Synonyms in a broader sense
Medical: Hypacusis English: Chronic deafness
- Deafness
- Deafness
- Conductive hearing loss
- Sensorineural hearing loss
- Sensorineural hearing loss
- Hearing loss
- Hearing loss
- Hearing loss
Definition of hearing loss
Hearing loss (hypacusis) is a reduction in hearing ability that can range from mild hearing loss to complete deafness. Hearing loss is a widespread disease that occurs both in young people and far more frequently in the elderly. In Germany, approximately six percent of the population is affected by hearing loss.
Conspicuously, the age at which hearing loss occurs is decreasing more and more. Naturally, however, hearing loss only progresses with increasing age. One only becomes aware of a reduction in hearing when familiar noises, sounds and voices are suddenly no longer perceived or understood.
The hearing loss usually sets in gradually and can be perceived as a considerable handicap if the damage has already occurred. The focus is not so much on the treatment of hearing loss as on its prevention at a young age. For prevention, many measures can be taken to preserve our sense of hearing.
Although there are legal regulations in the workplace which stipulate that one may not expose oneself to a noise level of over 85 decibels (dB) without hearing protection, this limit is reached especially during leisure time. Discos, rock concerts, loud music through headphones, car races etc. generate such noise, which in the long run can cause unstoppable damage to our hearing.
Causes Chronic hearing loss
As with acute hearing loss, chronic hearing loss can be divided into conductive (the cause lies in the outer or middle ear) and sensorineural (the cause lies in the inner ear or the auditory nerve). There is a clear difference in therapy depending on the location of the disorder.
Origin and therapy
How does chronic conduction disorder occur and how is it treated? – Earwax (cerumen)Earwax, dust and skin particles are natural in the external auditory canal and are usually transported to the outside of the ear by themselves or flushed out when showering. However, an excessive accumulation or increased formation of earwax occurs when the ear canal is narrow or when working in dusty conditions.
Attempting to remove earwax with sticks unfortunately results in even more being transported towards the eardrum and further obstructing the ear canal. Other foreign bodies such as cotton wool residues can also increasingly block the auditory canal. Children sometimes run the risk of putting small objects in their ears while playing without their parents noticing.
These foreign bodies or earwax become visible through an otoscope (ear mirror) and can be removed with small instruments at the family doctor’s office. If a mechanical removal is not successful, the earwax or the foreign body is rinsed out with water. – Increased bone growth (exostoses)Some people experience increased bone growth at an advanced age or in the case of hormonal diseases.
If the bone grows in the area of the auditory canal, a narrowing occurs. When less sound reaches the eardrum, hearing loss gradually creeps in. Excess bone tissue can be removed surgically.
- Narrowing due to scarring (stenosis)After every inflammation in the auditory canal, be it due to a fungal infection or hair follicle inflammation (boils), a small scar is left. The more often an inflammation and injury of the auditory canal has occurred, the more scar tissue is formed and narrows the canal. The increasing narrowing leads to progressive hearing loss.
Surgical removal can expose the auditory canal again, but again results in scarring. – Chronic inflammation of the middle ear (Otitis media chronica)In the case of chronic inflammation of the middle ear, the inflammation is permanent. The symptoms are characterised by alternating severe ear pain and ear running.
The inflammation can spread to nearby bones and worsen the course of the disease. An increasing hearing deterioration creeps in and is difficult to treat later. Therapy focuses on the surgical rehabilitation of the middle ear by a radical removal of purulent and inflammatory tissue.
If possible, one naturally tries to preserve residual hearing. Today, it is possible to replace the ossicular chain with artificial implants (tympanoplasty). Further information on this topic can also be found at Chronic inflammation of the middle ear
- Chronic tubal aeration disorder (chronic middle ear catarrh)The auditory tube (Tuba Eustachii, Tuba auditiva) normally equalises the pressure differences between the middle ear and the outside world.
Due to constant infections in colds (rhinitis, sinusitis, tonsillitis), the tube can become permanently blocked and its function severely impaired. In addition to a latent feeling of pressure in the ear, which cannot be relieved even by swallowing and yawning, hearing loss creeps in. Permanent closure also promotes fluid accumulation (serotympanum) or inflammation-induced mucus accumulation in the middle ear (mucotympanum).
If the fluid additionally presses on the eardrum from the inside, the vibration of the eardrum is impaired and worsens the existing hearing loss. If a therapy (see polyps, tonsillitis) is not initiated soon, the mucous membrane of the middle ear (tympanosclerosis) will change, resulting in severe hearing loss. Chronic middle ear catarrh is usually due to enlarged pharyngeal tonsils, which should be removed in case of recurring infections.
If the condition does not heal, the middle ear is ventilated through a small incision (paracentesis) and a tube is inserted into the eardrum (tympanic drainage). The tube can be removed after healing. The defect in the eardrum heals after some time.
- Otosclerosis Otosclerosis causes a stiffening of the ossicular chain in the area of the stapes. The stirrup attaches to the inner ear and ossifies there with the oval window, making it immobile and unable to transmit sound. This fixation restricts the mobility of the entire ossicular chain and greatly reduces sound transmission.
The hereditary disease occurs more frequently in women than in men and has its peak between the ages of 20 and 40. During pregnancy, the disease process can be accelerated. The resulting hearing loss has the peculiarity that the patients hear their conversation partner better than usual in loud noise (Parakusis Willisisii).
In addition to hearing loss, tinnitus also occurs. Otosclerosis can be treated by surgical therapy (stapesplasia). Here, the stapes is replaced by a prosthesis made of titanium or platinum in its function.
- Tumour, tumoursCancerous tumours can also occur in the ear region. They can be benign or malignant. What they all have in common is that they increasingly impair hearing and create a feeling of pressure with occasional ringing in the ears (tinnitus). They can be found in all areas of the ear, from the outer ear canal to the middle and inner ear. Fortunately, ear tumours are relatively rare and can be easily removed by microsurgery.
