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Health

When silence is not golden

Hearing loss is sometimes called 'the invisible disability'. David Hughes reports...

Eleven million people in the UK- eight million of them over the age of 60- suffer from hearing loss, ye because it's not obvious it often goes unnoticed.

But hearing impairment is linked to a greatly increased risk of trips and falls in older age, as well as increased incidence of illness (due to stress) and feelings of loneliness and isolation.

People with hearing loss are twice as likely to suffer depression, and up to five times as likely to develop dementia, according to Action on Hearing Loss. As Helen Keller said, "blindness cuts us off from people."

So what can be done to prevent hearing loss, and can it be cured?

In a nutshell, there are indeed steps we can take to protect our hearing; and some types of hearing loss can be corrected and improved.

Hearing loss sometimes gets better on its own, or can be treated with simple procedures- excessive earwax, for example, can be sucked out or softened with ear drops.

For more permanent cases of hearing loss, the use of hearing aids or implants can restore normal hearing levels and make a huge impact on quality of life.

There are two main types of hearing loss: sensorineural hearing loss- where the inner ear is affected- and conductive hearing loss, affecting the middle and outer ear, but where the inner ear is functioning normally. Of the two, sensorineural problems are harder to treat, and a hearing test will determine where the problem lies and the best way forward in terms of improvement. 

Reduced hearing is often regarded as an inevitable part of ageing. That's not the case- good hearing can be maintained into a very old age- but we're all different, and symptoms such as having difficulty hearing people clearly, particularly in noisy environments, having to turn the television up louder than before, or needing to ask people to repeat themselves, are all signs that a hearing test may be a good idea.

The earlier hearing loss is detected, the more options there are for improving it, so a regular hearing test- say once a year- is no bad thing as we get older.

There's evidence that cognitive decline can be halted through early detection of hearing loss, says Action on Hearing Loss.

Gradual or sudden hearing loss in one or both ears can be caused by a variety of things- a build up of fluid in the ear, for example (glue ear), a bony growth (otosclerosis), or a build up of skin cells (cholesteatoma). All can be successfully treated to remove the obstruction and restore hearing. Preventing hearing loss can be helped by avoiding exposure to very loud noises (or wearing ear defenders), and not having our television, radio or music turned up too loud. 


Hearing aids

Hearing aids amplify sounds, making them louder and clearer . It’s estimated that more than six million adults in the UK could benefit from using hearing aids, but only about two million actually use them. As we all know from current advertisements, hearing aids have come a long way from the bulkier , more obvious devices of the past, and are nowadays more discreet, and more effective. The main types are those that fit behind the ear; those that fit in the opening of the ear; and very small aids that fit further into the ear, making them only just visible. GPs can recommend specialists who will advise on the most suitable type, some of which – mainly the behind-the-ear type – are available on the NHS.

Implants

Some people, often those with severe, permanent hearing loss, find that hearing aids don’t help. In such cases, implants may be an option.

There are a variety of implants, fitted in an operation. A cochlear implant, for example, has a microphone behind the ear which picks up sounds and converts them into electrical signals that are sent to a part of the inner ear called the cochlear, from where they travel to the brain and are heard as sound.

There are also bone-anchored hearing aids; attached in a minor operation and which transmit sounds to the inner ear by vibrating the bone. Auditory brainstem implants work in a similar way to a cochlear implant, but transmit signals directly to the brain instead of via the cochlear. A middle ear implant may be an option if you’re allergic to materials used in hearing aids. It again helps sounds to travel to the inner ear and brain.

Assisive listening devices

Apart from hearing aids, there are other devices to help hearing. Personal hearing loops allow you to hear music or phone calls directly through your hearing aid; TV amplifiers assist in hearing television through hearing aids without having to turn up the volume.

Herbs

In the USA – and it’s a trend likely to be mirrored in the UK – 75 per cent of people with impaired hearing are said to investigate the use of natural approaches such as herbs to improve their hearing.

Hard evidence for the effectiveness of herbal treatments for hearing loss is thin on the ground, but traditionally and anecdotally, certain herbs are cited for usefulness in maintaining ear health.

They include echinacea, an immune system booster which may help fight viruses and reduce inflammation; ginger, which is said to regulate and activate nerves which assist sound transmission to the brain; turmeric, an anti-inflammatory spice rich in potassium; and ginkgo biloba, which promotes blood circulation.

A qualified medical herbalist would be able to give advice on these, and it would always be worth checking with your GP in case of conflict with any medications.

Drugs and hearing loss

Some medications may have an adverse effect on your hearing, according to research, so it’s worth asking your GP if prescription medications, especially if taken on a regular basis, may have the effect of ototoxicity, as it’s known.

According to the American Speech-Language-Hearing Association, there are more than 200 chemicals and medications that cause hearing loss and balance disorders, usually by damaging the delicate hair cells in the inner ear . Damage may be temporary or permanent, with the more serious outcome linked with prolonged use and accumulation in the body.

Types of drugs which may cause damage are:

Antibiotics: Most are OK, but a particularly powerful type known as aminoglycosiges, usually prescribed when other types haven’t worked, are considered to have hearing loss as a potential side effect, according to researchers at Oregon Hearing Research Centre at Oregon University

Chemotherapy: Research has discovered a strong link between platinum-based chemotherapy, such as cisplatin, and hearing loss. Researchers are currently working to find ways to overcome this

NSAID:. Prolonged use of nonsteroidal anti-inflammatory drugs can cause hearing loss, according to a study in the March 2010 issue of The American Journal of Medicine

Diuretics: Sometimes these drugs can cause temporary hearing loss or tinnitus, although the reasons are not understood.

This does not mean we should stop taking such medications, which are prescribed for very good reasons and may be of vital importance for serious health conditions. Each person reacts differently to medications anyway, and we may notice no adverse effect on hearing from any of these drugs. But it is worth discussing the issue with prescribing doctors beforehand, and work with them to monitor and minimise any side effects. 

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