Deafness, therapies and misconceptions about hearing loss
It’s not talked about too much, but deafness or hearing loss is a widespread phenomenon. Many people are affected by the problem (even the great Beethoven, pictured), and no age group is exempt
The great strides that medicine has made in the treatment of this deficit are, unfortunately, still little known.
Thus, prejudices about deafness remain: among these is the idea that, apart from the use of hearing aids, there are no other means of reducing or curing it.
Hearing aids and surgery can restore good hearing in the majority of cases.
The three types of deafness
The mechanisms behind deafness are different and can originate from problems in different parts of the auditory system.
It can be a problem in the outer ear, the part of the ear that runs from the pinna and ear canal to the tympanic membrane, or a malfunction in the middle ear, where the chain of bones that transmits the sound wave to the inner ear is located, or in the inner ear, where the sound is “picked up” by the nerve tissue and sent to the cerebral cortex.
If the sound wave cannot reach the inner ear, deafness is of the transmissive type, and is what usually occurs as a result of a pathology involving the outer and middle ear. In this case it is almost always possible to intervene surgically.
Examples are the reconstruction of the perforated eardrum following chronic otitis or the reconstruction of the ossicular chain compromised by a developmental disease such as cholestetatoma (in simple terms “skin” that grows where it should not).
Sensorineural hearing loss, on the other hand, refers to deafness affecting the inner ear, the nerve and the auditory pathways.
Different causes of deafness
A certain degree of hearing loss affecting both ears in an older person is usually part of the normal ageing process.
In a young person, however, it may be caused by major acoustic trauma, as is the case, for example, with clubbers or those who work with pneumatic hammers or in particularly noisy environments.
This type of deficit initially manifests itself as a loss of hearing at a frequency of 4000 hertz.
If one avoids the noise source, deafness may not develop, but worsens the longer one is exposed.
In the case of damage caused by acoustic trauma, there is a certain subjectivity, the cause of which is not yet known.
Hearing loss affecting only one side may be due to the direct action of a virus that has an affinity for nerve tissue, as is common in children, or it may be the result of less specific infections that are also transmitted to the internal hearing organ, as is the case in some forms of meningitis.
In the case of deafness affecting only one part, it is imperative to carry out an in-depth diagnosis
This is done by means of radiological investigations in order to exclude neoformations of the auditory nerve (the most frequent being neurinoma).
Deafness can also be congenital; the result of a head injury caused by a road accident; secondary to the use of certain drugs, including chloroquine, used in malaria prophylaxis, certain chemotherapeutic drugs and some antibiotics (e.g. aminoglycosides), which at very high doses can induce ototoxicity.
Deafness, when to be alert
Every age group has its own hearing disorders.
In women, especially after pregnancy and breastfeeding, deafness due to otosclerosis can occur, and in this case the only way to resolve it is surgery.
In children, around the age of 4-5, due to the hyper-activity of the upper airways, seromucous otitis is frequent (the middle ear appears filled with secretion instead of air, thus blocking the correct movement of the eardrum-ossicular complex).
Neurinoma, a benign tumour of the auditory nerve, generally occurs from the age of 30 onwards.
In general, it can be said that any deafness, even more so if it only affects one ear, should always prompt the doctor to carry out thorough investigations.
All the possibilities of contemporary medicine in the treatment of deafness
In the treatment of deafness, which is widespread and generally underestimated, the combination of medicine and technology is making great strides. There are now many possibilities for people with hearing loss for a variety of reasons.
If the cause of the hearing loss is in the middle ear, surgery is usually possible.
For the inner ear, in the most common case of senescence, the use of an appliance is used, which unfortunately is still not well accepted, despite being an aid comparable to glasses.
There are very small ones that fit into the ear canal and are almost invisible.
In the case of the profoundly deaf, a cochlear implant can be used, which consists of a small electrode inserted into the cochlea (hearing organ) to stimulate the nerve.
However, this is only done when the external prosthesis is no longer sufficient.
In cases where there is a loss of hearing on one side only, there is a somewhat artificial stratagem that restores full hearing: the ear with reduced possibilities is connected to the healthy ear by means of a prosthesis, allowing the person to hear from the less receptive side.
Encouraging hearing care
People with poor hearing are not always aware of their hearing loss, especially if the problem is only in one ear and is mild.
This is especially true for those ages 5 to 10 years old who are less aware of their problems, but it can also happen in adults.
These deafnesses usually go unnoticed and may only be detected at a casual medical check-up.
The National Health Service covers practically all interventions involving the auditory system, including cochlear implantation, which is very expensive.
It is desirable for those who suffer from these disorders to abandon their preconceptions about the use of implants and the belief that little can be done to resolve them.
It should not be underestimated that some deafnesses can be warning signs of other diseases.
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112 SORDI: Italy’s Emergency Communication Portal For Deaf People