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September 2011 Otologic, Head & Neck Newsletter >>
Hearing Loss: Steps & Options
Hearing loss is a condition that affects approximately 31 million Americans and 278 million people worldwide.
There are three types of hearing loss:
What are the common causes of hearing loss?
Other important factors that may contribute to hearing loss:
What do to when you hear the words, “Hearing Loss”?
Identify the following:
Factors that should increase the physician’s concern are unilateral loss, sudden loss or complete loss.
Symptoms that can be associated with hearing loss include otorrhea, otalgia, tinnitus, vertigo, facial palsy or fullness. A relevant history can also include ototoxic medication exposure, otitis, otologic surgery, family history, trauma or meningitis.
In addition to a thorough clinical history, work-up includes a physical examination and testing which can include the following:
Details of a tuning fork examination:
*Starting with 256 hz tuning fork
Additional testing to consider:
Treatment of conductive hearing loss
As a first measure, utilize medical therapy with ototopical and systemic antibiotics as indicated for the underlying pathology. Surgery may be needed for chronic otitis media, cholesteatoma tympanic membrane perforation or otosclerosis.
Treatment of sensorineural hearing loss
As a first measure, address treatable causes such as Meniere’s disease, acoustic neuroma or autoimmune related hearing loss. In general, sensorineural hearing loss can be rehabilitated with hearing aids or cochlear implants.
Who is a candidate for cochlear implantation?
When do we place a cochlear implant?
Cochlear implants can be placed as soon as hearing loss is confirmed, which can be as early as 12 months. Best outcomes occur with early implantation, shorter duration of deafness and with bilateral implantation.
A thorough otological exam and audiogram are the central components of the hearing loss work-up. If otoscopy is abnormal, treat underlying causes and consider referral if unresponsive. If normal otoscopy, unilateral losses warrant more in depth work-up and likely referral. Sudden hearing loss, however, requires a prompt work-up and referral if sensorineural in nature.
For more information on adult or pediatric hearing loss disorders and treatments, please click here.