Hearing loss

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Hearing loss , also known as hearing loss , is a partial or total inability to be heard. The hearing-impaired person has no hearing. Hearing loss can occur in one or both ears. In children, hearing problems can affect the ability to learn spoken language and in adults can cause work-related difficulties. In some people, especially the elderly, hearing loss can lead to loneliness. Hearing loss can be temporary or permanent.

Hearing loss can be caused by a number of factors, including: genetics, aging, noise exposure, some infections, birth complications, ear trauma, and certain drugs or toxins. Common conditions that cause hearing loss are chronic ear infections. Certain infections during pregnancy such as syphilis and rubella can also cause hearing loss in children. Hearing loss is diagnosed when hearing tests find that one can not hear 25 decibels in at least one ear. A poor hearing test is recommended for all newborns. Hearing loss can be categorized as mild, moderate, moderate-severe, severe, or profound. There are three main types of hearing loss, conductive hearing loss, sensorineural hearing loss, and mixed hearing loss.

Half of the hearing loss can be prevented. These include immunization, proper care around pregnancy, avoid loud noise, and avoid certain medications. The World Health Organization recommends that young people limit the use of personal audio players for up to an hour a day in an effort to limit noise exposure. Early identification and support is very important in children. For many hearing aids, sign language, cochlear implants and subtitles are useful. Reading lips is another useful skill that some people develop. Access to hearing aids, however, is limited in many areas of the world.

In 2013, hearing loss affects about 1.1 billion people to some extent. This causes disability at 5% (360 to 538 million) and moderate to severe defects in 124 million people. Of those with moderate to severe disabilities, 108 million live in low- and middle-income countries. Of those who experience hearing loss, it starts at 65 million in childhood. Those who use sign language and members of the Deaf culture see themselves as different from illnesses. Most members of the Deaf culture are opposed to efforts to heal deafness and some in this community see cochlear implants with concerns because they have the potential to eliminate their culture. The term hearing loss is often viewed as negative because it emphasizes what no one can do.

Video Hearing loss

Definitions

• Hearing loss exists when there is a reduced sensitivity to the sound that is usually heard. The term hearing or hearing loss is usually reserved for people who have a relative insensitivity to speak out in speech. The severity of hearing loss is categorized according to an increase in volume above the level normally required before the listener can detect it.
• Deaf is defined as the rate of loss so that one can not understand speech even in the presence of amplification. In deep deafness, even the loudest sound produced by an audiometer (an instrument used to measure hearing by producing pure sound over various frequencies) may not be detected. In total deafness, no sound at all, regardless of amplification or production method, is heard.
• Perception of speech - Another aspect of hearing involves the perceived clarity of a word rather than the amplitude of sound produced by the word. In humans, that aspect is usually measured by speech perception tests. These tests measure a person's ability to understand speech, not just detect sound. There is a very rare kind of hearing loss that affects speech perception alone.

The use of the term "deaf," "deaf-mute" or "deaf and dumb" to describe deaf and deaf people is not recommended by advocacy organizations because they offend many deaf and deaf people.

Hearing standards

Human hearing extends in frequency 20-20,000 Hz, and in amplitude from 0 dB to 130 dB or more. 0 dB does not represent the absence of sound, but the softest sound that the average undead of the human ear can hear; some people can hear up to -5 or even -10 dB. 130 dB represents the threshold of pain. But the ears do not hear all the frequencies well; Hearing sensitivity reaches about 3000 Hz. There are many qualities of human hearing in addition to the frequency range and amplitude that can not be easily quantified quantitatively. But for many practical purposes, normative hearing is defined by a graph of frequency versus amplitude, or an audiogram, that maps the sensitive hearing threshold at the specified frequency. Due to the cumulative impact of age and exposure to noise and other acoustic humiliation, 'typical' hearing may not be normative.

Maps Hearing loss

Signs and symptoms

• having trouble using the phone
• lose voice direction
• difficulty understanding speech, especially children and women whose sounds are of higher frequency.
• difficulty distinguishing speech with background sounds (cocktail party effect)
• sound or speech becomes dull, muffled or weakened
• the need for increased volume on television, radio, music, and other audio sources

Hearing loss is sensory, but may have accompanying symptoms:

• pain or ear pressure
• feeling blocked

There may also be secondary symptoms accompanying it:

• hyperacusis, increasing sensitivity to certain volume and frequency of sound, sometimes due to "recruitment"
• tinnitus, ringing, buzzing, hissing or other sounds in the ear when no external sound is present
• vertigo and disequilibrium
• tympanophonia, abnormal hearing from a person's voice and breathing sound, usually as a result of an obedient eustachian tube or an unhealthy superior semicircular canal
• facial movement disorder (indicating a possible tumor or stroke)

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Cause

Hearing loss has many causes, including aging, genetics, perinatal problems, and causes such as noise and illness. For some types of hearing loss, the cause can be classified as an unknown cause.

Age

There is a loss of progressive ability to hear high frequency with aging known as presbycusis. For men, this can start at age 25 and women at the age of 30 years. Although genetically variable, but along with aging and different from hearing loss caused by exposure to noise, toxins or disease agents. Common conditions that may increase the risk of hearing loss in the elderly are high blood pressure, diabetes or the use of certain drugs that are harmful to the ear. While everyone loses hearing with age, the number and type of hearing loss varies.

Noise

Exposure to noise is the cause of about half of all cases of hearing loss, causing some degree of problems in 5% of the population globally. The National Institute for Occupational Safety and Health (NIOSH) recognizes that most of the hearing loss is not due to age, but because of noise exposure. By correcting the age in assessing hearing, a person tends to exaggerate hearing loss due to noise for some people and underestimate it for others.

Hearing loss due to noise can be temporary, so-called 'temporary threshold shift', the sensitivity is reduced to be heard over a wide frequency range resulting from short but very loud sound expositions such as shooting, firecrackers, jet engines, jackhammer, etc. or are exposed to loud sounds for several hours such as pop concerts or nightclubs. Hearing recovery is usually within 24 hours, but can take up to a week. Both constant exposure to loud noises (85 dB (A) or above) and one very loud sound exposure (120 dB (A) or above) may cause permanent hearing loss.

Noise-induced hearing loss (NIHL) usually manifests as an increased hearing threshold (ie less sensitive or lethal) between 3000 and 6000 Hz, centered on 4000 Hz. As the noise damage progresses, the damage spreads to affect the lower and higher frequencies. In the audiogram, the resulting configuration has a special notch, called 'noise' notch. Because aging and other effects contribute to higher frequency losses (6-8 kHz in the audiogram), this position can be obscured and completely disappeared.

Various government, industry and standard organizations set noise standards.

The US Environmental Protection Agency has identified 70 dB (A) levels (40% harder to twice as louder than normal conversations, typical levels of TV, radio, stereo, city street noise) for 24 hours as the level required to protect people from loss hearing and other disturbing effects of noise, such as sleep disorders, stress-related problems, learning loss, etc. The noise level is usually in the range of 65 to 75Ã, dB (A) for those living near the highway airport and can cause hearing damage if enough time is spent outdoors.

A louder voice causes damage in less time. Estimated duration of "safe" exposure is possible using the 3 dB exchange rate. Since 3 dB represents the doubling of sound intensity, the duration of exposure should be cut in half to maintain the same energy dose. For workplace noise settings, the amount of "safe" daily exposure at 85 dB A, known as the exposure action value, is 8 h, while "safe" exposure at 91 dB (A) is only 2 h. Different standards use exposure action values ​​between 80dBA and 90dBA. Note that for some people, noise can damage at levels lower than 85 dB A. Exposure to other ototoxins (such as pesticides, some drugs including chemotherapy agents, solvents, etc.) may cause greater susceptibility to sound damage, as well as cause the damage itself. This is called a synergistic interaction . Because voice damage is cumulative over long periods of time, people exposed to outside workplace noise, such as recreational activities or environmental noise, may suffer multiple damage from all sources.

Some national and international organizations and institutions use 4 dB or 5 dB exchange rates. While this exchange rate may indicate a wider comfort or security zone, they can significantly underestimate the damage caused by loud noise. For example, at 100Ã, dB (nightclub music level), exchange rate 3Ã, dB will limit exposure to 15 minutes; 5 dB exchange rate allows one hour.

Many people are unaware of the existence of environmental noise at a destructive level, or the level of sound that becomes dangerous. Common sources of destructive noise levels include car stereos, children's toys, motor vehicles, crowds, lawn and maintenance equipment, power tools, use of firearms, musical instruments, and even hair dryers. Damage to noise is cumulative; all sources of damage should be considered to assess risk. If a person is hit by a loud sound (including music) at a high level or for long periods of time (85 dB A or larger), then hearing impairment will occur. The intensity of the sound (sound energy, or the tendency to cause damage to the ear) increases dramatically with proximity according to the inverse square law: reducing half the distance to sound by four times the intensity of the sound.

In the US, 12.5% ​​of children aged 6-19 years experience permanent hearing damage due to excessive sound exposure. The World Health Organization estimates that half of those aged between 12 to 35 years are at risk of using overly loud personal audio devices.

Loss of hearing due to noise has been described as primarily a condition of modern society. In preindustrial times, humans had less exposure to loud noises. Studies in primitive societies show that much of what is associated with age-related hearing loss may be the long-term cumulative damage of all sources, especially noise. People living in pre-industrial societies are much less likely to suffer from hearing loss than similar populations living in modern societies. Among the primitive people who have migrated to modern society, hearing loss is proportional to the number of years spent in modern society. The military service in World War II, the Korean War, and the Vietnam War, most likely also caused hearing loss to a large number of men of that generation, despite proving that hearing loss is a direct result of troubled military service without entry and exit of audiograms.

Hearing loss in teens may be caused by loud noises from toys, music by headphones, and concerts or events. In 2017, the Centers for Disease Control and Prevention bring their researchers together with experts from the World Health Organization and academia to examine the risk of hearing loss due to excessive noise exposure inside and outside the workplace across different age groups, as well as actions taken to reduce the burden condition. Summary reports are published in 2018.

Genetic

Hearing loss can be inherited. Approximately 75-80% of all cases are inherited by recessive genes, 20-25% are inherited by dominant genes, 1-2% are inherited by X-linked patterns, and less than 1% are inherited by mitochondrial inheritance.

Some drugs may affect hearing in a reversible way. These drugs are considered ototoxic. These include loop diuretics such as furosemide and bumetanide, non-steroidal (NSAID) over-the-counter (aspirin, ibuprofen, naproxen) and prescription drugs (celecoxib, diclofenac, etc.), paracetamol, quinine, and macrolide antibiotics. The association between NSAIDs and hearing loss tends to be greater in women, especially those who consume ibuprofen six or more times a week. Others can cause permanent hearing loss. The most important groups are aminoglycosides (major members of gentamicin) and platinum-based chemotherapy such as cisplatin and carboplatin.

On October 18, 2007, the US Food and Drug Administration (FDA) announced that a warning about possible sudden hearing loss would be added to the PDE5 inhibitor drug label, which is used for erectile dysfunction.

Audiological monitoring for ototoxicity allows for (1) early detection of changes in auditory status that may be associated with a drug/treatment regime so that changes in drug regimens may be considered, and (2) audiologic interventions when deaf disabled have occurred. [1]

Co-administration of anti-oxidants and ototoxic drugs can limit the extent of muscle damage

Chemicals

In addition to drugs, hearing loss can also occur due to certain chemicals in the environment: metals, such as lead; solvents, such as toluene (found in crude oil, gasoline and car exhaust, for example); and asphyxia. Combined with noise, these ototoxic chemicals have an additional effect on a person's hearing loss.

Hearing loss because chemicals start at a high frequency range and can not be changed. It destroys the cochlea with the lesion and lowers the central part of the auditory system. For some muscle-toxic chemistry exposures, especially styrene, the risk of hearing loss can be higher than just exposure to sound. The effect is greatest when combined exposures include impulse sounds.

• Solvent
  • toluene, styrene, xylene, n -hexane, ethyl benzene, white spirit/stoddard, carbon disulfide, jet fuel, perchlorethylene, trichlorethylene, p - xylene
• Asphyxia
  • carbon monoxide, hydrogen cyanide
• Heavy metals
  • lead, mercury, cadmium, arsenic, tin-hydrocarbon compounds (trimethyltin)
• Pesticides and herbicides - The evidence is weak on the relationship between herbicide and hearing loss; Hearing loss in such circumstances may be caused by insomnia exposure to insecticides.
  • paraquat, organophosphate

An information bulletin 2018 by the US Occupational Safety and Health Administration (OSHA) and the National Institute of Occupational Safety and Health (NIOSH) introduced the problem, providing samples of ototoxic chemicals, lists of industries and occupations at risk and providing prevention information.

Physical trauma

There is damage either to the ear itself or to the brain center processing the aural information conveyed by the ear. People suffering from head injuries are particularly vulnerable to hearing loss or tinnitus, temporarily or permanently.

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Pathophysiology

Sound moves to the brain: as follows: sound waves reach the outer ear and are carried under the ear canal to the eardrum. Sound waves cause the eardrum to vibrate. This vibration is passed through 3 small ear bones in the middle ear, which transfer vibrations to the fluid in the inner ear. The fluid moves the hair cells, and the movement of hair cells converts the vibrations into nerve impulses, which are then carried to the brain by the auditory nerve. The auditory nerve takes an impulse to the brain stem, which sends the impulse to the midbrain. Finally, the signal goes to the auditory cortex from the temporal lobe to be interpreted as sound.

Hearing loss is most often caused by long-term exposure to loud noise, from recreation or from work, which damages the hair cells, which do not grow back by themselves.

Older people may lose their hearing from prolonged exposure to sound, changes to the inner ear, changes in the middle ear, or from changes along the nerve from ear to brain.

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Diagnosis

Identification of hearing loss is usually done by a GP general practitioner, otolaryngologist, a certified, certified audiologist, or industrial audiometry, or other audiologist technician. Diagnosis of the cause of hearing loss is done by a specialist (audiovestibular doctor) or an otorhinolaryngologist.

Case history

A case history (usually a written form, with a questionnaire) can provide valuable information about the context of hearing loss, and indicate what type of diagnostic procedure will be used. The case history will include items such as:

• main concern
• birth and pregnancy information
• medical history
• development history
• family history
• workplace environment
• home environment

Checkout

• otoscopy, visual examination of the outer ear, ear canal, eardrum, and middle ear (through translucent eardrums) using optical instruments inserted into the ear canal called otoscope
• tympanometry
• differential testing - Weber, Rinne, Bing and Schwabach tests are simple manual tests of auditory functions performed with low frequency tuning forks (usually 512Ã, Hz) that can give a quick indication of the type of hearing loss: unilateral/bilateral, conductive, or more

Lab testing

In case of infection or inflammation, blood or other body fluids may be submitted for laboratory analysis.

Hearing test

Hearing loss is generally measured by playing the sound produced or recorded, and determining whether the person can hear it. Hearing sensitivity varies according to the frequency of sound. To account for this, auditory sensitivity can be measured for various frequencies and plotted on an audiogram.

Another method of measuring hearing loss is a sound-in-voice test. As the name implies, speech-in-noise tests give an indication of how well a person can understand speech in a noisy environment. A person with hearing loss is often less able to understand the conversation, especially in noisy conditions. This is especially true for people who experience sensorineural loss - which is the most common type of hearing loss. Thus, speech-in-noise tests can provide valuable information about a person's hearing ability, and can be used to detect the presence of sensorineural hearing loss. A recently developed digit-triple speech-in-noise test can be a more efficient screening test.

Otoacoustic emission test is an objective hearing test that can be given to toddlers and too young children to work together in conventional hearing tests. This test is also useful in older children and adults.

Auditory brainstem response testing is an electrophysiological test used to test the auditory deficit caused by pathology within the ear, the cochlear nerve and also within the brain stem. This test can be used to identify delays in nerve impulse conduction due to tumor or inflammation but can also be an objective test of the auditory threshold. Other electrophysiological tests, such as cortical raised responses, can see the auditory path down to the hearing cortex level.

Scan

MRI and CT scans can be useful for identifying the pathology of many causes of hearing loss. They are only needed in certain cases.

Classification

Hearing loss is categorized by type, severity, and configuration. In addition, hearing loss may be present only in one ear (unilateral) or in both ears (bilateral). Hearing loss can be temporary or permanent, sudden or progressive.

Severity

The severity of hearing loss is ranked according to the nominal threshold range where the sound should be so that it can be detected by the individual. This is measured in decibels of hearing loss, or dB HL. Measurement of hearing loss in individuals is done over several frequencies, mostly 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Individual hearing loss is the average of hearing loss values ​​over different frequencies. Hearing loss can be ranked differently according to different organizations; and so, in different countries, different systems are being used.

Hearing loss may be classified as mild, moderate, moderately, reasonably heavy, weight or weight as defined below:

• Less: between 16 and 25 dB HL
• Lightweight:
  • for adults: between 26 and 40 dB HL
  • for kids: between 20 and 40 dB HL
• Medium: between 41 and 54 dB HL
• Fairly enough: between 55 and 70 dB HL
• Weight: between 71 and 90 dB HL
• Deep: 91 dB HL or greater
• Really deaf: Not heard at all. This is called anacusis .

The 'Audiometric Classification of Hearing Impairment' according to the International Bureau of Audiophonology (BIAP) in Belgium is as follows:

• Normal or subnormal hearing: average tone loss below 20 dB HL
• Light hearing loss: average tone loss between 21 and 40 dB HL
• Loss of moderate hearing loss
  • First level: average tone loss between 41 and 55 dB HL
  • Second degree: average tone loss between 56 and 70 dB HL
• Lose hearing loss
  • First degree: average tone loss between 71 and 80 dB HL
  • Second degree: average tone loss between 81 and 90 dB HL
• Severe hearing loss
  • First degree: average tone loss between 91 and 100 dB HL
  • Second degree: average tone loss between 101 and 110 dB HL
  • Third degree: average tone loss between 111 and 119 dB HL
• Total hearing loss or Cophosis: average tone loss of more than 120 dB HL

Hearing loss may affect one or both ears. If both ears are affected, then one ear may be more affected than any other ear. It is possible, for example, to have normal hearing in one ear and not at all in the other ear, or have a mild hearing loss in one ear and hearing loss on the other.

For certain legal purposes such as insurance claims, hearing loss is described as a percentage. Given that hearing loss may vary by frequency and the audiogram was plotted on a logarithmic scale, the notion of percentage of hearing loss is somewhat arbitrary, but where decibels loss is converted through a legally recognized formula, it is possible to calculate the standard "hearing loss percentage", which suitable for legal purposes only.

Type

There are four main types of hearing loss, conductive hearing loss, sensorineural hearing loss, central deafness and a combination of conductive and sensorineural hearing loss called hearing loss mixtures. The additional problem that is increasingly known is the auditory process disorder that is not a hearing loss like that but the difficulty of understanding the sound.

• Conductive hearing loss

Conductive hearing loss occurs when the sound does not reach the inner ear, the cochlea. This can be caused by external ear canal malformations, ear drum dysfunction or damage to the middle ear bone. The eardrum can show defects from small to total resulting in hearing loss at different degrees. Scar tissue after ear infections can also make ear drum dysfunction and when pulled and attached to the middle of the medial ear.

Dysfunction of the three small bones of the middle ear - malleus, incus, and stapes - may cause conductive hearing loss. Ossicle mobility may be impaired due to various reasons and ossicular chain disorders resulting from trauma, infection or ankylosis may also cause hearing loss.

• sensorineural hearing loss

Sensoryineural hearing loss is one that is caused by inner ear dysfunction, the cochlea or nerve that transmits impulses from the cochlea to the hearing center in the brain. The most common reason for sensorineural hearing loss is damage to the hair cells in the cochlea. Depending on the definition it can be estimated that more than 50% of the population over the age of 70 suffers from hearing loss.

• Central deafness

Damage to the brain can cause central deafness. The peripheral ears and auditory nerve can function well but the central connections are damaged by tumors, trauma or other diseases and the patient can not hear.

• Mixed hearing loss

Mixed hearing loss is a combination of conductive and sensorineural hearing loss. Chronic ear infections (a fairly common diagnosis) can cause damage to the eardrum or damage to the middle ear ossicle, or both. In addition to conductive loss, the sensory component may be present.

• Central hearing processing impaired

This is not a true hearing loss but creates significant difficulties in hearing. One type of auditory process disorder is King-Kopetzky syndrome, which is characterized by an inability to process background noise in noisy environments despite normal performance on traditional hearing tests.

Configuration

The audiogram shape shows the relative configuration of hearing loss, such as notch carhart for otosclerosis, 'noise' notch for damage caused by sound, high frequency rolloff for presbycusis, or flat audiogram for conductive hearing loss. In conjunction with speech audiometry, it may indicate a central hearing process impairment, or the presence of schwannoma or other tumors. There are four general configurations of hearing loss:

1. Flat: the threshold is the same across all test frequencies.

2. Leaning: lower (better) threshold in low frequency area and higher (poorer) threshold in high frequency area.

3. Increased: higher (lower) thresholds in lower frequency areas and lower (lower) thresholds in areas with higher frequencies.

4. Trough-shaped ("cookie-bite" or "U" shaped): the largest hearing loss in the medium frequency range, with a lower threshold (better) in low and high frequency regions.

Unilateral and bilateral

People with unilateral or single-sided hearing disorders (SSDs) are having difficulty in:

• hear conversations on their disrupted side
• localization voice
• understand speech before background noise.

In quiet conditions, speech discrimination is more or less the same for normal hearing and those with unilateral deafness; However, in noisy environments, speech discrimination varies individually and ranges from mild to severe.

One of the reasons for the hearing problem that patients often experience is because of the shadow effect of the head. Newborns without hearing on one side but a normal ear can still have problems. Speech development can be delayed and difficulty concentrating in school is common. More children with unilateral hearing loss should repeat the class than their peers. Taking part in social activities can be a problem. Therefore, initial assistance is very important.

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Prevention

It is estimated that half of cases of hearing loss can be prevented. Approximately 60% of hearing loss in children under the age of 15 can be avoided. A number of effective prevention strategies include: immunization against rubella to prevent congenital rubella syndrome, immunization against H. influenza and S. pneumoniae to reduce meningitis cases, and avoid or protect against exposure excessive voice. The World Health Organization also recommends immunization against measles, mumps, and meningitis, preventing preterm delivery, and avoiding certain drugs for prevention.

Exposure to noise is the most significant risk factor for hearing loss caused by preventable noise. Different programs exist for specific populations such as school-aged children, youth and workers. Education on noise exposure enhances the use of hearing protectors. Use of antioxidants is being studied for the prevention of noise-induced hearing loss, especially for scenarios where noise exposure can not be reduced, as during military operations.

Workplace noise settings

Noise is widely recognized as a work hazard. In the United States, the National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) work together to provide standards and enforcement at the noise levels in the workplace. The hazard control hierarchy shows different levels of control to reduce or eliminate noise exposure and prevent hearing loss, including engineering controls and personal protective equipment (PPE). Programs and other initiatives have been made to prevent hearing loss at work. For example, the Safe-in-Sound Award was created to recognize organizations that can demonstrate successful noise control results and other interventions. In addition, the Buy Quiet program is designed to encourage entrepreneurs to purchase quieter machines and equipment. By purchasing less noisy power tools such as those found in the NIOSH Power Tools Database and limiting exposure to ototoxic chemicals, major steps can be taken to prevent hearing loss.

The company may also provide personalized hearing protection devices customized for workers and occupations. Some hearing protectors universally block all noise, and some allow certain sounds to be heard. Workers are more likely to wear hearing protectors when they are installed properly.

Often interventions to prevent hearing loss caused by sound have many components. The Cochrane 2017 review found that tighter legislation could reduce noise levels. Giving workers with information about their noise exposure levels is not proven to reduce noise exposure. Ear shields, if used correctly, can reduce noise to safer levels, but often, providing it is not enough to prevent hearing loss. Engineering noise and other solutions such as proper equipment maintenance can lead to noise reduction, but further field studies on exposure to noise generated after such intervention are required. Other possible solutions include improvements to existing law enforcement and better implementation of well-designed prevention programs, which have not yet been proven to be effective. The conclusion of the Cochrane Review is that further research may modify what is now about the effectiveness of evaluated interventions.

Screening

The United States Preventive Services Task Force recommends checks for all newborns.

The American Academy of Pediatrics suggests that children should undergo their hearing tests several times during their school years:

• When they enter school
• At age 6, 8, and 10
• At least once during high school
• At least once during high school

While the American College of Physicians shows that there is not enough evidence to determine the usefulness of screening in adults over 50 who have no symptoms, American Language, Speech Pathology and Hearing Association recommend that adults should be screened for at least every decade through the age of 50 and intervals 3 years later, to minimize the adverse effects of untreated conditions on quality of life. For the same reason, the Office of Prevention of Illness and Promotion of the Health of the United States is included as one of the aims of the Healthy Person 2020: to increase the proportion of people who have undergone hearing examination.

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Treatment

Treatment depends on the specific cause if known also the extent, type and configuration of the hearing loss. Most hearing loss, which results from age and noise, is progressive and irreversible, and no treatment is currently approved or recommended; management is with hearing aids. Certain types of hearing loss may receive surgical treatment. In other cases, treatment is directed to the underlying pathology, but any hearing loss that occurs may be permanent.

There are a number of devices that can improve hearing on those who are deaf or deaf or allow people with these conditions to better manage their lives.

Hearing aid

Hearing aids are devices that work to improve hearing and speech impairment of those with hearing loss. It works by enlarging the vibration of the sound in the ear so that one can understand what is being said around them. The use of this technological device may or may not affect a person's sosiability. Some people feel as though they can not live without one because they say it is the only thing that keeps them engaged with the public. Conversely, there are many people who choose not to use their hearing aids for many reasons. Much of this reason comes from poor help performance, where users see more background sound amplification than their intended voice, or from problems with the convenience, maintenance or maintenance of the device; financial factors have also been reported. A small percentage of people choose not to use hearing aids because of the aesthetic and/or stigmatizing problems surrounding using the device.

Tools

Many are deaf and hard of hearing people use the tools in their daily lives:

• Individuals can communicate over the phone using a phone typewriter (TTY). Other common names are textphone, minicom and telecoms for deaf (TDD) devices. This device looks like a typewriter or word processor and sends typed text over regular phone lines. It allows communication through visual messages. TTY can send messages to individuals who do not have a TTY by using the National Relay service which is an operator that acts as a courier for each caller. For mobile phones, software applications are available to provide TDD/textphone functionality on some operators/models to provide 2-way communication.
• There are several new telecommunication relay service technologies including IP Relay and written phone technology. People who are deaf or hard of hearing can communicate over the phone with people who hear through human translators. Telephone tagging is a service in which the person's hearing speech is stamped by a third party, enabling the deaf or hard-to-hear person to have a conversation with the person over the phone. Wireless, Internet and mobile phones/SMS text messages are starting to take over the role of TDD.
• Real-time text technology, which involves streaming text that continues to be sent as it is typed or composed. This allows the use of text conversations. A software program is now available that automatically generates closed captions from the conversation. Examples include discussion in conference rooms, teleconference calls, lecture classes, and/or religious services.
• Instant messaging software.
• Videophone and similar video technologies can be used for remote communication using sign language. Video conferencing technology allows signed conversations and allows language-sign language translators to voice and sign conversations between deaf or hearing-impaired people and those who hear them, negating the use of TTY devices or computer keyboards.
• The relay video and remote video translation service (VRI) service also uses third party telecommunications services to enable deaf or hearing-impaired people to communicate quickly and comfortably with the person hearing, through the sign language interpreter./li>
• Hearing dogs are special types of help dogs that are specifically selected and trained to help deaf and deaf people by telling their keepers about important sounds, such as doorbells, smoke alarms, ringing telephones, or alarm clocks.
• The emergence of the Internet World Wide Web and closed captions have provided access to information that is deaf and hard to hear. Electronic e-mail and online chat have reduced the need for deaf and hearing impaired people to use third party Telecommunication Relay Services to communicate with hearings and other deaf people.
• A person with a hearing loss can not always hear the phone or distinguish one from another. A signal transmitter can be attached to a phone that will cause a light or vibration device to activate. Transmitters can also be used to enable visual cues to represent a fire alarm.
• Individuals with hearing loss require mobile phones with amplifiers that have a higher amplification power when compared to regular phones. The Hearing Aid Telephone Interconnect System is a handsfree amplification system that allows people to amplify sound when using a phone, cell phone, computer and pay phone by installing a portable unit.

Wireless hearing aid

The wireless device has two main components: a transmitter and a receiver. The transmitter broadcasts the captured sound, and the receiver detects the broadcast audio and allows incoming audio streams to be connected to the accommodation such as hearing aids or text systems.

Three common types of wireless systems are used: FM, audio induction loop, and InfraRed. Each system has advantages and benefits for a particular use. The FM system can be operated by battery or plugged into an electrical outlet. FM systems produce analog audio signals, which means they have very high accuracy. Many FM systems are very small, allowing them to be used in mobile situations. The audio induction rotation allows a listener with a hearing loss to be free to wear a receiver provided that the listener has hearing aids or a cochlear implant processor with an accessory called "telecoil". If the listener does not have a telecoil, then he/she must bring the receiver with the earpiece. Like FM systems, infrared (IR) systems also require the receiver to be used or carried by the listener. The advantage of an IR wireless system is that people in adjacent rooms can not hear the conversation, making it useful for situations where privacy and confidentiality are required. Another way to achieve confidentiality is to use an embedded speaker, which contains or connects to a microphone and transmits no signal outside the earhole directly plugged into it.

Surgery

No treatment, surgery or other, for hearing loss due to the most common causes (age, noise, and genetic defects). For certain conditions, surgical intervention may provide medication:

• surgical correction of superior channel dehiscence
• myringotomy, surgical insertion of drainage ventilation channels on the tympanic membrane. Such placement is usually temporary until the underlying pathology (infection or other inflammation) can be overcome.
• radiotherapy or surgical excision of vestibular schwannoma or acoustic neuroma, although, in many cases, it is unlikely that hearing will be maintained
• Stapedectomy and stapedotomy for otosclerosis - replacement or re-establishment of middle ear stapes bone can recover hearing in cases of conductive hearing loss

Surgical and implantable hearing aids are an alternative to conventional external hearing aids. If the ear is dry and uninfected, air conduction aid can be tried; if the ears dry, direct bone hearing aid is often the best solution. If the conductive part of the hearing loss is more than 30-35 dB, air conduction devices can have problems overcoming this gap. A bone-hearing aid can, in this situation, be a good choice. Bonebridge active bone conduction hearing implant is also an option. This implant is not visible under the skin intact and therefore minimizes the risk of skin irritation.

Cochlear implant improves results in people with hearing loss in one or both ears. They work with artificial stimulation of the cochlear nerve by providing electric impulse substitution to fire hair cells. They are expensive, and require programming along with extensive training for effectiveness.

Cochlear implants and bone conduction implants can help with one-sided deafness. Middle ear implants or bone conduction implants can help with conductive hearing loss.

People with cochlear implants are at a higher risk for bacterial meningitis. Thus, meningitis vaccination is recommended. People who have hearing loss, especially those who develop hearing problems in childhood or old age, may need technical support and adaptation as part of the rehabilitation process. Recent research has shown variations in efficacy, but some studies show that if planted at a very young age, some very disturbed children may have effective hearing and speech, especially if supported by appropriate rehabilitation.

Class

For classroom settings, children with hearing loss often benefit from direct instruction and communication. One option for students is to attend a school for deaf people, where they will have access to language, communication, and education. Another option is to have the child attend the main program, with special accommodation such as providing a pleasant seat for the child. Getting students seated as close as possible to the teacher improves students' ability to hear the teacher's voice and more easily read the teacher's lips. When giving lectures, teachers can help students by dealing with them and by limiting unnecessary noise in the classroom. In particular, teachers can avoid speaking when their backs are directed to the classroom, such as when writing on the board.

Some other approaches to class accommodations include pairing deafness or difficulty hearing students with hearing students. This allows students with hearing impairment or deafness to ask students' questions about concepts they do not yet understand. The use of CART (Communication Access Real Time) system, where an individual writes the title of what the teacher says, is also helpful. Students see this captioning on their computer. Automatic text systems are also a popular choice. In automated systems, software, rather than someone, is used to generate text. Unlike CART systems, automated systems generally do not require an Internet connection and thus they can be used anywhere and anytime. Another advantage of the automated system over CART is that the price is much lower. However, automated systems are generally designed to simply write down what the teacher says and not write down what the other students say. An automated system works best for situations where only the teacher speaks, while the CART system will be preferred for situations where there is much class discussion.

For students who are really deaf, one of the most common interventions is to have children communicate with others through a translator using sign language.

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Epidemiology

Globally, hearing impairment affects about 10% of the population to some extent. This resulted in moderate to severe disability in 124.2 million people in 2004 (107.9 million of whom were in low- and middle-income countries). Of these 65 million conditions were obtained during childhood. At birth ~ 3 per 1000 in developed countries and more than 6 per 1000 in developing countries are experiencing hearing problems.

Hearing loss increases with age. Among the 20 and 35 levels of hearing loss is 3% whereas in those 44-55 it is 11% and in those 65-85 it is 43%.

The 2017 report by the World Health Organization estimates the costs of unhealed hearing loss and cost-effectiveness of interventions, for the health care sector, for the education sector and the widespread social costs. Globally, the annual cost of untreated hearing loss is estimated to be in the range of $ 750-790 billion internationally.

United States

Data from the United States in 2011-2012 found that the rate of hearing loss has decreased among adults aged 20 to 69 years, when compared with results from the previous time period (1999-2004). It also found that adult hearing loss was associated with increased age, gender, race/ethnicity, education level, and noise exposure.

Almost one in four adults has an audiometric result that indicates hearing loss caused by noise. Almost one in four adults who reported very good or good hearing had the same pattern (5.5% on both sides and 18% on one side). Among those who reported exposure to loud noise at work, nearly a third had such a change.

src: www.healthline.com

History

Abbé © © -the Charles de Michel de l'ÃÆ'â € pà © e opened the first school for the deaf in Paris at the school of the deaf. The American Thomas Gallaudet witnessed a demonstration of deaf teaching skills from a substitute ÃÆ' â € ° pÃÆ' © e's AbbÃÆ'  © Sicard and two members of the deaf school faculty, Laurent Clerc and Jean Massieu; accompanied by Clerc, he returned to the United States, where in 1817 they founded the American School for the Deaf in Hartford, Connecticut. American Sign Language (ASL) began to evolve from French Sign Language (LSF), and other outside influences.

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Society and culture

After language

Post-lingual deafness is a sustained hearing loss after language acquisition, which can occur due to illness, trauma, or as a side effect of the drug. Typically, hearing loss is gradual and often detected by family and friends of affected individuals long before the patient itself will recognize the disability. Post-lingual deafness is much more common than pre-language deafness. Those who lose their hearing in later life, such as in late adolescence or adulthood, face their own challenges, live with adaptations that allow them to live independently.

Before language

Deafness occurs is a hearing loss suffered before language acquisition, which can occur due to a congenital condition or through loss of hearing in early infancy. It is believed that pralingual deaf interferes with the ability of individuals to acquire spoken language, but some deaf children may acquire spoken language through conversations accompanied by support from sign language and hearing aids or cochlear implants. Parents who do not sign deaf usually go with oral approaches without sign language support because the loss of pralingual hearing is obtained through illness or trauma rather than genetically inherited, so families with deaf children almost always lack previous experience with sign language. Unfortunately, this leads to the risk of language deprivation for deaf babies because deaf babies will not have language if the child can not obtain spoken language successfully. Deaf babies born in signatory families rarely have a delay in language development because they meet the language milestone, but in sign language as a substitute for spoken language.

Display care

There is much controversy in the cultural community of deafness over cochlear implants. For the most part, there is little objection to those who lose their hearing in later life, or cultural deaf adults choose to have cochlear implants installed.

Many in the deaf community strongly object to deaf children who have cochlear implants (often on the advice of the audiologist); new parents may not have enough information about raising deaf children and being placed in an oral program only that emphasizes the ability to speak and listen through other forms of communication such as sign language or total communication. Many deaf people see cochlear implants and other hearing aids as confusing one's identity. The Deaf will never be a listener and therefore will try to adjust to a way of life that is not theirs. Other issues include loss of Deaf culture and identity and limitations on hearing recovery.

Jack Gannon, a professor at Gallaudet University, says it's about the Deaf culture: "Deaf culture is a set of learned behaviors and perceptions that shape the values ​​and norms of deaf people based on their shared or common experience." Some doctors believe that being deaf makes one become more social. Bill Vicar, from ASL University, shared his experience as a deaf man, "[deaf people] tend to gather around a kitchen table rather than a living room sofa... our goodbye takes almost forever, and our hellos are often made up of serious hugs. of us meet for the first time, we tend to exchange detailed biographies. "The culture of the deaf is not about reflecting on what the deaf can not do and how to correct their problems, an approach known as the" pathological view of deafness ". Conversely the deaf people celebrate what they can do. There is a strong sense of unity among deaf people as they share their experiences of suffering through the same struggle. This celebration created unity among the deaf aliens. Bill Vicars expressed the strength of this bond when he stated, "if given the opportunity to hear most [deaf people] would choose to remain deaf."

The US-based National Association of the Deaf has a statement on its website regarding cochlear implants. NAD asserts that the choice to inculcate is up to the individual (or parent), but strongly advocates a wholly informed decision in all aspects of cochlear implants. Most of the negative reactions to cochlear implants originate from a medical standpoint that deafness is a condition that needs to be "cured", while the deaf community actually considers deafness a defining cultural feature.

Many other tools are more acceptable to deaf communities, including but not limited to hearing aids, closed captions, email and the Internet, text phones and video relay services.

Sign languages ​​

Sign language conveys meaning through manual communication and body language rather than sound patterns that are conveyed acoustically. It involves a simultaneous combination of hand shape, orientation and movement of the hand, arm or body, and facial expression to express the speaker's mind. "Sign language is based on the idea that vision is the most useful tool that deaf people have for communicating and receiving information".

Government policy

Deaf people (either by state or federal standards) have access to a free and proper public education. If a child does not qualify as deaf or hard of hearing and accepts an individual education plan, the IEP team should consider, "the language and communication needs of children.IEP should include opportunities for direct communication with colleagues and professionals, finally must include students full of various needs "

In part, the Department of Education defines deaf as "... a very severe hearing loss that the child is disturbed in processing linguistic information through hearing, with or without amplification...." Hearing loss is defined as "hearing impairment, whether permanent or fluctuate, which adversely affects the performance of children's education but that does not fall under the definition of deafness.... "

Inclusion versus withdrawal

In the school where all children live using the same communication system (whether the school uses ASL, Total Communication or Oralism), students will be able to interact normally with other students, without having to worry about being criticized. An argument in favor of inclusion, on the other hand, exposes students to people who are not like them, preparing them for adult life. Through interaction, children with hearing disabilities may expose themselves to other cultures that in the future may be beneficial to them when it comes to finding work and living alone in a society where their disability can put them in a minority. These are some of the reasons why someone may or may not want to put their child in an inclusion class.

Family

The limitation of communication between deaf people and their hearing family members can often lead to difficulties in family relationships, and affects the strength of relationships between individual family members. It was found that most deaf people have heard parents, which means that channels communicated by children and parents can be very different, often affecting their relationships in a negative way. If parents communicate well verbally, and their children communicate well using sign language, this can lead to ineffective communication between parents and children. Ineffective communication can potentially lead to fights caused by misunderstandings, lack of willingness to talk about life events and problems, and overall weaker relationships. Even if individuals in the family try to learn deaf communication techniques such as sign language, deaf family members will often feel excluded from casual banter; such as daily event exchange and news on the dining table. It is often difficult for deaf people to follow this conversation because of the nature of this rapid and overlapping exchange. This can cause a deaf person to become frustrated and take part in poor family conversations. This could potentially result in a weaker relationship between the listener and their close family member. This communication barrier can have a very negative effect on relationships with family members as well. Communication between a deaf and member of their extended family can be very difficult because of the gap in verbal and non-verbal communication. This can cause the individual to feel frustrated and unwilling to try to communicate effectively. Lack of effort to communicate can lead to anger, miscommunication, and reluctance to build strong relationships.

Community

People who experience hearing loss can often experience many difficulties as a result of communication barriers among themselves and other hearing individuals in the community. Some of the key areas that could be affected are involvement in extracurricular activities and social relationships. For young people, extracurricular activities are vehicles for physical, emotional, social, and intellectual development. However, it is often the case that communication barriers between deaf people and their hearing counterparts and club coaches or advisors limit them to engage. These communication barriers make it difficult for a person with hearing impairment to understand directions, accept suggestions, collaborate, and form bond ties with other team members or clubs. As a result, extracurricular activities such as sports teams, clubs and volunteers are often unpleasant and beneficial to individuals with hearing impairment, and they are rarely involved. Lack of community involvement through extracurricular activities can also limit the social networks of individuals. Generally

Source of the article : Wikipedia