HEARING LOSS

doi:10.1016/S0025-7125(05)70092-4

Medical Clinics of North America

Volume 83, Issue 1, 1 January 1999, Pages 125-137

https://doi.org/10.1016/S0025-7125(05)70092-4 Get rights and content

In a broad sense, there are three types of hearing loss. The first, sensorineural, involves the inner ear or cochlea, the auditory nerve, or a central neural lesion. The second, conductive hearing loss, is caused by the inhibition of sound from gaining access to the inner ear. This inhibition can be caused by something as simple as an ear canal filled with cerumen, fluid in the middle ear, or something complicated such as ossicular chain fixation. The third type of hearing loss is a mixed loss, that is, a combination of sensorineural and conductive. This article outlines the causes for these types of hearing loss, how they relate to the pediatric and adult populations, and treatment options.

Section snippets

HEARING EVALUATION

Simple tests can be performed in the office by the physician to assess a patient's hearing status. A history of the hearing loss and familial tendency to such loss and a comprehensive physical examination, including gross evaluation of hearing with the use of a 256- and 512-Hz tuning fork, are mandatory. The two most useful tests are the Rinne and the Weber. In an ear with normal hearing, air conduction (sound waves traveling to the tympanic membrane) is always louder than bone conduction

OUTER EAR

All hearing loss related to the outer ear is by nature a conductive hearing loss.

MIDDLE EAR

The middle ear consists of the tympanic membrane, the ossicular chain, and the middle ear space. Just as in the outer ear, all hearing loss associated with middle ear diseases consists of conductive hearing loss.

INNER EAR

Disorders of the inner ear normally cause a sensorineural hearing loss. The cause may be associated with the cochlea, eighth cranial nerve, internal auditory canal, or brain.

CONCLUSION

There are many causes for both conductive hearing loss and sensorineural hearing loss. A complete history and physical examination should point to the problem. Whenever a hearing loss is suspected, an audiogram is essential. Anytime questions arise that concern the auditory or vestibular system, referral to an otolaryngologist is appropriate.

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Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population
2016, Brazilian Journal of Otorhinolaryngology
Citation Excerpt :
Various otological diseases can lead to tinnitus and different types of hearing loss. This is due to infection or stiffening of bones or spasms of one of the two tiny muscles attached to bones of the middle ear, which affects the sound transmission system in the ear.9,16,17 Furthermore, various nasopharyngeal factors are involved in Eustachian tube dysfunction, predisposing to middle ear infections.
Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity.
The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population.
A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT) specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ² test and binary logistic regression.
Tinnitus was observed in 29.3% (956) of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02–3.16) and inner (OR = 3.00, 95% CI = 1.65–5.45) inner ear diseases. It was noted that 96.9% (n = 927) of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%), presbycusis (16.6%) and otosclerosis (14.3%) are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM) subjects.
The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.
O zumbido é um distúrbio comum que ocorre com frequência em todos os estratos da população, constituindo um problema importante de saúde. O zumbido é frequentemente associado a diferentes formas de perda auditiva e sua gravidade é variada.
O presente estudo teve como objetivo identificar a associação entre zumbido e perda auditiva em várias doenças otológicas na população do Sul da Índia.
No total, 3.255 indivíduos encaminhados ao Hospital MAA ENT em Hyderabad de 2004 a 2014, com diversas doenças otológicas, foram incluídos neste estudo transversal. O diagnóstico das doenças foi confirmado pelo otorrinolaringologista por meio de exames médico e clínico detalhados. A análise estatística foi realizada com o teste do χ² e regressão logística binária.
Zumbido foi observado em 29,3% (956) do total de participantes do estudo, com maior prevalência em indivíduos com mais de 40 anos de idade. Houve um aumento significante do risco de zumbido em doenças da orelha média (OR = 1,79, IC 95% = 1,02-3,16) e interna (OR = 3,00, IC 95% = 1,65-5,45). Observamos que em 96,9% (n = 927) dos indivíduos com zumbido houve associação com perda auditiva.
O presente estudo pôde identificar os fatores etiológicos mais prevalentes que levam ao desenvolvimento de zumbido associado à perda auditiva em uma população do Sul da Índia. Otite média (60,9%), presbiacusia (16,6%) e otosclerose (14,3%) são doenças otológicas frequentemente associadas ao zumbido. Em indivíduos com otite média crônica supurativa (OMCS), o zumbido foi significantemente associado ao maior grau de perda auditiva.
Functional status of elderly people with hearing loss
2009, Archives of Gerontology and Geriatrics
Citation Excerpt :
These alterations have been termed presbycusis and, although there is no pathognomonic lesion, there are circumstances, such as previous illnesses, vascular alterations or exposure to noise that could favor the progression of sensorineural hearing loss (Davanipour et al., 2000). The onset and level of intensity of the age-related degenerative changes vary widely and large differences in auditory function are observed in older people (Frisina and Frisina, 1997; Weber and Klein, 1999; Marcincuk and Roland, 2002). Unfortunately, the prognosis for patients with presbycusis is progressive hearing loss.
The objective is to determine the prevalence of hearing loss in people over 65 years of age, to describe the functional status of people with hearing loss and to identify the need for hearing aid use. In a cross-sectional study, a random sample of 1387 people aged 65 years and over was selected. The primary study variables were: hearing level by audiometric assessment, self-perceived hearing loss, screening for hypoacusia using the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) and physical, cognitive and emotional functional status. Using the HHIE-S it was determined that 11.3% of the subjects had severe hearing handicap. According to the Ventry/Weinstein criteria 43.6% had hearing handicap. When asked about the use of hearing aids, 4.5% of the study subjects said they used them, although 41.9% had hearing loss of 35 dB or more in their better ear. The variables associated with the need for a hearing aid were age >75 years (odds ratio = OR = 3.2), ADL dependence (OR = 2.7), cognitive impairment (OR = 2.0), multiple health problems (OR = 1.8), male sex (OR = 1.6) and single/widowed (OR = 1.5). In conclusion, there is a high prevalence of hearing loss associated with other functional limitations. Of those people who would benefit from a hearing aid (more than a third of people over 65 years old), 89.3% do not own one. The screening of hearing loss needs to be improved.
Ringing in ears (tinnitus)
2006, Essential Family Medicine: Fundamentals and Cases With STUDENT CONSULT Online Access
Ringing in Ears (Tinnitus)
2006, Essential Family Medicine
Ringing in ears (tinnitus)
2006, Essential Family Medicine: Fundamentals and Case Studies, Third Edition
The incidence, management and consequence of tinnitus in older adults
2008, Reviews in Clinical Gerontology

View all citing articles on Scopus

: Address reprint requests to Peter C. Weber, MD, Department of Otolaryngology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425

^*: Department of Otolaryngology and Communicative Sciences, Medical University of South Carolina, Charleston, South Carolina

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HEARING LOSS

Section snippets

HEARING EVALUATION

OUTER EAR

MIDDLE EAR

INNER EAR

CONCLUSION

Otolaryngol Head Neck Surg

A comprehensive study of tumors of the glomus jugulare

Laryngoscope

Prognosis of perceptive hearing loss in children with respect to genesis and use of hearing aid

Acta Otolaryngol

Conservative treatment of patients with acoustic tumors

Neurosurgery

Intratemporal complications and sequelae of otitis media

Middle ear disease in children: Pathogenesis, diagnosis and management

Pediatr Clin North Am

Temporal bone fractures

Arch Otolaryngol Head Neck Surg

Acute and chronic infections of the temporal bone including otitis media with effusion

Atresia of the EAC

Exostoses of the external canal

Ann Otol Rhinol Laryngol

The acute deafness of definite multiple sclerosis: BAEP patterns

Electroencephalogr Clin Neurophysiol

Hearing loss