Hearing Loss

WHEN TO SEE YOUR DOCTOR

* Any hearing loss should be brought to the attention of your physician.

What Your Symptom Is Telling You

When it comes to predicting someone's age, you may be better off checking their hearing instead of counting their gray hairs. That's because by age 60, nearly everyone suffers from some hearing loss, and after age 70, they continue to lose hearing steadily.

But there's at least one factor that ensures hearing loss long before age-related problems set in. And that's continued exposure to loud noise.

"Noise damage is caused by both the intensity of the sound and the duration of the exposure," says Charles P. Kimmelman, M.D., professor of otolaryngology at Manhattan Eye, Ear and Throat Hospital." But because the effect of noise damage is cumulative, hearing loss from noise adds to the hearing loss you'll get from aging."

In fact, repeated exposure to high-decibel noise—like jet engines, gunshots or sternum-thumping rap music—actually deadens the sensitive nerve endings in your eardrums that help you hear, he says.

Not surprisingly, a ruptured eardrum can also cause temporary hearing loss, says Clough Shelton, M.D., an associate clinical professor of otolaryngology at the University of California, Los Angeles, and a member of the House Ear Institute at the University of Southern California. A number of things can rupture the eardrum, including severe ear infections and sports that cause pressure changes in the ear—scuba diving, parachuting and lifting heavy weights.

Certain diseases can also cause hearing loss. Among them are rheumatoid arthritis, syphilis, Menière's disease and otosclerosis. Menière's disease is a somewhat rare ailment that attacks the inner ear, causing dizziness and tinnitus (ringing in the ear). Otosclerosis, which affects mostly young adults and twice as many women as men, is a disease that causes the growth of calcium in the inner ear. People who have otosclerosis may feel as if one ear is plugged or they're listening to the world from inside a barrel.

Some particularly powerful prescription antibiotics, called aminoglycosides, may bring about hearing loss in some people.

Not all hearing loss is irreversible. In fact, in some cases, the cure is delightfully simple. Sometimes a sudden hearing loss in children is traced to something stuck in the ear. That something can be as simple as a wad of gum or paper.

Other hearing loss culprits include swimmer's ear, earwax buildup and otitis media—a common childhood inflammation of the middle ear, resulting in an accumulation of fluid behind the eardrum.

Symptom Relief

Because a wide range of health problems can cause hearing loss, it's a good idea to see your doctor for diagnosis and appropriate treatment. For example, a course of antibiotics may clear up an infection causing the problem. Here are a few other possibilities.

Get a test. If you have even the faintest suspicion that a child may be hard of hearing, make an appointment with a pediatrician. Early detection and correction can actually prevent learning disabilities in children, says David Marty, M.D., a Jefferson, Missouri, otolaryngologist and author of the The Ear Book. "Maybe a child's not doing well in school, or a child who's doing well in school starts bringing home failing grades—that's not necessarily the sign of a behavioral disorder," says Dr. Marty. It could simply mean that the child is not hearing what the teacher is saying, he explains. Treating the hearing loss may improve the child's academic performance as well.

Tune in to a hearing aid. When normal conversation is difficult to understand, it may be time to consider using a hearing aid, says Dr. Kimmelman. But the real question is how much you're willing to pay. "They come in all types, from compacts to limousines—generally from a few hundred dollars to about $2,000," he says. Even the least expensive hearing aid will do a fair job of amplifying sound. But by spending a little more you get better construction, higher fidelity and in some cases, the ability to remove background noise, says Dr. Kimmelman. By law, you don't need to see a doctor to buy a hearing aid, but it still may be a good idea. "The right way to do it is to see an ear specialist who can review the history of the problem and make sure that a proper diagnosis has been reached so that there are no serious medical problems underlying the complaint," say Dr. Kimmelman.

Get an electronic boost. If you're having a hard time hearing your television or radio, you might consider a set of earphones, says Dr. Kimmelman.

Consider surgery. If you have otosclerosis, an operation called a stapedectomy may be an option, says Dr. Marty. "The doctor will remove a small bone in the inner ear and generally replace it with a stainless steel wire prosthesis or some kind of plastic tube prosthesis that allows you to hear," he says.

Protect your ears. Wearing earplugs when you're working in the yard or participating in hobbies that create noise may seem inconvenient—but so is going deaf. Earplugs can be effective at protecting your ears if you frequently use a gas-powered leaf blower or a chainsaw or ride a snowmobile. These activities are all potentially damaging to your ears, says Jack Vernon, Ph.D., professor of otolaryngology and director of the Oregon Hearing Research Center at the Oregon Health Sciences Center in Portland.

But it might be best to avoid some activities—like loud concerts—altogether. The average rock concert generates 140 decibels of noise, nearly as much as a jet engine. "People who go to these events will regret it when they're older, because they're getting excessive exposure and damage already," says Dr. Kimmelman.

Get the wax out . . . carefully. Resist the urge to go after a plug of earwax with a cotton swab. You run the risk of puncturing an eardrum. (For tips on safe earwax removal, see Earwax Buildup on page 148.)