Open Your Ears! Your Guide To Healthy Hearing

Open Your Ears! Your Guide To Healthy Hearing

Open Your Ears! Your Guide To Healthy Hearing

Hearing Awareness Week is upon us, and what better time to gain a better understanding of how our hearing works, how to tell and what to do when things go wrong, and how to live a full and happy life with hearing loss, including advice on choosing between hearing aid solutions.

How hearing works

Hearing is a complex process involving both the ears and brain working together to create a ‘hearing pathway’. In simple terms, sound travels through the ear as sound waves, vibrates in the ear drum (and gets processed in other ways through a complex organisation of bones, hair, and cells), and is then sent as electrical impulses along the auditory nerve to the brain. These impulses are then interpreted by the brain as different types of sound, allowing us to make sense of and participate in the world around us. Read on for a more in-depth look at the different parts of the ear and how they work together to help us hear.

Our ears are made up of many parts, which are usually divided into three categories: the outer ear, the middle ear, and the inner ear. Each of these parts plays an important role in helping us to hear.

1. The Outer Ear
The outer ear collects ambient sound from the world and directs it along the ear canal so it can reach the ear drum. The visible shape of our outer ears (known as the pinna) acts like a funnel, directing and amplifying the soundwaves into our ears. When sound hits our ear drums—a very thin membrane—it vibrates, transferring the sound deeper into our ear.

2. The Middle Ear
Once the sound reaches our eardrums, it interacts with the middle ear. The role of our middle ear is to transmit the sounds collected by our outer ears. It does this via a group of specialised bones—the smallest bones of the human body—that vibrate and conduct the soundwaves, directing them into our inner ears.
There’s also another important job performed by our middle ears: ensuring that the air pressure that builds up is equalised with the surrounding air pressure. We have all felt the uncomfortable sensation of unequal pressure when flying, or going for a scenic drive through the mountains. The Eustachian tube is responsible for remedying this imbalance, opening with swallowing, yawning, or chewing, which equalises the pressure and brings our ears back into balance.

3. The Inner Ear
Our inner ear, made up of a series of tubes and passages, transforms the soundwaves that have travelled through the outer and middle ear. The sounds are converted into electrical impulses that are sent to our brains along the auditory nerve, allowing us to interpret and recognise what we are hearing from the world around us.
Here, in our inner ears, lies an important organ called the vestibular. It has a critical job within our bodies that we likely give little thought to—controlling our sense of balance. Inside, little fluid-filled passages monitor our body’s movement, letting our brains keep track of where we are in space and keeping us upright and on our feet.

how our hearing works

Hearing is a complex process involving both the ears and brain working together.

Hearing loss can occur as a result of problems at any stage of the hearing pathway, and at any age. To find out about the different types of hearing loss read on.

Types of hearing loss

There are 4 types of hearing loss: Conductive Hearing Loss, Sensorineural Hearing Loss, Mixed Hearing Loss and Central Hearing Impairment. The main difference between them is the physical location of the problem within the ear.

1. Conductive hearing loss
Sometimes the sound from the outside world is not conducted efficiently within our outer and middle ears, resulting in difficulty hearing soft sounds. This type of hearing loss is called Conductive Hearing Loss. It can occur with an ear infection or from the common cold, damage to the Eustachian tube, or a build up of wax inside the ear. There are medical or surgical options available as treatment for conductive hearing loss. An audiologist can recommend which treatment type would best suit you.

2. Sensorineural hearing loss
A more common cause of hearing loss involves damage to either the tiny hair cells in our inner ears or damage along the auditory nerve. This means that the sound vibrations reaching the inner ear can’t be converted into electrical signals, or that those signals cannot travel into the brain. This type of hearing loss is known as Sensorineural Hearing Loss. It can occur with repeated exposure to loud noise, and also occurs as a natural process of ageing. It results in permanent hearing loss, as the hair cells are unable to do their job of transmitting vibrations once damaged. Hearing aids are the most common treatment option for Sensorineural Hearing Loss.

3. Mixed Hearing Loss
Some cases of hearing loss involve both Conductive and Sensorineural Hearing Loss. This type of hearing loss is known as Mixed Hearing Loss. Talk to your audiologist for the best combination of treatment/s for this type of hearing loss.

4. Central hearing impairment
Hearing can also be impaired by injury or disease, which is known as Central Hearing Impairment. Sometimes it’s associated with hearing loss, and sometimes not. If you experience sudden hearing loss, seek medical attention as soon as possible.

sudden hearing loss

If you experience sudden hearing loss, seek medical attention as soon as possible.

A comprehensive audiological evaluation should be undertaken in order to determine the type and severity of hearing loss, and to make appropriate recommendations for treatment. Find out more about each type of hearing loss and preventive measures you can take to avoid them here, or read on to find out how you can check to see if you have hearing problem.

How can I check if I have a hearing problem?

Hearing loss is the second most common health condition experienced by Australians, but most people don’t notice they have a problem until they start to experience symptoms. To get ahead of the game, the best course of action is to take a baseline hearing test and annual follow-up hearing tests to help identify and treat any hearing issues early.

A visit to a professional audiologist for a hearing test will provide a comprehensive assessment of your current hearing, as well as any recommendations for treatment. During your visit the audiologist will run a series of tests and examinations using professional equipment, which helps to build a full picture of your current hearing, your lifestyle, and to assess the nature and level of any hearing loss.

For more information on the comprehensive range of hearing tests available from Ear & Hearing Australia clinics, or to take action now, start our simple online hearing test.

hearing tests

Identify and treat any hearing issues early by taking a hearing test.

Living with hearing loss

Hearing loss often happens slowly, so it’s not always immediately obvious. Even after the hearing loss is identified, people may have difficulty accepting it, or deny that the problem is important enough to warrant a visit to a specialist. The first step in living with hearing loss is acknowledging that there is a problem. It’s very difficult to take measures to minimise the long-term impact of the hearing loss if you are in denial that it even exists. As difficult as it can be to accept, hearing loss is serious and seeking professional advice will always be beneficial in terms of getting the information you need and starting any suitable treatment options.

Living with hearing loss can be difficult not only for you, but also for those around you. The people closest to you are likely to notice things like having to turn the TV volume up, or asking them to repeat themselves over and over again. If you notice yourself limiting your social interactions and not enjoying the places and activities you used to, seek professional advice from a qualified audiologist. With correct advice and treatment, your quality of life doesn’t need to suffer because of hearing loss.

People living with hearing loss can have a rewarding and enjoyable life through the use of modern technology including hearing aids and other assistive devices, as well as lip reading, sign language and other trainable skills. These can all help with communication and interaction with others at work, school and home. Depending on the type and severity of hearing loss, medical treatments (such as surgery) may also be helpful.

Read more about how you can learn to live a full and happy life with a hearing loss here, or read on to find out about the latest hearing aid technologies available.

hearing aid technology

People living with hearing loss can have a rewarding and enjoyable life through the use of modern technology.

New technology hearing aids

Hearing aids used to be bulky, uncomfortable eyesores, but not anymore! Modern technology and advances in design and function mean that hearing aids have vastly improved from past models, with electronics now miniaturised to the point where designers can focus more on aesthetics and developing hearing aid solutions that are so tiny, they’re considered invisible. Lyric from Phonak has been described as ‘the contact lens for your ear’, and there are many other hearing aid options in a choice of styles to suit your lifestyle and even your fashion sense.

Modern hearing aids also boast increasingly sophisticated features including compatibility with smartphones and computers, waterproof options for use in a wide range of environments, ‘smart’ processing that can detect where sound is coming from, adjust speech sounds relative to background noise, and change settings depending on the activities you’re doing (like talking on the phone or listening to music) and bluetooth compatibility, which allows aids to communicate with one another and exchange data.

The different types of hearing aid technology available is extensive and may feel overwhelming, so it’s important to consider your needs and preferences before you make a decision on what type of hearing aid you want to purchase. These technologies range from simple settings that may require manual adjustment in certain environments, to automated and sophisticated settings that have greater processing power. The main overall difference is the level of fine tuning you require or want from your device. Looks are also an important consideration, and now more than ever there are a wide range of options available once you have chosen the style of hearing aid you’d like.

Modern hearing aids come in two distinct styles: models that sit in the ear, and models that sit behind the ear.

In The Ear (ITE) hearing aids:Hearing aids designed to fit in your ear are discreet and can be invisible to others, as they either sit inside the ear canal or just at the entrance to your ear. To others, it will not be obvious that you are wearing a hearing aid at all! Because of their small size, and the fact that they sit inside your ear, ITE hearing aids are limited in their ability to be manually adjusted, and will need to be custom fit by a trained audiologist. They also have small switches and battery sizes.

Behind The Ear (BTE) hearing aids:The latest BTE hearing aids are much more contemporary in both design and look; they are small, sleek, and are a much more attractive option compared to past designs. Modern BTE models are customisable not only in the types of controls and battery types, but also in terms of colour and style. You can even choose them to match your hair and skin tone.

Lyric hearing aid

The Lyric hearing aid from Phonak is so small it is invisible to others and has been referred to as the contact lens for your ear.

Hearing Loss in Children

Hearing Loss in Children

Hearing Loss in Children

Hearing loss can have a lifelong impact on children. It can affect their speech, language and learning, their social, physical and emotional development, and their long-term education and employment opportunities.

Colds, infections, allergies and flu can temporarily affect your child’s hearing, however some children have or develop permanent hearing loss. In Australia, between 9-12 children in every 10,000 will be born with a moderate or greater hearing loss in both ears. Around another 23 children per 10,000 will acquire a hearing impairment that requires hearing aids by the age of 17 through accident, illness or other causes.

Most Australian newborns are tested before they leave hospital to identify if they require further hearing and middle ear function testing. If a hearing loss is diagnosed, other tests may include blood tests, an electroencephalogram and a CT scan of the middle and inner ear. The earlier you find out your child has a hearing impairment, the earlier they can begin therapy and develop language to communicate with. It also means you and your family can receive advice and support as soon as possible, all to help give your child the best start in life.

hearing loss in children

Hearing loss can have a lifelong impact on children.

Degrees of Hearing Loss in Children

There are various degrees of hearing loss, classified as mild, moderate, moderate to severe, severe or profound.

Mild hearing loss
Children with mild hearing loss usually have normal speech and can hear normal conversation but may not hear whispers or soft sounds, and will have trouble in the school setting because it will be difficult to hear speech from more than 4 metres away or when there is background noise. Some children with a mild loss are not suspected of poor hearing until they reach grade one. They are often thought to be ‘slow’ learners because they cannot understand when the teacher speaks from a distance and, therefore, respond erratically. When these children receive hearing aids, they usually find that school is easier and their school performance improves.

Moderate hearing loss
Children with moderate hearing loss can clearly hear speech only when the speaker is very close – less than one metre away. They need hearing aids to hear the softest sounds and to acquire understandable speech. If they receive hearing aids before four years of age, they usually progress rapidly in learning speech. They can attend regular schools, but may need some special help.

Moderate to severe hearing loss
Children with moderate to severe hearing loss need conversations to be very loud to be able to hear them. Even when speech is loud, not all words and sounds will be heard clearly. Speech and language development will be affected and specialised professional help will be beneficial.

Severe hearing loss
Children with severe hearing loss will not hear normal conversation and will only be able to pick out a few loud sounds and words. Speech and language development will be affected and hearing aids and specialised professional help will be needed.

Profound hearing loss
Children with a profound hearing loss receive even less auditory information. No sounds can be heard without the help of a hearing aid. The younger a child is when fitted with hearing aids or a cochlear implant, the greater the likelihood he/she will develop improved speech. Children with a profound loss often depend greatly on their vision to perceive speech.

Phonak hearing aids for children

Leo the Lion from Phonak has hearing aids just like your child! Ask your audiologist for more information.

Types of Hearing Loss in Children

There are two main types of hearing impairment, based on which part of the ear is affected: conductive or sensorineural.

Conductive hearing loss
Conductive hearing impairment indicates there is a problem with the mechanism that conducts sound from the environment to the inner ear. It can be caused by a wax blockage, middle ear infections (otitis media), a punctured eardrum, a build-up of fluid or abnormal bone growth. This kind of hearing loss can usually be corrected by medication or surgery. If it cannot be corrected, the child with conductive hearing loss can usually do very well with hearing aids.

Sensorineural hearing loss
In the case of sensorineural hearing impairment, there is damage to the innermost part of the ear (cochlea) or to the nerve which carries hearing (the auditory nerve). It can be caused by abnormal inner ear development, a physical injury to the inner ear, or damage to the ear from diseases such as meningitis and rubella, or a tumour. This type of hearing loss is usually permanent. However, children with sensorineural hearing loss can benefit from hearing aids, FM systems, cochlear implants, communication therapies, and a careful analysis and implementation of educational and communication approaches.

Some children can have both types, which is called a mixed hearing loss, or another type called retrocochlear.

hearing loss in children

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Causes of Hearing Loss in Children

Hearing loss can either be congenital or acquired. Congenital means that the hearing loss was present at the time of birth, or occurred very soon after birth. An acquired hearing loss occurs after birth, often as a result of an illness or an injury.

Congenital hearing loss
There are various causes of congenital hearing loss, though they are not always easily identified. There are both non-genetic and genetic factors that might cause hearing loss.

Non-genetic factors include:

  • Birth complications
  • Premature birth
  • A nervous system or brain disorder
  • The use of ototoxic medication by the mother during pregnancy
  • Infections that occur during pregnancy such as measles and toxoplasmosis
  • Maternal diabetes
  • Drug or alcohol abuse by the mother, or smoking during pregnancy

The above causes of congenital hearing loss are all non-genetic factors. However, non-genetic factors account for only around 25 percent of congenital hearing loss. Experts agree that genetic or hereditary factors cause more than 50 percent of all hearing loss in children, whether the loss is present at birth or manifests later in life.

Genetic factors that might cause congenital hearing loss include:

  • Autosomal recessive hearing loss, which is the most common type of genetic congenital hearing loss. It means that neither parent has a hearing loss, but each parent carries a recessive gene that gets passed to the child. Parents are usually surprised when their child is born with this type of hearing loss because people typically aren’t even aware they have the recessive gene.
  • Autosomal dominant hearing loss, which means that one parent carrying a dominant gene for hearing loss passes it to their child. This parent may or may not have hearing loss, but he or she might have other symptoms or signs of a genetic syndrome.
  • Genetic syndromes like Usher syndrome, Treacher Collins syndrome, Waardenburg syndrome, Down syndrome, Crouzon syndrome and Alport syndrome.

Acquired hearing loss

There are various causes of acquired hearing loss, including:

  • A perforated eardrum
  • Otosclerosis or Meniere’s diseases, which are progressive
  • Infections like meningitis, measles, mumps or whooping cough
  • Taking ototoxic medications
  • A serious head injury
  • Exposure to very loud noise over long periods
  • Untreated or frequent ear infections (otitis media)
  • Exposure to second-hand smoke

However, in some cases it may not be possible to identify the cause of deafness or hearing loss. Children of all ages should undertake a full hearing evaluation if they have experienced diseases that can cause hearing loss, if they have been taking medications that list hearing loss as a side effect, or if you have a family history of hearing problems.

hearing evaluations for children

Hearing loss can either be congenital (present at or soon after birth) or acquired (as a result of an illness or an injury).

Symptoms/Signs of Hearing Loss in Children

Awareness of communication milestones can help identify early signs of hearing loss.
Hearing impairment in infants may be difficult to detect, but the sooner hearing loss is detected, the better the chances for your child to socialise, communicate, learn, accept their hearing loss, and learn how to live with it.

Some signs that your infant may have hearing impairment include that they:

  1. 1. Do not startle at the sound of loud noises by four months of age, or do not turn towards the source of a sound
  1. 2. Notice you only when they see you
  1. 3. Do not make sounds other than gargles and other vibrating noises that they can feel
  1. 4. Need to search right and left to find the voice or sound
  1. 5. Have delayed speech or are hard to understand by 15 months of age
  1. 6. Do not always respond when called
  1. 7. Hear some sounds but not others
  1. 8. Have trouble holding their head steady, or are slow to sit up by themselves or walk

Older children could also acquire hearing loss that is either permanent or temporary. Here are some things to look for if you think your toddler or preschool-age child might have hearing loss:

  1. 1. Has difficulty understanding what people are saying
  1. 2. Speaks differently than other children of similar age
  1. 3. Doesn’t reply when you call their name, or doesn’t seem to notice that you have spoken to them
  1. 4. Responds inappropriately to questions (misunderstands)
  1. 5. Turns up the TV volume incredibly high or sits very close to the TV to hear
  1. 6. Has problems academically, especially if they weren’t present before. This can develop into apparent ‘behavioural problems’ at school (which are in fact masking a hearing problem)
  1. 7. Has speech or language delays or problems articulating things
  1. 8. Watches others in order to imitate their actions, at home or in school
  1. 9. Complains of ear pain, earaches or noises
  1. 10. Cannot understand over the phone or switches ears frequently while talking on the phone
  1. 11. Says “what?” or “huh?” several times a day
  1. 12. Watches a speaker’s face very intently. Many children’s hearing loss escapes detection because they are very successful lip readers
  1. 13. Appears inattentive and prone to daydreaming
  1. 14. Starts to develop low self-esteem. Teachers and peers may conclude that a child is cognitively delayed if they are missing information due to a hearing loss, and the child may start to believe they are not capable of doing the things their peers can
  1. 15. Acts shy particularly around people they don’t know (because they can’t understand everything they say)
  1. 16. Becomes quiet and withdrawn at school if they can’t hear the teacher well or follow instructions
  1. 17. Appears exhausted by the end of the day because hearing takes a lot of energy

Treatment Options

If your child suffers from hearing loss, hearing aids are one of the remedies that can help them to improve their hearing ability and minimise the adverse effects of their hearing problem. The choice you make about which type of hearing aids will depend on a number of factors including the type and degree of your child’s hearing loss; your child’s general abilities and level of activity (the hearing aids must be robust and able to withstand the impact from normal playing, and be resistant to dust and moisture. Many hearing aids for children also include special coverings and other accessories to ensure that young children don’t remove or misplace their hearing aids); your child’s age and school level (hearing aids for older children must have audio ports for hooking-up to radio transmission in classrooms and elsewhere); your child’s personal taste (children often like colourfully finished hearing aids and there are many options and styles to choose from).

There are several models of hearing aid devices to choose from, including behind-the-ear (BTE), in the ear (ITE) or in the canal (ITC) hearing aids.

BTE hearing aids:Young children will normally be fitted with hearing aids worn behind-the-ear (BTE). These come in compact sizes and a variety of bright, cheerful colours.

ITE hearing aids:Older children may be candidates for in-the-ear (ITE) hearing aids, which are custom made and fit inside the ear. These can help for children with mild to moderate hearing losses.

ITC hearing aids:One option for older children is in-the-canal (ITC) hearing aids. The microphone remains in the ITC casing but the receiver is externally placed in the ear canal. This allows the hearing aid to be smaller and more cosmetically appealing.

The Sky V and Sky Q from Phonak, Sensei from Oticon, Motion M, Motion P and Aquaris from Seimens, Supremia Super Power from Bernafon, and the ReSound Up Smart from ReSound are a few examples of hearing aid options available for children.

When your child has begun using hearing aids, you must remember that it takes time to get used to them. Getting used to hearing aids requires strong motivation, support and participation from you as a parent. Advanced, well-fitted hearing aids are not very useful if the child does not wear them or if they are not maintained.

hearing aids for children

The Sky V hearing aid from Phonak has been specially designed for children with hearing loss.

At Ear & Hearing Australia, we are here to help you find the right hearing aid for your child, fit and adjust it, and inform you about all relevant aspects of hearing impairment and hearing aids. Do not hesitate to contact us on 1300 761 667 or find a clinic near you to discuss your child’s individual hearing needs.