineural, or mixed hearing loss may be identified using this test. The extent of your hearing loss may also be measured this way.
Sometimes, this will be the only test necessary to establish a diagnosis. Other tests that may be necessary are:
- CT Scans, MRI Scans, Or Other Imaging Tests
- Acoustic Reflex
- Audiometric Tests
- Static Acoustic Measures
Mixed hearing loss
"Hearing loss" is a mix of sensorineural and conductive forms of impairment. A person with mixed hearing loss will experience some degree of difficulty with both conductive and sensorineural hearing loss. As a result, there is harm to the ear's outer and inner ear.
Since the inner ear cannot process the sound correctly, the outer ear cannot send it to the brain. Conduction hearing loss (outer ear) may be reversible, but sensorineural hearing loss (inner ear) is typically irreversible. People with a combination of hearing loss types often report that sounds are tranquil and challenging to understand. You can find the most effective ear drops for infections in The Best Rated Ear Drops For Infections by Ulti Best Products.
What causes mixed hearing loss?
Any condition that causes either sensorineural or conductive hearing loss can also cause mixed hearing loss. Several of the fundamental causes are as follows:
- Head or ear trauma
- The buildup of earwax in the ear canal
- Ear wax and middle ear fluid
Mixed hearing loss diagnosis
An audiometric hearing evaluation, in addition to an ENT (ear, nose, throat, and neck) examination and thorough patient history, is the standard method for diagnosing mixed hearing loss. Your audiologist will use the physical exam results to diagnose any underlying physiological problems, while audiometry will provide a detailed analysis of the degree of hearing loss.
A professional audiologist uses an audiometer to perform an audiometric evaluation. The audiogram that results from this test is what the audiologist uses to diagnose the patient's level of hearing loss. The multiple causes of your hearing loss can be visualized on an audiogram using the term "mixed hearing loss." A person may experience mixed hearing loss due, for instance, to both age-related hearing loss and an abnormally large amount of earwax. Your audiologist will review the findings with you, explaining what's happening and what can be done to help.
Hearing loss and noise exposure
After the age-related hearing loss, noise-induced hearing loss is the most common cause of severe to profound impairment in sensorineural hearing. Approximately 80% of people between the ages of 13 and 18 listen to music on headphones anywhere from 1 to 3 hours per day.
Long-term exposure to loud noises can damage hearing. The inner ear's hair cells and auditory nerve are harmed as a result. According to the study, approximately 1.7% of the global population will suffer from noise-induced hearing loss in 2021. Hearing loss was 4.5 times more likely in people who used headphones in a noisy environment.
Eight hours a day at 85 dBA is the safe limit for exposure to loud noise.
Hearing loss can occur from prolonged or repeated exposure to sounds at or above 85 dB. The duration of exposure is just as dangerous as the loudness itself. Hearing loss can occur even at moderate volumes, according to health experts at Oklahoma Hearing Center.
Methods for preventing hearing loss by using headphones
- Limiting exposure to loud sounds by decreasing headphones' volume below the acceptable level.
- Using noise-canceling headphones that block out external sound enables people to listen to music at low volumes.
- Swapping out earbuds or in-ear headphones for over-ear headphones.
- minimizing listening times
- Receiving routine ear tests.
- A person can reduce the volume while not wearing headphones, such as on televisions or cellphones, and can use ear protection at loud events or in noisy surroundings.
Why exposure to extremely loud noise is harmful to your hearing
The primary risk with headphones is volume due to the speaker's proximity to the ear canal. Because loud noises are harmful to your ears, you should avoid doing this.
Sound waves vibrate the eardrum as they reach the ear canal. The cochlea receives this vibration after traveling through numerous tiny bones in the middle ear. Many thousands of tiny "hairs" are packed into the cochlea, a fluid-filled chamber in your ear. The fluid in the cochlea vibrates in response to sound waves, which in turn causes the hairs to sway. The vibrations caused by louder sounds are more significant. Therefore, the hairs move more.
Damage to these hair cells occurs when one repeatedly exposes him or herself to sounds that are too loud. Because of the excessive noise, the cells are distorted or even folded over. This phenomenon results from the "temporary hearing loss" that follows exposure to loud noises. When subjected to extremely high frequencies, such as those produced by loud noise, the hair cells require time to recuperate.
Inner ear injury currently has no known treatment. However, there are cases in which the cells never fully recover. They may be too injured to carry out their usual duties. Long-term hearing loss is the result of this condition. When caused by loud noises, this kind of hearing loss is usually always permanent.
The function of earphones
The same phenomenon known as "noise-induced hearing loss" occurs when using headphones as when listening to other loud noises. The constant exposure to loud noise from headphones can permanently damage your hearing by bending the cochlear hair cells too far down. There may be irreversible consequences if they aren't given adequate time to heal.
Nonetheless, even moderately loud headphones can cause permanent hearing loss. Hearing loss can occur from even moderately loud listening with headphones or earbuds. That's because it's not simply the volume of noise but also the duration of exposure that causes damage to your ears. For the same reason, a considerably quieter gunshot or explosion will not protect your hearing any better than a concert or the use of noisy power tools. The time it is exposed to is equally important to the sound level.
Managing hearing loss
Hearing aids do not restore normal hearing but improve the sound quality that reaches the ear. A variety of hearing aids are available. A variety of sizes, circuit configurations, and output strengths are available.
The main components of a hearing aid are a battery, a speaker, an amplifier, and a microphone. You can even hide them in your ear because they are so tiny. Many up-to-date iterations feature noise cancellation to isolate speech from the background.
A person with profound deafness would not benefit from a hearing aid. The audiologist will mold an impression of your ear to ensure a proper fit. In other words, it will be modified to make it more audible.
Behind-the-ear (BTE) hearing aids
They are assistive listening devices. These have a dome on top called an earmold and a case that is connected to it by a cable. The dome attaches to the case, which rests behind the outer ear, and the cable runs down in front of the ear. The device's output is transmitted to the listener's ear using either an electrical or acoustic path.
Because the electronics in BTE hearing aids are housed away from the ear, they are less susceptible to wear and tear from sweat and earwax. Children, who require a reliable and simple device, are the primary consumers of these products.
In-the-canal (ITC) hearing aids
These are the visible contents of the external ear canal. The speaker is placed inside the ear with the help of a soft ear insert, typically made of silicone. Most patients can start using these devices immediately, and the sound quality is much enhanced.
Completely in the canal (CIC) hearing aids
These tiny, unobtrusive aids aren't suggested for those with profound hearing loss, but they're great for everyone else.
Bone conduction hearing aids
Beneficial for those with conductive hearing loss or for those who can't use traditional hearing aids. Wearing one of these gadgets for an extended period may cause discomfort or pain. A headband secures the vibrating part of the device against the mastoid. The mastoid bone acts as a conduit for the vibrations to reach the inner ear, where they are processed.
Cochlear implant systems
A cochlear implant may be beneficial if the eardrum and middle ear work well.
The cochlea is implanted with this tiny electrode. A microprocessor is implanted behind the skin behind the ear to stimulate electricity.
A cochlear implant helps individuals whose hearing loss is caused by damaged hair cells in the cochlea. Typically, the implants improve speech comprehension. The most recent cochlear implants feature innovative technology that allows patients to enjoy music, better understand speech even in noisy environments, and utilize their processors while swimming.
As of 2012, the National Institutes of Health (NIH) reported that around 58,000 adults and 38,000 children in the United States had cochlear implants.
- A microphone is used to collect ambient sound.
- A speech processor highlights the patient's most essential sounds, such as speech. The electrical sound signals are separated into channels and transmitted to the transmitter through a tiny wire.
- A transmitter consists of a magnet-secured coil. It is situated behind the external ear and sends sound signals to the implanted device.
- A surgeon implants a receiver and stimulator beneath the epidermis and into the bone. The signals are translated into electrical impulses and transmitted to the electrodes through internal connections.
- Impulses are transmitted to the nerves in the cochlear's lower channels and straight to the brain. Up to twenty-two electrodes are wrapped around the cochlea. The number of electrodes depends on the implant manufacturer.
A cochlear implant's exterior consists of the following:
People with hearing loss can struggle with speech and have trouble understanding what others are saying. Many persons who are deaf or hard of hearing can pick up alternative modes of communication. Using sign language and lip reading as an alternative to or in addition to speech communication is possible.
Find out the best apps for American Sign Language in Sign language apps for ASL: What to know and best options by Medical News Today.
Lip reading is a method for understanding spoken language, also known as speechreading. It involves watching the movements of the speaker's lips, face, and tongue, as well as extrapolating from the data provided by the context and any residual hearing the patient may have.
Lip reading comes more naturally to people who lost their hearing after they had already learned how to communicate verbally, as opposed to those born deaf or hard of hearing.
No sounds are utilized in this sign language; it communicates through hand gestures, facial emotions, and body postures. Deaf people are the most common users of this device.
There are many different sign languages to choose from. American Sign Language (ASL) and British Sign Language (BSL) are two extremely distinct sign languages (ASL). For example, British Sign Language (BSL) has a two-handed alphabet, while American Sign Language (ASL) employs a one-handed alphabet.
Missionaries from far away brought the sign language used in some countries with them when they went there. A good illustration of this would be the use of Norwegian sign language in Madagascar.
Word order and grammar in British Sign Language are not the same as in spoken English since sign language differs entirely from the spoken variety. Grammar-wise, American Sign Language is more comparable to spoken Japanese than it is to spoken English.
An evaluation of some potential treatment options and cure for hearing loss
Millions of people every year suffer from some form of severe hearing loss. There is currently no cure for hearing loss; however, technological advancements in areas such as surgical implants and prescription hearing aids have made a world of difference for those who suffer from it. Hearing loss is permanent and incurable except in highly unusual circumstances. However, that may soon change.
Many promising treatments for hearing loss are currently in clinical trials or in the early stages of development. Restoration of inner ear tissue lost to damage by stem cell therapy is a promising area of research. The potential benefits of gene-editing research are comparable.
Progenitor cell activation research
One promising experimental treatment to keep an eye on is progenitor cell activation. Founded by Massachusetts Institute of Technology researchers, Frequency Therapeutics is developing this novel regenerative therapy to treat hearing loss. Its mechanism is both straightforward and fascinating.
We need to briefly discuss stem and progenitor cells to help you understand better.
What are stem cells and progenitor cells?
Stem cells are the basis for all human cells because they can self-renew indefinitely. That's pretty common knowledge at this point. Yet, you might not be aware of two distinct kinds of stem cells.
Stem cells derived from embryos serve as the body's "living blueprints," from which all other cells are derived during pregnancy. Adult stem cells, on the other hand, are limited in their differentiation potential. The progenitor cell is a type of stem cell that bridges the gap between adult and embryonic stem cells.
Progenitor cells activation therapy: Fx-322
The new therapy from Frequency Therapeutics is aimed squarely at progenitor cells. To a lesser extent than stem cells, progenitor cells can maintain their viability and proliferate. They are more potent than adult stem cells but less so than embryonic stem cells.
It involves a drug called FX-322 that, when injected, activates progenitor cells in the inner ear to start growing stereocilia again.
Because of the positive outcomes seen in clinical trials, this treatment is highly encouraging. More than 200 patients have received the injection from the company so far. Nearly all participants across three studies showed what the company called "clinically meaningful improvements" in their ability to understand spoken language.
According to the clinical trial website, Frequency is currently accepting participants for a clinical trial with 124 people involved and is expected to have preliminary results by the beginning of 2023. The founders of Frequency believe their work will improve scientists' capability to manipulate progenitor cells, thereby developing novel treatments.
Relationship between stereocilia and hearing loss
The stereocilia, found on the inner ear's microscopic hair cells, are essential to hearing. They convert fluid movement within the cochlear organ into electrical impulses that the auditory nerve carries to the brain.
The stereocilia are highly vulnerable to noise because of their sensitivity to sound. The primary issue is that stereocilia do not regenerate like other human cells; they are lost for good once they are lost. Over time, even stereocilia that haven't been damaged can lose their ability to conduct impulses.
Where does FX-322 stand at the moment?
For FX-322 to gain approval from the FDA in the United States, it must demonstrate its safety and efficacy in several clinical trials. It has already been tested in five studies involving 193 subjects, with no severe side effects reported.
The speech recognition data from three of the studies showed statistically significant improvements:
- In March of 2021, Frequency Therapeutics announced encouraging results from a clinical trial. A single dose of FX-322 was injected into one ear, while a placebo group was injected into the other. After 90 days, 34% of people saw statistically significant improvements in word recognition scores in the treated ear.
- Twenty-three participants in another study showed at least a 10% increase in word recognition scores in the treated ear after treatment. When assessed again 13-21 months later, 70% of those who had made significant progress maintained it.
- Also, those with profound sensorineural hearing loss participated in clinical trials of FX-322. Average word recognition scores did not improve. However, some subjects scored better on the Bamford-Kowla-Bench Sentence-in-Noise test (BKB-SIN).
What are frequency therapeutics and FX-322's long-term prospects, starting in 2022?
Using the data from the previous studies, Frequency Therapeutics has initiated Phase 2b clinical trials.
- About 124 people are expected to participate in this new study, which is expected to wrap up in the fall of 2022.
- Initial dosing of FX-322 began in October 2021, after a month-long screening period, to ensure that patients were suitable for the study. This time, potential subjects must maintain consistent performance across three visits to the clinic.
- The researchers set up the study because they suspect some participants may have exaggerated their hearing problems to get their hands on the experimental drug. This hypothesis was supported by data published in March 2021: participants in both the treatment and placebo groups showed significant gains in word recognition. A rise in word recognition abilities is not to be anticipated in the placebo group because they did not receive FX-322.
- Participants in the current FX-322 study are given either the active drug or a placebo via a single injection. After 90 days, researchers will evaluate participants' word recognition scores to determine if they have improved their ability to understand spoken language.
- All participants must have had a hearing threshold between 35 and 85 dBHL and have been diagnosed with either noise-induced sensorineural hearing loss or idiopathic sudden sensorineural hearing loss.In its current state, FX-322 is not intended to treat hearing loss due to aging.
Frequency Therapeutics is developing a drug candidate called FX-345 that may offer hope to those with age-related hearing loss. The researchers believe that by targeting regions further into the cochlea with FX-345, they will be able to treat additional forms of sensorineural hearing loss, which is the main difference between FX-322 and FX-345.
How the GFI1 protein helps create new inner ear hair cells for hearing?
The University of Maryland School of Medicine (UMSOM) discovered how a protein helps generate new hair cells in the inner ear. This study demonstrates that embryonic hair cells require the GFI1 protein to mature into fully functional adult cells.
The expression of these genes suggests that these cells will eventually take on the properties of neurons. They think reversing hearing loss is possible once the intricate path to normal hearing is discovered.
A cure for hearing loss has yet to be discovered, so in the meanwhile, it's essential to take steps to protect your hearing and avoid future damage. During a hearing consultation, a specialist will assess your hearing to determine the best course of action, which may include a hearing aid.
What Is The Most Recent Treatment For Hearing loss?
Advanced cochlear implants are among the most popular treatment options for hearing loss.
What Is The Most Effective Way To Prevent Hearing Loss?
You can reduce your risk of hearing loss by protecting your ear from loud noises.