Age Associated Hearing Loss
Hearing loss is common in the elderly but usually comes on gradually. Deciding when hearing loss has become bad enough to take action is often difficult. Many patients find its their family that takes the decision to seek help when communication problems become too much.
Typical features of age associated hearing loss are
- Difficulties in group situations
- Problems understanding conversations when background noise is present.
- Difficulties on the phone
- Turning up the TV and radio louder than is comfortable for others in the room
- Inability to hear high pitched noises such as microwave 'pings', telephones ringing, doorbells etc.
In many cases 'wear and tear' is responsible. It is however worth getting a medical opinion on the cause as in some cases the problem is due to disease or infection. Management involves taking a history, examining the ears and sometimes the throat and nose, performing a hearing test (pure tone audiogram) and then coming to a diagnosis. For many people the best treatment is a hearing aid.
Sudden Hearing loss
There are several reasons why this can occur, but if no trauma is associated, it is worth getting an ENT opinion on the likely cause. All cases require a full history and examination, together with a hearing test. In most cases an MRI scan is ordered to visualise the inner ear and connecting cranial nerve leading to the brain. Blood tests may also be requested. If the MRI scan is normal it may be possible to offer surgical intervention to rescue a degree of hearing. The results of treatment are variable and worsen if not performed close to the time of the onset of hearing loss.
The cause of the hearing loss when a normal MRI scan is obtained, is thought to probably be a viral infection or blockage of one of the small blood vessels which supply the cochlea (hearing organ)
Wax is usually very helpful and protects the ear canal from infection but in some people the ears produce so much wax that it completely blocks the ear canal and can actually reduce hearing. In these cases removal with microscopically controlled suction will restore a patent ear canal and previous hearing thresholds.
Hearing loss after trauma
The patient's history together with otoscopy (looking in the ear with an otoscope) will usually give a diagnosis in this situation. A hearing test (pure tone audiogram) and pressure test (tympanogram) is essential. If the hearing is poor due to a tear of the tympanic membrane (eardrum), this will sometimes heal if the ear is kept dry. If the small bones (ossicles) behind the ear drum have been disrupted, surgery is required as soon as possible to put them back in alignment.
Delaying this can result in scar tissue and the bones may be difficult to relocate. For tympanic membrane perforations that fail to heal, an operation can be performed to seal the eardrum with a graft (tympanoplasty or myringoplasty). This tends to be successful in most cases.
If you would like to arrange a consultation with Mr Banerjee to look into this condition further please contact us.