Introduction

Most of hearing loss in adult are acquired.

Definition

It is defined as inability of a person to hear in one or both ears.

There are three type of hearing loss :

• Conductive hearing loss – Hearing loss due to disease of external and / or middle ear.
• Sensorineural hearing loss – Hearing loss due to disease of the inner ear i.e cochlear and coclear nerve that bring the sound to the brain.
• Mixed hearing loss.

Sudden sensorineural hearing loss is one of emergency situation . It is defined as progressive hearing loss in one or both ears within three days. Urgent treatment should be sought.

Causes

Causes of conductive hearing loss :

• Infection of Ear canal (otitis externa).
• Blocked ear canal due to foreign body, impacted wax and growth or tumour.
• Tympanic membrane perforation either due to injury or infection of middle ear (otitis media).
• Fluid in the middle ear without tympanic membrane perforation with or without infection.
• Otosclerosis.
• Tumour in the ear.

Hearing loss and fullness sensation in one ear without ear pain may be a first symptom of Nasopharyngeal Cancer (Cancer back of the nose!/Nasopharynx).

Causes of sensorineural hearing loss :

• Presbyacusis, hearing loss due to aging
• Noise induced hearing loss
• Hearing loss due to medications
• Injury to the ear or head injury
• Meningitis; infection of layers or fluid surroundings the brain
• Diabetis mellitus

Signs & symptoms

• Hearing loss in one or both ears

Associated symptoms :

• Tinnitus or ringing sound in the ears
• Ear discharge; can be foul smelling
• Ear pain
• Bleeding from the ear
• Vertigo; sensation of imbalance and spinning
• Headache

Complications

People with hearing loss may experience some or all of the following problems :

• Difficulty hearing conversations, especially when there is background noise.
• Hissing, roaring, or ringing in the ears (tinnitus).
• Difficulty hearing the television or radio at a normal volume.
• Fatigue and irritation caused by the effort to hear.
• Dizziness or problems with balance.

Treatment

Treatment of conductive hearing loss is dictated by the diseases. It consist of :

• Medical treatment : antibiotic ear drop, proper ear cleansing by ENT Doctor (removed ear wax, ear discharge, foreign body)
• Surgery when indicated

Sensorineural hearing loss is irreversible. Thus, prevention is more important.

Cochlear Implant in selected cases.

Prevention

Prevention of ear infection will be based on the good ear care practices.

• Frequent ear pricking is not a good practice
• Protect water from entering the ear for those have ear infection or tympanic perforation
• Swimming in public swimming pool predisposed to ear infection
• Avoid swimming and diving for those have ear problem

Prevention of Sensorineural hearing loss

• Avoid exposure to loud noise such example using walkman with high volume, shooting, working in noisy machinery etc. Use appropriate ear protector deligently.

Rehabilitation

Provision of hearing Aid by trained Audiologist.

Speech Therapy is required in certain condition.