||Do people seem to be mumbling more than they used to? Are your
friends complaining because it takes you forever to answer the phone?
Are you asking people to repeat themselves more frequently? Do you
find it easier to let your spouse do all the talking at parties because
all the noise runs together and prevents you from understanding conversations
If you answer yes to more than one of these questions, you may be one
of the approximately 20 million Americans who are considered to be hearing
impaired. Age-related hearing loss will ultimately happen to everyone,
it just affects some of us earlier than it does others. Ears have
a tendency to be like the family car. Sometimes they just don’t work,
they get damaged, or they simply wear out.
Statistics indicate that, for many people, the loss of hearing begins
at about age 55. In medical terminology, age-related hearing loss
is called presbycusis -- presby meaning elder and akousis
or hearing. Generally, this kind of hearing loss affects both ears;
it is permanent because there has been some degeneration of nerve cells;
it gradually worsens with age, and is more pronounced for high-pitched
If one or both of your parents had hearing difficulties relatively early
in life, the odds are pretty good that you will experience some hearing
impairment by the time your middle 50’s roll around. Medical science
now has evidence that Mom was right when she said to turn down the stereo;
there is a whole generation of people today who have hearing problems that
are traceable to teen years spent with the volume permanently set on “max.”
How the Equipment Works...
The human ear is an amazing mechanism, but not as efficient as those
belonging to some of our friends in the animal kingdom. Some foxes,
for example, have the ability to direct their outer ear to detect even
ants moving underground. That would be dandy if ants happen to be
a source of survival, but most humans would settle for hearing the news
on TV, or a grandchild’s laughter.
To refresh what most of us learned in junior high school health class,
the ear has three basic components: the outer ear, middle ear and
inner ear. The outer ear consists of the skin and cartilage that
hangs on both sides of your head and the ear canal, which extends about
an inch inside the head. This canal not only protects the delicate
inner parts of the ear, but actually amplifies the resonance of certain
pitches necessary for understanding speech.
The middle ear consists of the eardrum, the ossicles (tiny bones nicknamed
the hammer, anvil and stirrup), and the Eustachian tube. The eardrum
is highly sensitive to vibration which it passes along to the ossicles;
they, in turn, compress it; focusing all the vibration onto the tiny footplate
of the stirrup. Because sound is nothing more than a vibration in
the air, the body’s internal amplifier needs air provided by the Eustachian
tube. It has one open end in the middle ear and the other end in
the back of the throat, and provides a way to equalize pressure.
The inner ear consists of the snail-like cochlea, the semicircular canals
and the endings of the auditory nerve. The intensive vibration of
the stirrup on the oval window that connects the middle and inner ear creates
a wave in the fluid filling of the cochlea, setting in motion its tiny
hairlike projections, which then contact the nerve endings. The nerve
carries the signal to the brain for interpretation.
With all this delicate machinery, it is easy to see how something might
go wrong along the way. Sometimes it is as simple as an accumulation
of wax in the ear canal, which may only get packed deeper when you try
to clean it out. In other cases, a perforated eardrum can result
from an injury or an illness and cause temporary hearing loss. The
fragile inner ear is subject to infection by a variety of viruses including
mumps and measles and any illness accompanied by a very high fever.
In a conductive hearing loss, the outer or middle ear does not
conduct sound as well as it should, primarily causing a loss of sensitivity
for hearing soft sounds. When the problem is in the inner ear, stemming
from disease, injury or age (where the transmitter is operating but the
brain isn’t picking up the signal), this is misleadingly referred to as
“nerve deafness.” With this sensorineural hearing loss, there
is a reduced sensitivity to soft sounds as well as difficulty in clearly
distinguishing one sound from another.
There’s something wrong with
your hearing, not with you...
It is a real mystery why people hardly think twice about correcting
their eyesight with glasses, but find it difficult or impossible to admit
they don’t hear as well as they used to. Hearing loss is not a sign
of senility and it certainly doesn’t mean that your life is over.
Psychologists who have worked with hearing impaired patients do point
out, however, that there are often many vocational, social and emotional
aspects that require special attention. They need to be dealt with
not only by the person experiencing the loss, but by family and friends,
as well. There is a process very much like grieving that many hard-of-hearing
people go through; a process that may require understanding and quite often,
a great deal of patience.
Denial may be a natural initial reaction, but it is sometimes carried
to extremes. (“I can hear anything I want to hear, thank you.”)
Projection is the second emotional safety valve that allows all the blame
to be placed on someone else. (“Why do young people mumble all the
time?”) The next step is anger, usually misdirected, at the person
in closest proximity. (“Maybe I can’t hear so well, but I can still think
||Depression may come on the heels of anger, frequently made worse by
embarrassment, and may even result in self-imposed exile or a personality
change. There may be a very real reason for the depression; when
subtle background sounds -- like birds chirping or the wind in the trees
-- are no longer heard, there is often a profound sense of sadness.
The ability to hear helps warn of impending danger; so the loss of hearing
can also produce a sense of insecurity and vulnerability.
The final stage is acceptance, when the depression lifts and the person
is ready to get on with living again. This usually leads to contacting
a physician for a hearing examination, which may result in a recommendation
for a hearing aid. A hearing aid is not a cure-all. it will
never restore all of a person’s hearing ability. With a good emotional
adjustment and proper use, however, a hearing aid can often make it easier
Options and Choices...
If you suspect a hearing loss, you may want to schedule an appointment
with your family practitioner or an ear specialist (otolaryngologist or
otologist). After a basic examination, your physician may refer you
to an audiologist. This professional is trained in the non-medical
aspects of hearing impairment, and can help evaluate the extent of the
loss and provide screening, therapy, counseling and, if a hearing aid is
recommended, suggestions as to what type would best suit your needs.
There are four common treatments: medication, which may include
antibiotics in cases of infections causing conductive hearing loss; aural
habilitation, which involves training to help a person maximize their remaining
hearing ability; surgery to correct the outer ear, middle ear bones and
eardrum problems to relieve pressure; and hearing aids to help increase
and control sound sensitivity and expand the range of tones heard.
It may be an understatement to say that a hearing loss requires some
adjustments. There are likely to be some changes in your life; some
easier to cope with than others. Try to recognize your emotional triggers,
admit your problem to those around you, and seek professional assistance
at the first indication your hearing is failing.
It might be your hearing loss -- and it will affect others around you
-- but don’t allow it to harm your relationships with friends and family
or force you into isolation. There’s help available...all you have
to do is ask for it.