Hearing loss is the third-most self-reported health problem of individuals 65 years of age or older, listed after arthritis and hypertension. It has been reported that there are at least 464,000 and perhaps as many as 738,000 severe to profoundly hard of hearing individuals among the 28 million hearing impaired Americans. Fifty four percent of this population is over age 65 years.
Severe to profound hearing loss prior to development of language (prelingual) occurs in 0.5 to 3 per 1,000 live births. The incidence of hearing loss among children between the ages of 3 to 10 years has been reported to be 1.1 cases per 1,000 children. Factors that increase the risk for hearing loss in children include a family history of hearing impairment, ototoxic drug exposure, congenital or central nervous system infections, congenital head and neck deformities, birth trauma, minority ethnicity, lower socioeconomic status, and prematurity .
Hearing loss can result from many etiologies. A simple way of classifying hearing loss is to divide it into conductive and sensorineural types.
Conductive hearing loss results when the sound waves have difficulty being transmitted from the environment outside the ear to the tiny hair cells in the inner ear where the sound waves are transmitted as nerve impulses. Obstruction of the ear canal from wax or infections, as seen in swimmer's ear, can result in a conductive hearing loss.
After the sound waves travel through the ear canal they cause the tympanic membrane (eardrum) to vibrate. These vibrations are transmitted through the three tiny ear bones of the middle ear space and cause movement in the fluid that resides in the inner ear. The middle ear contains air that is replenished through the eustachian tube each time that we swallow. An upper respiratory infection can cause the eustachian tube to malfunction resulting in fluid instead of air in the middle ear. This fluid dampens the effective transmission of sound through the ear bones resulting in a mild or even moderate hearing loss. A middle ear infection prevents sound transmission in the same fashion. Middle ear fluid is the most common cause of conductive hearing loss in children, occurring at least on one occasion in 70% of children. Other causes of conductive hearing loss include tympanic membrane perforations (holes of the ear drum), cholesteatomas (cysts of the middle ear) and otosclerosis (stiffening of one the middle ear bones). Most types of conductive hearing loss can be managed either with a hearing aid or surgically.
Sensorineural hearing loss or nerve hearing loss occurs when the organ of hearing in the inner ear and/or the hearing nerve are damaged and fail to transfer acoustic information from the environment to the brain. Inherited malformations of the inner ear can either cause hearing loss at birth or progressive hearing loss later in life. Some inherited causes of hearing loss are associated with other inherited abnormalities, such as eye problems, heart abnormalities, or abnormalities of other body systems, but the majority of people with inherited hearing loss have no other abnormalities.
A very common cause of sensorineural hearing loss is exposure to loud noises. This type of hearing loss results from long-term exposure to noise, such as in factories, shooting guns or listening to loud music. Earmuffs or earplugs can protect the individual from inner ear damage in most circumstances.
The aging process can also result in hearing loss. Part of the hearing loss seen in old age may be due to the long-term effects of noise exposure in our industrialized society. Some individuals have a genetic predisposition for a progressive hearing loss as they get older.
A number of other conditions, such as Meniere's disease, sudden sensorineural hearing loss, acoustic neuromas and head injuries can cause sensorineural hearing loss.
Most causes of sensorineural hearing loss can be managed with hearing aids. Those individuals with sever/ profound hearing loss in whom a hearing aid is not providing adequate help, may benefit from a cochlear implant.
Facts regarding the impact of hearing loss
Hearing impaired individuals are more likely to be publicly insured, less likely to have private insurance, have lower family incomes, are less educated, and are more likely to be unemployed than the general population.
Approximately 42% of people with severe to profound hearing loss between the ages 18 and 44 years are not working, compared to 18% of the general population.
Forty four percent of severe to profoundly hard of hearing individuals fail to graduate from high school as compared to 19% of normal-hearing people. Only 5% of the severe to profoundly hard of hearing individuals graduate from college versus 13% of normal-hearing people.
Severe to profound hearing loss has been estimated to cost society $297,000 over the lifetime of an individual. Most of these losses (67%) are due to reduced work productivity, although the use of special education resources among children contributes an additional 21%. Lifetime costs for those with prelingual onset of hearing loss exceed $1 million.
The educational cost of a severe to profoundly hard of hearing child from kindergarten through grade 12, is close to half a million dollars per child, which is 5 times the cost of educating a normal-hearing child.
Depression and sleep disturbance are more frequent among elderly pre-lingually deaf people using sign language than among hearing people .
For an appointment with Dr. Sismanis concerning
hearing loss
or hearing aids, call (804) 628-4368 or (804) 323-0830.
Additional Information on Hearing Issues on the Web Hearing
The National Institute on Deafness and Communication Disorders (NIDCD), NIH
Deafness Genes (Society for Neuroscience)
The Genetic Alliance
Hearing Disorders and Deafness (MEDLINEplus)
Hereditary Hearing Loss Homepage (Guy Van Camp, University of Antwerp, and Richard Smith, University of Iowa)
General Information on Hearing and Ears
Anatomy of the Ear (Cochlear Fluids Lab, Washington University)
Ear and Hearing Disorder Resources (Listen-up.org)
Hearing Information (American Academy of Otolaryngology-Head and Neck Surgery)
Inner Ear Anatomy (Vestibular Disorders Association)
Seeing, Hearing and Smelling the World (Howard Hughes Medical Institute)
Ears
The Ear and Hearing (Gallaudet University)
Ear Disorders (MEDLINEplus)
How the Ear Works (American Academy of Otolaryngology-Head and Neck Surgery)
Ear Problem Flowchart (American Academy of Family Physicians)
Earwax (American Academy of Otolaryngology-Head and Neck Surgery)
Hearing Tests and Screening
Early Hearing Screening (National Institute on Deafness and Other Comunication Disorders)
Early Hearing Detection and Intervention Program (Center for Disease Control)
Five Minute Hearing Test (American Academy of Otolaryngology-Head and Neck Surgery)
Hearing Evaluation in Children (Nemours Foundation at KidsHealth.org)
What is Early Detection? (American Academy of Otolaryngology-Head and Neck Surgery
Ten Ways to Recognize Hearing Loss (National Institute on Deafness and Other Comunication Disorders)
Hearing and Noise
About Hearing Loss (H.E.A.R.)
Are You At Risk? (H.E.A.R.)
Noise and Hearing Loss, Consensus Statement (National Institute on Deafness and Other Comunication Disorders)
Noise and Hearing Protection (American Academy of Otolaryngology-Head and Neck Surgery
Noise Induced Hearing Loss (National Institute on Deafness and Other Comunication Disorders)
Hearing Loss
Hearing: Consumer Guides (American Academy of Audiology)
Hearing Disorders and Deafness (MEDLINEplus)
Hearing Loss (University of Washington)
Hearing Loss and Deafness (Norman J. Harris, MD, otohns.net)
Hearing Loss Topics (American Speech-Language Hearing Association)
Hearing Problems Flowchart (American Academy of Family Physicians)
Sudden Deafness: Quick Facts (National Institute on Deafness and Other Comunication Disorders)
Deaf and Hard of Hearing Web Sites (Disabled People's Association of Singapore)
Clinical Trials Deafness (ClinicalTrials.gov from the National Library of Medicine)
Hearing Loss in Children
Basic Concepts of Hearing and Genetics (Boys Town)
Deafness and Hearing Loss: General Information (National Information Center for Children and Youth with Disabilities)
Hearing Problems in Children (American Academy of Family Physicians)
Your Child's Hearing Loss (American Academy of Otolaryngology-Head and Neck Surgery)
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