Health
Better Hearing,
Better Living
Don’t despair over hearing loss!
by Dr Elliot Eng Soh Ping
Do you sometimes find yourself
in a situation where you have to ask
others to repeat themselves during
conversations? Do others complain that
the sound level from your television or
radio is too loud? Do you experience
a ringing noise in your ears? If
you answered YES to any of these
questions, be aware that these could be
warning signs of hearing loss.
Hearing loss can present
gradually or could suddenly occur.
While the causes of hearing loss
are many, the commonest reasons
include noise-induced deafness, ear
infections or simply the degenerative
process of an ageing ear. Whatever
the cause, hearing loss often
significantly impacts one’s quality of
life – both at home and socially.
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Symptoms and Signs
Think about your spouse or partner
who has to repeat himself/herself
during conversations with you, each
time having to raise their voice in
order to communicate with you.
This could lead to unnecessary
frustration for both parties, leading
to a strain in your relationship.
If you find yourself speaking
loudly or often asking people to repeat
themselves during conversations,
increasing the volume of the television,
or having difficulty hearing in a noisy
environment, you should suspect
hearing loss. Besides these symptoms,
one could also experience associated
symptoms including sound in the ear,
vertigo, ear discharge or pain in the ear,
depending on the causes.
These symptoms could socially
estrange someone from the community
since the sufferer may fear not being
understood and would rather not
participate in any conversations at all.
At the workplace, you may not want to
participate in meetings like you once
did due to lack of understanding of
what is being discussed.
However, there are solutions. The
most important step you can take is
to understand that hearing loss is not
a total loss. A deeper understanding
of its cause and associated treatment
options can help you make a decision
on what to do next.
Diagnosis
Typically, an otoscopic examination
is performed in the clinic which may
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Treatment Options
Treatment will depend largely on the cause of
hearing loss. Some individuals can be treated
with medication or surgery but others may be
rehabilitated with hearing aids.
Hearing Preservation Surgery
depend on
the underlying
aetiology and
severity of
hearing loss.
Hearing Aids
Implantable
hearing aids are
recommended
in situations
where patients
have bilateral profound
hearing loss for which hearing aids are not
helpful, single sided deafness or absent/
malformed external ears which may hinder
placement of the external hearing device.
Hearing aids help amplify sound delivery to the
inner ear. They can be broadly divided from
conventional hearing aids which are worn
externally to implantable hearing aids. The
type of hearing aid suitable for a patient would
There are currently three commonly used hearing
implants: Bone anchored hearing aids (BAHA),
middle ear implants (vibrant sound bridge) and
cochlear implants.
There are many options available to treat outer,
middle and inner ear conditions while preserving
hearing. These include procedures involving repair
of the damaged ear drum, removing disease
in the middle ear and thus improving aeration,
restoring mobility of the middle ear bones and
removing middle ear fluid.
reveal abnormalities in the external
auditory canal, ear drum or middle ear.
To determine the type of hearing loss
(conductive or sensorineural), a bedside
tuning fork test can be performed. In
addition, a pure tone audiogram (to
test for threshold
response to
pure tones),
The first step in preventing hearing loss is to reduce
exposure to noise and loud sounds. Reduce the chance
of an ear infection by minimising the use of cotton swabs,
as well as avoid the use of hairpins or other objects in
your ear to try to remove earwax or to scratch your ear.
These actions often cause more damage than good.
tympanogram (to measure middle ear
pressure) and speech discrimination
scores can be conducted by an
audiologist in the clinic. At times,
a computer tomography scan of
the temporal bone (CT TB) can be
performed.
Prevention and
Precautions
We ultimately hear with our brains
as sound is collected by the ears
and delivered to the brain to
be analysed and interpreted.
Only hearing from both
ears provides the ability to
distinguish speech from
background noise, to follow
a group conversation and
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to localise sounds from space.
The first step in preventing hearing
loss is to reduce exposure to noise and
loud sounds. Reduce the chance of an
ear infection by minimising the use of
cotton swabs, as well as avoid the use
of hairpins or other objects in your ear
to try to remove earwax or to scratch
your ear. These actions often cause
more damage than good. Finally, be
mindful of the early warning symptoms
so that you can seek early and prompt
treatment with an ENT specialist.
Dr Elliot Eng Soh Ping is Director and Consultant
ENT Surgeon at ASCENT Ear Nose Throat SG
Alvernia at Mount Alvernia Hospital.
MAY 2015
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