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Is Hearing Loss Reversible? (podcast)

Hearing loss can be improved with proper treatment

Dr. Thomas Alexander, otolaryngologist at Scripps Clinic, discusses hearing loss in San Diego Health podcast.

Thomas Alexander, MD, Otolaryngology, Scripps Clinic

Hearing loss can be improved with proper treatment

According to the Centers for Disease Control and Prevention, about 40 million adults in the US suffer from some type of hearing loss.


It’s natural to lose some of our high-frequency hearing as we age, and exposure to loud noises, physical blockages, and nerve or brain problems can contribute as well.


Having a hard time hearing conversations amid background noise is usually the first indicator that’s there’s a problem.

 

In this episode of San Diego Health, host Susan Taylor and Thomas Alexander, MD, a neurotologist and ear surgeon at Scripps Clinic Torrey Pines, discuss the causes of hearing loss, how to keep it from getting worse, and treatment options for once the damage is done. Dr. Alexander also outlines how hearing aids and cochlear implants work to restore hearing.

Listen to the episode on causes and treatments for hearing loss

Listen to the episode on causes and treatments for hearing loss

Podcast highlights

What causes hearing loss? (0:42)

There are several different things that can cause hearing loss. Sound has to get through your ear canal and then go deeper into the eardrum. The eardrum has to vibrate and then the attached hearing bones have to move and vibrate. That causes movement inside the hearing organ, called the cochlea. There are little cells that detect that and trigger a nerve impulse to the brain.


The most common type of hearing loss is where the cochlea that is taking the mechanical sound energy and turning to a nerve impulse has stopped working. That’s what most people who have hearing loss have.That’s the one that’s caused by noise exposure throughout life.


A less common cause is conductive hearing loss, where something is just physically blocking sound transmission from outside the head to inside the head. That’s one that usually we can repair by surgery or medicines.


Then you can have mixed hearing loss, where it’s a combination of both of those two types.


The least common is where there’s a problem with the nerve only, or with the brain itself, where the speech is not getting encoded properly or the brain can’t interpret speech. That would be called an auditory spectrum disorder, but those are extremely rare.

What kind of loud noises can cause hearing loss? (2:00)

Really, any loud sound can cause hearing loss. It’s a combination of how loud the sound is and how long you’re exposed to it.


A leaf blower is about 85 decibels, which is a measurement of loudness. You might be able to be exposed to that for two hours before you have damage. But a jackhammer might be more like 120 decibels and that can potentially cause instantaneous damage to your ears.

Can headphones or earbuds cause hearing loss? (2:40)

It’s important to try to keep it at a reasonable volume. If you have it even at a moderate volume, if you’re listening to it all day long, that can conceivably cause damage.

Do we naturally lose hearing as we age? (3:18)

All of us are slowly losing high frequency hearing throughout life from noise damage. It turns out that our ears are so sensitive and so delicate that our daily lives are too loud for them. The longer we live, the more noise we’re exposed to, the more high frequency hearing loss occurs. Even young people can start to notice that.

Does hearing loss increases with age? (3:51)

Yes. One in five adults aged 20 to 29 will have a significant hearing loss. One in four from age 50 to 59. By the time you get to age 80, it’s nine out of 10.

Who is more at risk, men or women? (4:05)

Generally men are more at risk.

What are early signs of hearing loss? (4:09)

What most people notice first is they hear fine if they’re in a quiet environment or one on one, but if there’s any background noise, they have a lot harder time understanding what people are saying and have to start asking people to repeat themselves.


The reason for that is we all are slowly losing our high frequency hearing throughout life because of noise damage. It’s the high frequency sounds that are most important for the brain to filter out background noise for us. The brain actively suppresses surrounding sound to allow us to understand speech that is coming from in front of us. We start to lose that ability first.

What are social side effects of significant hearing loss? (4:48)

Significant hearing loss can lead to social isolation and that can lead to depression. There has been an association discovered with significant hearing loss in the risk of progressing to dementia.

What can one do to reduce the risk of significant hearing loss? (5:09)

One of the ways to keep hearing loss from getting worse is to protect yourself from loud noise exposure. To get a handle on it, the first thing to do is to get a hearing test with an audiologist so they can figure out exactly what type of hearing loss it is and exactly how severe it is.


For most people it’ll turn out to be a sensorineural hearing loss, and the treatment option to start with is typically hearing aids.


A hearing aid has a small piece that goes over the ear with the battery and the processor, and it’s got a little tube that goes down into the ear canal where the speaker is.

What is a cochlear implant? (5:57)

A cochlear implant has a device that can restore hearing for someone whose hearing loss is so severe that they can no longer get sufficient benefit from hearing aids. It’s a surgically implanted device that can provide sound by electrically stimulating the hearing nerve. It can take someone who’s functionally deaf and allow them to understand speech again.

 

The device is a tiny little coiled electrode that gets fed into the hearing organ, the cochlea, and then it can activate the hearing nerve. On the outside, the patient wears something that looks like a hearing aid. It’s got a microphone, computer and batteries and a magnet that lines it up with the part that’s on the inside.

What is a cochlear implant procedure? (7:02)

It’s an outpatient surgery done in an operating room. The patient would be asleep with a general anesthetic. It takes about an hour and a half or so to put the device in and then they would wake up and go home the same day. Then they’d wait about a month for things to heal up and then they’d have the device turned on and start learning to hear with it.

Can ear plugs help lower the risk of hearing loss? (7:32)

Earplugs are the main thing. It’s possible that noise-canceling headphones might be helpful. It’s really just a matter of trying to limit the volume of noise you’re exposed to and especially avoiding long duration of loud volume.

 

At concerts, definitely wear earplugs. What earplug is right depends on how loud it is. But for most concerts, the foam insert earplugs that you can get in any drugstore work well. You can have what are called musicians earplugs, which are created to maintain the fidelity of the frequencies of music, but reduce it to a level that’s not damaging to your ear.

What is acceptable noise? (8:29)

It’s hard to give a definite number for that because everybody’s TV and earbuds are going to put out a different amount of volume, but it should definitely just be at a comfortable level.


Normal conversation is about 60 decals of sound. A lawnmower is about 85 decimals of sound. We know that sound at or above 70 decibels for extended periods of time can cause damage to the ears.


I would just want people to know that if they notice that they’re having increasing difficulty understanding speech, that would be a good time to come in and get a hearing test to find out exactly what’s going on with their ears.

What does a hearing test involve? (9:16)

It involves measuring the quietest sound that can be heard at every different frequency. It involves a test that’ll figure out whether hearing loss is sensorineural or conductive. Then they’ll test the movement of the eardrum and the pressure behind the eardrum to try to figure out exactly what might be causing the hearing loss.

Lightly edited for clarity

Watch the video on what causes hearing loss?

Watch the San Diego Health video with host Susan Taylor and Dr. Alexander discussing the causes and treatments for hearing loss.