Most causes of hearing loss in older people can be categorized into two main groups:
Conductive hearing loss involves abnormalities of the external or middle ear, such as earwax, ear infection, a ruptured eardrum, fluid in the middle ear, or tumor. Another possibility is otosclerosis . Here abnormal bone deposits occur on the bones of the middle ear. White women aged 15-45 may have a higher risk of developing this condition. Treatment involves wearing a hearing aid or having stapes surgery.
Sensorineural hearing loss involves abnormalities of the inner ear or the nerve pathways to the brain. Hearing loss related to aging, called presbycusis, is one of the most common causes of hearing loss in the US. It is characterized by high-frequency hearing loss (trouble hearing high-pitched sounds) that develops gradually in both ears. Other causes include exposure to loud noises, drug side effects, and health conditions, like cardiovascular disease.
Treatment of sensorineural hearing loss often consists of using some sort of device (a hearing aid) to amplify sound. In certain cases, a cochlear implant may be needed to restore hearing. If a tumor is compressing the nerve and causing the hearing loss, surgical removal of the tumor can sometimes improve the hearing.
A number of medical devices and treatments are available to help improve hearing. These include:
Hearing aids are small electronic devices that are worn in or behind your ear. They amplify sound as it enters your ears. There are two main types:
Assistive listening devices consist of a variety of devices that can be used as alternatives or supplements to hearing aids. An inexpensive option is to have the speaker talk into a microphone that is hooked up to the listener’s headphones. Other devices can connect the listener directly to the sound system in a TV, radio, stereo, or public place, such as a theater or church.
Cochlear implants are reserved for people with severe hearing loss. This device is a receiver about the size of a quarter that is surgically implanted just under the skin behind one ear. The receiver sends a sound signal to the brain. The person also wears a small external microphone behind one ear and a speech processor that fits in a pocket or on a belt.
It is essential to tell your friends, family, and colleagues that you have difficulty hearing so they can help you. Ask them to face you when speaking. Also, ask them to use these communication tips from the National Institute of Health:
Talk to your doctor to find out what you can do to prevent further hearing-related problems. For example, exposure to loud noise can worsen many types of hearing damage. Ask about limiting loud noise and wearing earplugs or protectors when noisy environments are unavoidable. Also inquire about safety precautions you can take in situations that involve auditory cues, such as driving or crossing streets. Getting the medical care you need can help you learn better ways to cope with your hearing loss.
American Academy of Audiology
American Speech-Language-Hearing Association
The Canadian Hearing Society
Carson-DeWitt R. Hearing loss. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated April 2007. Accessed June 28, 2012.
Hearing aids. National Institute on Deafness and Other Communication Disorders. Available at: http://www.nidcd.nih.gov/health/hearing/hearingaid.asp . Accessed January 20, 2004.
Hearing loss. National Institute on Aging. Available at: http://www.nia.nih.gov/health/publication/hearing-loss . Updated April 18, 2012. Accessed June 28, 2012.
Hearing loss and older adults. National Institute on Deafness and Other Communication Disorders. Available at: http://www.nidcd.nih.gov/health/hearing/older.asp . Accessed January 20, 2004.
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Leung J et al. Predictive models for cochlear implantation in elderly candidates. Arch Otolaryngol Head Neck Surg . 2005;131:1049-54.
Otosclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 4, 2012. Accessed June 28, 2012.
Otosclerosis. Massachusetts Eye and Ear Infirmary website. Available at: http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/otosclerosis/. Updated February 11, 2009 . Accessed June 28, 2012.
Presbycusis. National Institute on Deafness and Other Communication Disorders. Available at: http://www.nidcd.nih.gov/health/hearing/presbycusis.asp . Updated February 2002. Accessed June 28, 2012.
Stidham KR, Roberson JB Jr. Hearing improvement after middle fossa resection of vestibular schwannoma. Otol Neurotol . 2001 Nov;22(6):917-21.
Yueh B, Shapiro N, MacLean CH, Shekelle PG. Screening and management of adult hearing loss in primary care: Scientific review. Journal of the American Medical Association. 2003; 289: 1976-1990.
Last reviewed June 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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