Common Hearing and Ear Problems

Hearing and Ear Care Importance of a Healthy Lifestyle

As we age, our hearing can suffer through normal use or excessive noise in the workplace or at home. Because it happens gradually, often we’re not aware of how bad it might be. If you’re experiencing any of these problems you may have suffered some hearing loss:

• Do you complain people are mumbling?
• Do others tell you they have to repeat things before you hear them?
• Is it difficult to hear close conversations in noisy places like restaurants or pubs?
• Do you hear better with one person than a group?
• Is your television or music higher than others think necessary?
• Do you find conversations tiring because you need to concentrate?
• Do you struggle to hear telephone conversations?

Suffering with just one of these issues can mean some loss of hearing. For more information visit Royal National Institute for Deaf (RNID) www.rnid.org.uk

You can download their range of free, expert factsheets covering a range of topics, including Hearing aids, Tinnitus, Ear Health, Equipment and Benefits.

You can also take a short hearing test on the website, that may help you identify hearing loss. You can contact the Information line and speak to an advisor.

In 2035 it is expected that 14.2 million adults with hearing loss greater than 25dBHl across the UK.

Hearing impairment has many causes but the most common are due to the effects of impaired circulation of the blood (vascular) or exposure to noise.

The most common cause of all is simply getting older. Less common causes are infections, ototoxic drugs which are damaging to the auditory system and disorders resulting from an unhealthy lifestyle.

There is a significant link between hearing loss and diabetes, with diabetics being more than twice as likely to experience hearing loss as non-diabetics. It is believed this is caused by damage to the nerves and blood vessels of the inner ear. If you have diabetes, you should have your hearing screened regularly. There are over 18 million adults in the UK who suffer some form of hearing loss.

Your ears and your hearing

Our hearing mechanism, more properly called the auditory system, is an amazing structure and unbelievably complex. The auditory system has three main parts: the outer, middle and inner ears. The outer ear collects sound and directs it to the middle ear via the eardrum. The middle ear converts sound into mechanical vibrations for transmission to the tiny but amazing structure of the inner ear.

The inner ear converts the middle ear sound vibrations into incredibly complex nerve impulse patterns which travel, via the auditory nerve, to the hearing centres of the brain. Ultimately, it is our brain which hears all the sounds of the world around us, including the most important and complicated of all the human voice.

Accumulation of ear wax or skin infection in one of both ear canals

For many people, either a gradual or a sudden loss of hearing may be caused by something as easily treatable as a build-up of ear wax or an outer ear infection. If you visit your doctor, they will check for these problems straight away and begin an appropriate course of treatment. It is always important to see your doctor if you experience a rapid loss of hearing or have earache.

A build-up of fluid in the middle ear can lead to ear infections. This problem is a lot more common in children - in fact, three out of four children will have suffered an ear infection by the age of three. Symptoms of an ear infection include difficulty hearing, a red or swollen ear, pain in the ear, and the appearance of a bulging eardrum. Fluid build-up in the ear often occurs alongside a cold or fever.

Tinnitus

Over 7.6 million adults in the UK are living with Tinnitus.

A condition called tinnitus is surprisingly common. People with tinnitus usually report ringing, buzzing, humming or whistling sounds in one or both ears. Tinnitus is at the very least annoying but, for some sufferers, it is very distressing.

Tinnitus is not a disease and is rarely a sign of a serious, earrelated condition. However, if tinnitus persists for any length of time, you should consult your doctor. Tinnitus can affect people of any age and statistics show that about one in ten adults in the UK have mild tinnitus and up to 1% have tinnitus that affects their quality of life.

Hearing problems after a head injury

Hearing problems are quite common after a head or brain injury because the inner ear is directly connected to the central nervous system. People often experience hearing tinnitus or hearing loss after a head injury, but problems such as hyperacusis (normal situations seem loud); difficulty filtering one set of sounds from background noise; and auditory agnosia (pure word deafness, i.e. being unable to recognise the meaning of certain sounds) can also occur.

In most cases, these hearing problems will usually disappear with several days or weeks of an injury, although they can last indefinitely. It is usually recommended that anyone experiencing a traumatic head injury be evaluated by an audiologist, even if their hearing appears to be fine.

Working in noisy environments

Working in a noisy environment can cause permanent hearing damage. This can be gradual hearing loss or damage caused by a sudden, extremely loud noise. This damage can affect your ability to understand speech, keep up with conversations or use the phone. It is also common for people who work in noisy environments to development tinnitus.

To protect you from the risks of working in a noisy environment, the Control of Noise at Work Regulations 2005 requires employers to take action to reduce the noise exposure and to provide you with personal hearing protection. They must also ensure that the legal limits on noise exposure are not exceeded, maintain and ensure the use of equipment to control noise risks, monitor your hearing ability, and provide you with information, instruction and training to ensure you know what steps you can take to protect your hearing in the workplace.

You can find out more about safeguarding your hearing in noisy work environments, through the Health and Safety Executive (www.hse.gov.uk).

Hearing problems in babies and children

All newborns are given a hearing test before they leave hospital or in the first few weeks at home - either by your GP, midwife or health visitor - under the Newborn Hearing Screening Programme.

A small number of babies are born with a hearing loss and the screening test allows for potential problems to be identified as early as possible. This can be very important for their later development as well as giving you access to the support and information you need should there prove to be a problem.

The screening test cannot harm your baby in any way - it is very quick and usually carried out while your child is asleep. A trained hearing screener or your health visitor will place a soft tipped earpiece in the outer part of your baby's ear, which sends clicking sounds down the ear. When an ear receives a sound, the inner part - known as the cochlea - usually produces an echo. Using a computer, the screener can see how your baby's ears respond to the sound; this is call the Otoacoustic Emissions test (OAE) - it only takes a few minutes to complete and you can stay with your baby while it is done. You will be given the results of the hearing test straight away.

If the test shows a strong response in both ears that it is very unlikely that your baby has any form of hearing loss. After the test, you may still be given a checklist of sounds that your baby should react to, both immediately and as they develop.

If the screening test doesn't show a strong response in one or both of your baby's ears, you should not panic as there may be a number of reasons for this result. Often, if a baby is unsettled at the time of the test, they may show a weak response. It is also quite common for babies to have some fluid in their ears following the birth, which may have caused a temporary blockage. Other background noises may also affect the test results. At this stage, you will be asked to bring your baby back for further tests and will be given a leaflet explaining what these will involve.

If you have concerns about your baby or child's hearing as they grow older, you should mention them to your doctor or health visitor who will arrange a referral to your hospital audiology department. You can ask for your child's hearing to be tested at any age.

Glue ear

The most common cause of hearing loss in young children is called 'glue ear'. This is usually caused by poor ventilation and drainage of the middle ear(s), usually due to enlarged adenoids at the back of the nasal cavity. If your child appears to not be hearing normally, you should always consult your doctor.

Resolving Hearing Problems

Hearing assessments

If you suspect that you have a hearing loss or find it hard to hear a conversation, particularly in a noisy environment, you should not ignore this. You have two options: either you should contact your doctor or arrange for a hearing test at a private hearing care centre. Most private centres provide a free-of-charge and thorough hearing assessment by a professionally qualified person with very little waiting for an appointment which is usually timed for your convenience.

Alternatively, your doctor can give advice on hearing tests and arrange the test itself but usually this means being referred to your nearest hospital Audiology Department. A hospital appointment for hearing tests can take some time to arrange as you may be put on a waiting list before being offered an appointment.

The most important advice which would be given to you by any hearing care professional is that you should never delay in having your hearing professionally assessed if you are experiencing any hearing difficulties.

Your hearing is just as important as your eyesight. At any age, good hearing and good eyesight are important to the quality of your life and general wellbeing.

Rehabilitation to better hearing and a more enjoyable life

Once a hearing impairment has been identified, you will be offered a full assessment of your needs by an audiology professional who will explain which hearing aid systems would be most suitable for you. You will then be offered a separate appointment for the fitting of your hearing aid system. It is at the fitting appointment that personalised and important advice is given about the gradual period of adjustment to a more enjoyable life with hearing aids. This is called auditory or aural rehabilitation and is a very important stage requiring the advice and support of your hearing care professional.

One of the differences between the NHS and private hearing aid services is the amount of time it is possible to devote to advising and assisting you. With private hearing aid services, you will generally be provided with more time at your appointments and with a greater range of aftercare services. It is not always possible for a NHS hospital audiology department to provide their services, although they certainly do their best to provide a high standard of care. With private hearing aid services, you receive aftercare services whenever needed.