Hearability Limited

Types of hearing problems

There are numerous reasons why people suffer hearing difficulties, the two most common are age related and exposure to loud noises either long or short term. Some however maybe hereditary or Iatrogenic - induced by other medical intervention such as a reaction to anti-biotics.

Here is a brief summary of causes. For more in depth information, you can click on the links to download some useful fact sheets.

Presbyacusis (Age - related hearing loss)

Presbyacusis (derived from two Greek words - presbus meaning ‘old man’ and acusis meaning ‘hearing’) describes the type of hearing loss due to the ageing process. This is caused by the gradual deterioration of the hair cells in the cochlea, the part of the ear that processes sound.

For most people with presbyacusis, it is the high-frequency sounds that become more difficult. This means that heard speech will become unclear and they may have trouble understanding what people are saying.

Who might suffer from it?

The main cause of this condition is natural ageing, but other factors can also influence it, such as:

• Genetic Influences
• Diet
• Environmental Noise. It has been noted that people who live in a noisy environment suffer from age-related hearing loss more than those who live in quieter surroundings.

Noise Damage

Exposure to excessive levels of noise can damage the tiny hair-like cells in the liquid-filled cochlea, or inner ear. Hearing loss from such exposure is always permanent. Individuals may vary in sensitivity to noise, and this determines the amount of damage they may sustain. The degree of damage is also dependent on the level of noise to which a person is exposed, and the length of time over which this exposure occurs.

The intensity of sound is measured in dB. The decibel scale is a little odd because the human ear is incredibly sensitive. Your ears can hear everything from your fingertip brushing lightly over your skin to a loud jet aircraft. In terms of power, the sound of the jet engine is 2 million times pressure difference than the smallest audible sound. That's a big difference!

Loudness Recruitment

Continuous, loud noise can be a source of irritation to most people. However, some people have especially sensitive hearing and are unable to tolerate ordinary levels of noise. This can occur in people with hearing loss and sometimes in peope with normal hearing. The level at which a sound becomes uncomfortably loud for a particular person is called their ‘loudness discomfort level’ or ‘uncomfortable loudness limit’ (ULL).

What is Loudness Recruitment?

Recruitment is a condition usually associated with hearing loss. The effect of loudness recruitment is to reduce the range of sound levels that someone with a hearing loss can use efficiently. If all the sound is amplified so that the quiet sounds can be heard, other sounds, which are already loud, like a door banging, or a lorry passing, will be made uncomfortably or painfully loud. This is also known as having a reduced dynamic range of hearing. This refers to the range of sound levels between a person's threshold for hearing sounds and their loudness discomfort level.

Hyperacusis

Hyperacusis is a rare condition where abnormal discomfort is felt by a normal level of sound. It is not the same as loudness recruitment because it usually occurs in people who do not have a hearing loss and the discomfort is not always related to how loud the sound is.

What causes Hyperacusis?

There are probably a number of different causes for hyperacusis, but it seems to be linked to problems in the way the brain processes information about hearing, rather than problems in the hearing mechanism in the ear. Like tinnitus or a headache it cannot be measured using objective tests. Hyperacusis can occur on its own or along with a range of other conditions, including depression, migraine, visual over-sensitivity or 'photophobia' and also chronic fatigue syndrome. Hyperacusis may first occur after sudden exposure to very high levels of sound, or following a head injury. This suggests that it may be possible to cause damage to the feedback system between the brain and the ear and that this may underlie the hyperacusis.

Most people with hyperacusis don't appear to have any hearing loss as measured and recorded on an audiogram. However, they may have difficulty hearing speech in noisy environments or in poor listening conditions, even when hearing tests show no hearing loss. This is sometimes called obscure auditory dysfunction or auditory processing difficulty.

Physical & Acoustic Trauma

Sudden hearing loss may occur through physical or acoustic trauma which could be as a result of a head injury or an explosion for example.

* If you suffer sudden hearing loss seek immediate medical assistance.

Iatrogenic

Hearing loss maybe induced by medical intervention e.g. Streptomycin - a reaction to anti-biotics or bad syringing for example.

Congenital / Hereditary

An inherited condition

Viral infection

Ménière's Disease

Ménière's disease is a disorder of the inner ear, which causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear and fluctuating hearing loss. The area of the ear affected is the entire labyrinth, which includes both the semicircular canals (organ of balance) and the cochlea, (organ of hearing).

A typical attack of Ménière's disease is preceded by fullness in one ear. Hearing fluctuation or changes in tinnitus may also precede an attack. A Ménière's episode generally involves severe vertigo (spinning visual/spatial hallucinations of movement), imbalance, nausea and vomiting. The average attack lasts two to four hours. Following a severe attack, most people find that they are exhausted and must sleep for several hours. There is a large amount of variability in the duration of symptoms. Some people experience brief episodes and others have constant unsteadiness. An unusual sensitivity to visual stimuli, such as flashing lights, is also common.

Tinnitus

Tinnitus is a condition where noises are heard in the ears or in the head. Most people will experience some buzzing or ringing in the ears, especially after exposure to loud noise. Although this is a temporary problem for most people, for more than four million people in the UK these noises can be severe and permanent.

What noises do people hear?

The way people perceive tinnitus varies enormously - from just one sound to a mixture of whistling, ringing, buzzing and rushing sounds. The condition is common among deaf and hard of hearing people but it also happens to a small number of hearing people.

Abnormality of the outer ear

Ossicular discontinuity

The interruption of the transmission of sound through the middle ear.

Otitus media

Inflammation in the middle ear area.

Otosclerosis

A disease that affects the small bones in the middle ear particularly the Stapies. Normally effects only one ear

Perforated Tympanic Membrane

Commonly known as a perforated ear.

Ear Wax

This is one of the most common reasons for a reduction in hearing which is likely to be a gradual build up. You will need to have this treated by a GP prior to a hearing examination.

To arrange a free hearing examination call our Care Centre on 01903 237732