Dr Leong Chooi Kien Annabelle
Hearing loss is broadly defined as any deficiency in hearing. This may be mild, moderate, severe, or profound, and may affect one or both ears. It can also affect anyone of any age.
The condition may be brushed off as part and parcel of ageing, but hearing loss is not as uncommon as we think. The World Health Organization (WHO) estimates that approximately 466 million people worldwide suffer from hearing loss that is severe enough to be disabling. Closer to home, it is estimated that 360,000, or 1 in 11 Singaporeans have hearing loss.
Among the various causes of hearing loss, the most worrying is noise-induced hearing loss (NHL). This may be caused by constant exposure to loud noises, with machinery in the workplace and loud music from your earphones among the chief culprits. The WHO estimates that globally, 1.1 billion young adults (between 12 – 35 years old) are at risk of developing NHL from the exposure to loud recreational noises such as rock concerts and music festivals, as well as long periods of listening to music played loudly through earphones.
Obviously, hearing loss will negatively impact a person's quality of life, especially when you can't hear your loved ones speak.
In children, the main concern is in their speech and language development and ability to communicate. There are also emotional and psychological implications such as, feelings of social isolation, frustration, shame and low self-esteem. It also has a significant economic impact due to loss of work productivity that stem from problems concentrating and communicating in the workplace.
There are numerous causes of hearing loss and these are broadly categorised as hearing loss that happens from birth (congenital) or as a result of external causes (acquired).
These occur at birth or acquired soon after birth due to factors affecting the baby during pregnancy or delivery. Examples include:
These refer to hearing loss that may occur at any age. Examples include:
The volume of noise is measured by the unit, decibels (dB). Humans are able to hear (hearing threshold) sounds at 0dB. Anything louder than 110dB causes discomfort (threshold of discomfort) and volumes at, or above, 130dB can cause acute hearing loss (threshold of pain).
To put things into perspective, a normal conversation takes place at about 60dB whilst traffic is approximately 80dB. Loud sounds, such as the music in a nightclub, may reach an excruciating 120dB. Sounds at, or below, 70dB are considered safe whilst sounds above 85dB may cause hearing loss over time and should lead to the introduction of a workplace hearing protection scheme to prevent occupation-related hearing loss.
There is rising concern for NHL with the increasing use of headphones or earphones. This includes children and young adults who are increasingly dependent on these gadgets for entertainment, study, and work purposes. Both sound intensity (music volume) and duration of exposure are Important factors contributing to NHL. Music heard through a headphone can go up to 94 – 100dB at its highest volume, while time-based exposure to loud noises increases one's risk of hearing loss.
Long-term damage to your ears can occur if exposed to 85dB over a few hours, 100dB over 14 minutes and 110dB over 2 minutes.
The key to addressing hearing loss, is catching it early and taking the necessary steps to manage the condition. Should any of these signs and symptoms be experienced, consider seeking a professional opinion from your doctor and having a hearing test done.
These are some signs to note:
Additionally, in young children, they may exhibit slower speech development or do poorly in school. Young children with undetected hearing loss may also go on to develop behavioural problems such as becoming more withdrawn. Conversely, they may 'act up' more often to seek attention. They may also stick their fingers into their ears or tug at them repeatedly.
Most hearing loss can be prevented by eliminating its cause, such as reducing exposure to loud noises, or proper management of chronic ear infections by an ENT (otorhinolaryngology) specialist, or avoiding certain types of medicines. The same applies to NHL.
There are many ways to diagnose and subsequently manage hearing loss. This Is where an ENT specialist will play an important role in managing the condition by first making an accurate diagnosis and prescribing a suitable treatment plan. These are some ways the specialist will approach the matter.
These determine what type and how much hearing loss is being experienced and are conducted by an audiologist or an ENT specialist. Examples of hearing tests include:
Depending on the cause, type and severity of hearing loss, there are different treatment options available. These include:
New technology, such as cochlear and hearing aid implants, as well as digital hearing aids with many functions such as Bluetooth capability, have all helped to improve the quality and range of sound heard and hence the overall quality of life of individuals with hearing loss.
If you suffer from any of the signs or are exposed to any of the causes of hearing loss, make an appointment with an ENT specialist so that it can be diagnosed and managed effectively.