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Ear & Hearing

HOW WE HEAR

Ears are the organs that allow us to experience sound. They also play an important role in balance. Ears are complex and divided into three different sections: the outer ear, the middle ear and the inner ear. All three are involved in hearing but only the inner ear is responsible for balance.

All three components work together to allow us to hear as we do. The sound first enters the ear at the pinna where it is funnelled down the ear canal. The ear canal has hairs and glands that produce wax called cerumen. Cerumen keeps the ear canal moist and lubricated. Sound travels through the ear canal where it meets the tympanic membrane or eardrum.

The vibrations at the eardrum set the bones of the middle ear into motion. The three bones are called the ossicles which include the malleus, incus and stapes. These three bones are the smallest bones in the human body. The third bone, the stapes, transmits the vibrations of the middle ear to the inner ear through the stapes footplate.

The inner ear has two functions; the first is hearing and the second is balance. It is a warren of tubes filled with fluid encased within the temporal bone of the skull. The bony tubes also contain a set of cell membrane lined tubes. The bony tubes are called the bony labyrinth filled with perilymph fluid, which the membranous labyrinth tubes are filed with endolymph. This is where the cells responsible for hearing are located (the hairy cells of Corti).

The bony labyrinth itself has three sections. 1) The cochlea is responsible for hearing, 2) the semicircular canals have function associated with balance, and 3) the vestibule which connects the two and contains two more balance and equilibrium related structures, the saccule and utricle. The final structures of the inner ear are the round window and the eighth cranial nerve (cranial nerve VIII) which is composed of the vestibular nerve (balance) and the cochlear (hearing) nerve.

 

Role of Central Auditory Pathway in hearing and speech perception

Central Auditory Pathway plays a very important role in hearing and listening. This system is a complex network of neural pathways in the brain that is responsible for sound localization, speech understanding in noisy listening situations, and other complex auditory functions, such as music perception. The central auditory pathways extend from the medulla to the cerebral cortex. They consist of a series of nuclei (groups of nerve cell bodies in the central nervous system similar to a peripheral ganglion) connected by fibre tracts made up of their axons (processes that convey signals away from the cell bodies). This complex chain of nerve cells helps to process and relay auditory information, encoded in the form of nerve impulses, directly to the highest cerebral levels in the cortex of the brain. To some extent different properties of the auditory stimulus are conveyed along distinct parallel pathways. This method of transmission, employed by other sensory systems, provides a means for the central nervous system to analyse different properties of the single auditory stimulus, with some information processed at low levels and other information at higher levels. At lower levels of the pathway, information as to pitch, loudness, and localization of sounds is processed, and appropriate responses, such as the contraction of the intra-aural muscles, turning of the eyes and head, or movements of the body as a whole, are initiated.

Damage or impairment to any one of the above four components that make up our hearing system can contribute to hearing impairment. Hearing loss can mislead our brain with a loss of audibility and distortion in the message that is trying to reach the brain. The ears and the brain work together in a sophisticated manner to process sound and allow us to hear as we do.

 

Different types of hearing loss

The type of hearing loss that you suffer from mostly depends on which part of the hearing system is affected.

 

Conductive hearing loss

Conductive hearing loss is the result of sounds not being able to get through to the inner ear. This is caused by problems in the outer (1) and middle ear (2).

The most common cause can be a build-up of wax in the ear canal, fluid in the middle ear, perforated eardrums, or damaged middle ear bones. The result of this type of hearing loss is that sounds become quieter, although not usually distorted. Conductive hearing losses can often be treated medically.

 

Sensorineural hearing loss

This type of hearing loss happens when the delicate sensory cells or nerve fibres in the inner ear (3) get damaged. This stops them from transmitting sound properly. The most common causes are the natural process of ageing or excessive exposure to noise.

This type of hearing loss not only changes our ability to hear quiet sounds, but it also reduces the quality of the sound that is being heard, making it especially difficult to understand speech. Once these hair cells are damaged, they will remain so permanently. Therefore sensorineural hearing loss cannot be cured – at least not at the present time.

 

Do you have hearing loss?

Hearing loss is a gradual thing. It can happen over a number of years and at first most people don’t notice that their hearing is getting worse.

 

Some tell-tale signs

Do you find it difficult to hear what the actors are saying when you’re at the cinema or theatre? Does it sound like they’re mumbling?

Is it difficult sometimes to hear what the person on the end of the telephone is saying?

Do you have to ask people to repeat themselves?

 

Hard to follow?

Is it hard to follow a conversation when you’re in a group of people and more than one person is talking?

When you’re in a loud pub or restaurant, is it hard to follow what the person you’re talking to is saying?

Do you often mishear what others say or think that somebody has said something different?

 

Missing out?

Have any of your friends or family suggested that you might not be hearing as well as you used to?

Have you started avoiding places where you can’t hear properly?

Do you struggle to hear people who are calling you from another room?

If you answered ‘yes’ to one or more of the above questions, you may benefit from a diagnostic ear and  hearing assessment and professional advice from our very experienced audiologist Mini Gupta. Please feel free to call us on 0402476713 if you want to have a quick chat about your ear and hearing.

 

Why hearing is important

Your hearing matters

Of all the five senses, our hearing is perhaps the most precious. Consider all the sounds that surround you every single day: a child laughing, a bird singing, a friend chatting, or a great song on the radio - it is this symphony of sounds that makes life richer.

Hearing empowers us and helps us lead our everyday lives without limitations. It enables us to socialize, work and communicate. It also helps us to stay connected to the outside world and it keeps us safe by warning us of potential danger.

If we lose it, we lose contact with the people we love and the world around us, as when your hearing declines—and it does for most people at some point—it can feel like much of your life is going downhill. The fact is, hearing loss doesn’t just affect you physically. It can impact your emotional and social health, too.

Left untreated, hearing loss is often related to:

  • Negative attitudes, anger and irritability
  • Stress, fatigue and tension
  • Depression
  • Loneliness
  • Desire to avoid social scenes
  • Unsafe situations due to decreased alertness
  • Lower job performance
  • Trouble remembering things or following directions
  • Cognitive decline.

 

Myths about Hearing loss and Hearing solutions

 I'll just have some minor surgery like my friend did, and then my hearing will be okay.

Many people know someone whose hearing improved after medical or surgical treatment. It's true that some types of hearing loss can be successfully treated. With adults, unfortunately, this only applies to 5-10% of cases.

 

I have one ear that's down a little, but the other one's okay.

Everything is relative. Nearly all patients who believe that they have one "good" ear actually have two "bad" ears. When one ear is slightly better than the other, we learn to favor that ear for the telephone, group conversations, and so forth. It can give the illusion that "the better ear" is normal when it isn't. Most types of hearing loss affect both ears fairly equally, and about 90% of patients are in need of hearing aids for both ears.

 

If I had a hearing loss, my family doctor would have told me.

 Since most people with hearing impairments hear well in a quiet environment like a doctor's office, it can be virtually impossible for your doctor to recognize the extent of your problem. Without special training, and an understanding of the nature of hearing loss, it may be difficult for your doctor to even realize that you have a hearing problem.

 

My hearing loss is normal for my age.

Isn't this a strange way to look at things? But, do you realize that well-meaning doctors tell this to their patients every day? It happens to be "normal" for overweight people to have high blood pressure. That doesn't mean they should not receive treatment for the problem.

 

Your hearing loss cannot be helped.

In the past, many people with hearing loss in one ear, with a high frequency hearing loss, or with nerve damage have all been told they cannot be helped. This might have been true many years ago, but with modern advances in technology, nearly 95% of people with a sensorineural hearing loss can be helped with hearing aids.

 

The consequences of hiding hearing loss are better than wearing hearing aids.

What price are you paying for vanity? Untreated hearing loss is far more noticeable than hearing aids. If you miss a punch line to a joke, or respond inappropriately in conversation, people may have concerns about your mental acuity, your attention span or your ability to communicate effectively. The personal consequences of vanity can be life altering. At a simplistic level, untreated hearing loss means giving up some of the pleasant sounds you used to enjoy. At a deeper level, vanity could severely reduce the quality of your life.

 

Only people with serious hearing loss need hearing aids.

The need for hearing amplification is dependent on your lifestyle, your need for refined hearing, and the degree of your hearing loss. If you are a lawyer, teacher or a group psychotherapist, where very refined hearing is necessary to discern the nuances of human communication, then even a mild hearing loss can be intolerable. If you live in a rural area by yourself and seldom socialize, then perhaps you are someone who is tolerant of even moderate hearing losses.

 

Hearing aids will make me look "older" and "handicapped."

Looking older is clearly more affected by almost all other factors besides hearing aids. It is not the hearing aids that make one look older, it is what one may believe they imply. If hearing aids help you function like a normal hearing person, for all intents and purposes, the stigma is removed. Hearing aid manufacturers are well aware that cosmetics is an issue to many people, and that's why today we have hearing aids that are very discreet. But more importantly, keep in mind that "an untreated hearing loss is more obvious than a hearing aid." Smiling and nodding your head when you don't understand what's being said, makes your condition more apparent than the largest hearing aid.

 

Hearing aids will make everything sound too loud.

Hearing aids are amplifiers. At one time, the way that hearing aids were designed, it was necessary to turn up the power in order to hear soft speech (or other soft sounds). Then, normal conversation indeed would have been too loud. With today's hearing aids, however, the circuit works automatically, only providing the amount of amplification needed based on the input level. In fact, many hearing aids today don't have a volume control.

 

The impact of hearing loss on relationships and social life

“Blindness cuts us off from things, but deafness cuts us off from people.”

— Helen Keller

You might think your hearing loss only affects you, but consider this: Is your hearing loss causing problems in your relationship?

Hearing loss does not occur in a vacuum. It affects not only the person with hearing loss, but all of those surrounding him. Studies show that untreated hearing loss can have detrimental effects on relationships. Among these:

  • Frustration
  • Resentment
  • Loneliness, i.e. the hearing partners feel that they are missing out on companionship
  • Curtailing of social activities, withdrawal from social interaction
  • Decrease in intimate talk, joking with family
  • Shared communication difficulties
  • Decrease in shared activities such as watching TV
  • Loss of companionship
  • Decrease in communication (words are kept to a minimum)

On the flip side, the studies show that interventions such as hearing aids can not only improve quality of life, but can improve relationship satisfaction, communication and social functioning. From having intimate conversations with their partners to watching TV together or socializing, people who get hearing aids find that they are once again able to enjoy life. And more importantly, they are able to enjoy life once again as a part of a couple.

It’s common for someone with even a mild hearing loss (a loss in the ability to hear a sound at 25 to 40 decibels) to strain to hear or understand what a friend, loved one, or co-worker is saying — especially in noisy environments. Straining to hear another person’s words uses precious brainpower that could be spent thinking of a reply — continuing the conversation — rather than trying to understand what is being said.

Communicating with friends and loved ones becomes an exhausting, frustrating experience, and some people would rather avoid these situations altogether. Often, those with hearing loss have to ask for repetition multiple times. This causes others to get frustrated or angry as well.

If you don’t feel that you’re hearing as well as you could, please contact us at All Ears Hearing and book an appointment for a consultation and hearing test. It’s important to get a hearing test regularly to ensure that your hearing is healthy, and that you aren’t missing out on the little moments that make life truly enjoyable.

 

Hearing loss and Depression

Depressed? Have your hearing checked-there could be a connection.

Hearing is an easy thing to take for granted. Occasionally we might miss a few words, but in general we move around effortlessly in everyday life, talking to one another, chatting over the phone or listening to the TV, without paying it a second thought.

However, things are not nearly as easy with a hearing loss. When hearing loss occurs, a simple thing like following a conversation in a restaurant or hearing the doorbell or telephone can become a real issue. This can lead to stress, fatigue and social isolation. And social isolation in turn leads to depression, especially in older adults. But it wasn’t until recently that researchers were able to show that it was more of a problem than previously thought. Hence it stands to reason that depression and hearing loss go hand-in-hand.

 

Don’t suffer in silence

If you think you could have a problem with your hearing, it’s a good idea to sit down and have an honest conversation with your family and friends. Let them know how you’re finding things and ask whether they’ve noticed any changes.

Support from trusted people can really help you as you start to think about what’s happening to your hearing and how it might affect you. If the people you chat to have hearing loss themselves, they can share their own experiences. And if they don’t, then it can still helpful to talk about what actions might be best for you. Sometimes it’s the simplest things that help the most.

 

Take an action

Though prevalent, it is possible to minimize the risk of depression related to hearing loss. First and foremost, if you suspect hearing loss, seek the care of a hearing healthcare professional as early as possible. Studies show that those who seek treatment for hearing loss early greatly reduce their risk of depression. After seeking treatment, a well-planned adjustment period is necessary for new hearing aids; a good audiological rehabilitation program will help you adjust to new sounds gradually.

 

SOUNDS FAMILIAR?

If it does sound familiar, you may benefit from a diagnostic ear and hearing assessment and professional advice from our very experienced audiologist Mini Gupta. Please feel free to call us on 0402476713 if you want to have a quick chat about your ear and hearing.