Are Some Causes of Hearing Loss Preventable? Treatable?
Conductive Hearing Loss
Wax, or cerumen impaction causing conductive hearing loss can be worsened with Q-tip use or attempts to clean the ear canal with bobby pins, etc. A careful cleaning under a microscope in a surgeon's office, along with medicated ear drops if there is an infection, can help improve the hearing loss.
Otitis externa or swimmer’s ear can be caused or worsened by excessive Q-tip use, freshwater exposure, or poorly controlled diabetes. Avoidance of self-cleaning with Q-tips or bobby pins, use of ear plugs, and strict glucose control in diabetics can be very helpful in preventing otitis externa.
Allergies, a cold or flu, sinusitis, or a history of middle ear infections as a child can predispose an adult to develop an otitis media. This can be treated with decongestants and a myringotomy and tube can be place if the fluid in the middle ear does not go away.
A recent descent in an airplane causing pain and fullness of the ears can be associated with conductive hearing loss from the persistent negative pressure of the middle ear.
Sensorineural Hearing Loss
Noise exposure is a common cause of hearing loss. Noise exposure can come from occupational hazards such as loud machines and military service, and recreational exposure such as loud music, hunting or shooting, or the use of power tools.
Prevention is Important to Avoid Injury to the Inner Ear from Loud Sounds
According to the National Institutes of Health (NIH), a personal stereo or MP3 player can be as loud as 105-110 decibels. A rock concert can be 110-120 decibels, and a firecracker is 150 decibels or more. Power tools in a woodshop or a snowmobile can be as loud as 100-105 decibels.
Regular exposure of longer than ONE MINUTE at 110 decibels risks permanent hearing loss.
At 100 decibels, longer than 15 minutes of unprotected exposure risks permanent hearing loss.
A family history of hearing loss is commonly seen in patients with sensorineural hearing loss.
Severe head trauma or skull fracture is a risk factor for sensorineural hearing loss.
Exposure to medications like certain intravenous antibiotics and chemotherapy for cancer can risk permanent sensorineural hearing loss.
Medical conditions like diabetes and heart disease are associated with a greater risk of hearing loss. Autoimmune conditions are also associated with hearing loss.
Treatment options will depend on the condition that causes the hearing loss.
A cerumen impaction should be carefully removed in the office using a surgical microscope.
An otitis externa or swimmers ears is treated with antibiotic ear drops ALONE in an otherwise healthy person.
More stubborn infections require a careful cleaning of the ear in a otolaryngologist’s office and possibly oral antibiotics.
Patients with poorly controlled diabetes MUST improve glucose control in otitis externa or they are at risk of developing a dangerous infection called malignant otitis externa.
Otitis media is treated with antibiotics, and the fluid in the middle ear that persists and causes conductive hearing loss can be managed with oral and nasal decongestant until the fluid disappears.
In cases where fluid from otitis media in the middle ear does not resolve, a simple, relatively painless and safe 3 minute procedure in the office can be performed.
This procedure is performed by an otolaryngologist who makes a small opening in the eardrum – called a myringotomy.
A tympanostomy tube can also be placed at the same time to provide adequate ventilation and to allow for evacuation of fluid that does NOT drain through the Eustachian tube.
Other types of conductive hearing loss such as cyst or middle ear tumor (cholesteatoma), or stiffening or damage to the hearing bones – ossicles – may require a surgical procedure.
Patients who present with SENSORINEURAL hearing loss have fewer options. If the sensorineural hearing loss is slowly progressive, over months and years, there are no treatment options, yet. This is permanent hearing loss and hearing aids may be beneficial if there is enough word understanding.
For patients who have little to no word understanding, and severe to profound hearing loss (deafness) in BOTH ears, a cochlear implant may be a reasonable option.
A cochlear implant is a bionic device, a miniature computer and electrode, that is placed surgically into the deaf inner ear when conventional hearing aids no longer benefit the patient.
A patient with a sudden, or fluctuating sensorineural hearing loss may be a candidate for steroids, given by mouth or injected into the middle ear.
For those patients with one deaf ear and one normal ear, a bone-anchored hearing aid (BAHA) or a CROS hearing aid may be helpful to bring sound from the bad ear to the better hearing ear.