Signs and Types of Hearing Loss

What is sound?

Sound waves are essentially air vibrations. There are two fundamental characteristics of a sound wave: frequency and volume. The faster sound waves vibrate, the higher the frequency and the higher the pitch.

Frequency, in hertz (Hz), is the unit by which the depth of sound is measured (high or low). Hearing test frequencies range from 125 hertz (low-pitched sounds) to 8,000 hertz (high-pitched sounds).

Typical high-frequency sounds are the chirping of the birds, falling rain, or the voices of children. Examples of low frequency sounds are the growl of a tiger or the low rumble of an ocean liner. People with hearing loss most often have problems understanding the higher frequencies.

The icons on this diagram depict which sounds are heard at different frequencies:

Hearing-Loss-Audicus-Frequencies-Common-Sounds

The volume sets our perceived loudness of any given tone, and it’s measured in decibels (dB). Decibels represent the intensity, or loudness, of a sound. Zero decibels is silence, while 140 decibels is the loudness of a jet engine or firecracker.

This graph indicates the categories of hearing loss according to decibel range. Normal hearing extends from -10 decibels to 20 decibels.

Hearing-Loss-Audicus-Pitch-Hz-Decible-Range

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How do we hear?

The human ear is a fascinating organ. It detects sound and converts it into electrical impulses, which are then translated by the brain into meaningful information, such as speech or music. The ear is composed of three parts: outer ear, middle ear, and inner ear.

The Outer Ear

The outer ear consists of the auricle (also called the pinna), the ear canal, and the eardrum. The function of the outer ear is to pick up sound vibrations and send them through the ear canal to make the eardrum vibrate.

The Middle Ear

The middle ear is composed of three tiny bones called the ossicles (commonly known as hammer, anvil and stirrup) that connect the eardrum to the inner ear. The vibrations from the eardrum are amplified by these tiny bones and passed through to the inner ear.

The Inner Ear

The snail-shaped cochlea is the main component of the inner ear. Thousands of hair cells grow along the cochlear duct and convert the sound vibrations from the middle ear into electrical impulses. These impulses are sent through the auditory nerve to the brain, which perceives them as sound.

The process of hearing—from the ears picking up the sound, to the brain comprehending the converted electrical impulses—takes less than a second. Hearing loss can occur in a number of ways and they are almost all a result of a breakdown in this system.

Who gets hearing loss?

At least 48 million adults in America have hearing loss. The vast majority is due to presbycusis, or age-related hearing loss. The American Academy of Audiology estimates that one third of Americans over 60 experience this type of hearing loss. But what exactly causes hearing loss in older people? A number of changes that occur as we age can cause presbycusis, such as:

  • Changes in blood flow to the ear
  • Changes in inner ear structures
  • Impairment of the auditory nerves
  • Changes in the way the brain processes sounds
  • Damage to sensory receptors (hair cells) in the inner ear

In addition, diabetes, poor circulation, medications, high blood pressure, and smoking can also contribute to age-related hearing loss. Most people with presbycusis actually have a combination of age-related and noise-induced hearing loss. Long-term exposure to loud noises, such as noise in the workplace, is an influential factor in hearing loss.

Older people with age-related hearing loss may experience a decline in their quality of life, difficulty in maintaining relationships due to communication barriers, or, simply, frustration, as the ability to hear decreases. All these effects are serious issues that many older people deal with as they experience hearing loss. Luckily there are new technologies and methods being researched and created that aim to make life with hearing loss as easy as possible. While there is little a person can do to prevent age-related hearing loss, it is important to protect your hearing and avoid exposure to loud and prolonged noise—noise-induced hearing loss is a contributing factor in age-related hearing loss.

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Hearing loss in young people

About three out of 1,000 children born in the United States have hearing loss. These children are said to have congenital hearing loss, or hearing loss that was present at birth. Genetic factors amount to more than 50 percent of congenital hearing loss, in which genes that cause hearing loss are passed from parent to child. Prenatal infections, toxins consumed by the mother during pregnancy, prematurity, maternal diabetes and lack of oxygen can all contribute to a child being born with hearing loss.

The most common cause of non-congenital hearing loss in children is ear infections, particularly a disease called otitis media, which is an inflammation of the ear that is often accompanied by a buildup of fluid. Otitis media is the most commonly-diagnosed disease in children; 75 percent of children contract it by age three. It is caused by the small size of a baby’s Eustachian tube, which can get easily blocked. Otitis media can cause temporary or permanent hearing loss, especially in children who experience the inflammation multiple times. Meningitis, measles, chickenpox, mumps, influenza, and encephalitis can also cause hearing loss in young children.

New research from the Journal of the American Medical Association has discovered that American adolescents aged 12 to 19 have experienced increased incidences of hearing loss. Hearing loss reports for this age group have jumped from 14.9 percent in the years 1988-1994 to 19.5 percent in the years 2005-2006.

Young adults and children who experience hearing loss often face more problematic consequences than older adults, especially as they are learning to speak. Even though young children are able to use hearing aids and cochlear implants, hearing loss can greatly affect their ability to learn speech and language skills. This can cause developmental delays. If you suspect your child has hearing loss, look up warning signs and get them tested at a doctor’s office immediately.

Hearing loss in men

Men are twice as likely to sustain hearing loss compared to women, according to the National Institute on Deafness and other Communication Disorders. This applies especially to men in the age range of 20 to 69. Part of this discrepancy between men and women may be due to occupational differences, in that a higher percentage of men have jobs that expose them to excessive amounts of noise, such as construction workers or firefighters.

Non-steroidal anti-inflammatory drugs (NSAIDs), as well as acetaminophen and aspirin, may also be to blame, as these have been found to cause higher rates of hearing loss in men younger than 60. In fact, men aged 50 to 59 were 33 percent more likely to experience hearing loss than men of the same age bracket that didn’t normally use aspirin.

The ways in which men and women lose their hearing after age 80 are also different. Women initially experience low frequency hearing loss, whereas men normally experience high frequency hearing loss. This translates to men having a harder time hearing consonants and women having a harder time hearing vowels.

Women’s brains also respond to certain sounds differently when compared to men. A study from the National Institute of Child Health and Human Development found that women’s brains usually activate after hearing the sound of a baby’s cry while men’s brains remain in a resting state. However, both the brains of men and women activate when they hear the cries of autistic babies, which tend to be relatively higher-pitched.

Although men may be at an increased risk for hearing loss, women may be predisposed to conditions that result from hearing loss. For example, if hearing loss is left untreated, it may result in depression, which tends to affect more women than men.

Hearing loss worldwide

This condition affects a wide range of people regardless of their sex, age, race, or geographic location. In early 2015, the World Health Organization announced that one billion people are at risk of hearing loss. This is due in part to the increasing use of audio technology by people of all demographics.

A few steps that everyone can take to avoid hearing loss include using ear plugs during loud concerts, opting for noninvasive headphones that go over the ears rather than inside them, and taking quiet breaks in between noisy settings.

What are hearing loss causes, and how do I avoid them?

Some activities cause hearing loss more than others. Below we list a few activities that can damage your hearing. We’ve also listed the proper precautions you should take to avoid hearing loss.

Stress and Hearing Loss

High amounts of stress can be bad for your body, including your ears! Stress is a common part of day-to-day living but having increased amounts of stress can result in hearing loss, as well as headaches, irritability and digestive problems. Steps you can take to help stay relaxed include:

Get enough rest

Getting enough sleep is extremely important for a healthy body and mind. Sleep is the time during which the body repairs muscles and strengthens bones. Although children usually need more sleep than adults, it is essential at all stages of life. Fatigue weakens your ability to focus and think critically, which will eventually lead to stress in the work place.

A lack of sleep can also increase your risk for diabetes and obesity, diseases that also result in hearing loss. Get at least seven hours of sleep per night and increase the number of hours you sleep if you still find yourself waking up tired.

Take breaks during work

Be sure to take regular breaks during work. Many stress-inducing tasks that seem difficult or impossible to complete can be made less difficult if you take a short interlude and address them later on.

Individuals that work in particularly noisy environments like construction sites or subway stations are at an increased risk for hearing loss. Taking 15 minute breaks can reduce the chances of sustaining hearing damage in these work settings. Take advantage of lunch breaks and bathroom breaks to clear your head and move to a quieter place.

Avoid frequent multitasking

Have you ever thought that doing multiple assignments at the same time would help you complete tasks faster? Multitasking may actually be less efficient, making you less productive and increasing your stress levels.

Try to complete tasks one by one, rather than doing them altogether. If you find that you aren’t getting work done quickly enough, ask for help in completing tasks or find other methods to lessen your workload.

Exercise regularly

Exercise is one of the best methods for counteracting stress. Even walking for 30 minutes a day can better your mood and lower stress levels. Regular exercise like running and lifting weights can also help to maintain a normal body weight.

Obesity and diabetes are associated with hearing loss, so exercise will not only protect against stress-induced hearing loss, but might also reduce the risk of other hearing loss factors.

Communication

Many factors that cause stress can be resolved by extending communication efforts. Let your boss or coworkers know what they can do to create a more comfortable work environment. Don’t be afraid to ask questions; having extra clarity will often make assignments easier to complete.

Communicating with friends, family, and other loved ones can be a great stress reliever and also help to better relationships. These steps will help preserve your health and hearing, as well as increase your workplace productivity and quality of life.

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Smoking and hearing loss

Wait before you take a next puff from that cigarette—it might affect your hearing! The list of negative health effects of smoking is long and ugly, and it can ultimately be the harbinger of hearing loss.

One in five Americans, or roughly 20 percent of the US population, are smokers. With every draw, a plethora of toxic chemicals are ingested, such as formaldehyde, arsenic, vinyl chloride, ammonia, and hydrogen cyanide, just to name a few. Some of these substances, including nicotine, are ototoxic—they can impair your hearing, cause tinnitus, or affect your balance.

Smokers are 70 percent more likely to develop some form of hearing loss than non-smokers. Smoking combined with noise exposure is an even more explosive combination: a study among manufacturing workers exposed to steady noise environments revealed that smokers had four times higher incidences of hearing loss than their non-smoking co-workers in the same noisy line of work. Not surprisingly, the prevalence of hearing loss among smokers is directly related to the number of smoking years.

How does smoking cause hearing loss?

Smoking deposits nicotine and carbon monoxide in your body, which tighten the blood vessels, including the ones in your ears. This restricts the blood flow, and oxygen, to the inner ear. The tiny hair cells in the cochlea that are responsible for translating sound vibrations into electrical impulses for the brain can face damage as a result of asphyxiation.

Nicotine can affect the chemical messengers in the auditory nerve, damaging them so severely that they are unable to accurately relay sounds to the brain.

Another frightening consideration is the effect that smoking has on those around us. Studies have shown clear correlations between hearing loss and second-hand smoke. This is particularly troubling when it concerns children, since the auditory system is usually not fully developed until late adolescence.

Hunting

Hunting can be a challenging and entertaining sport, but using a rifle can be potentially harmful for your hearing when the proper precautions aren’t taken. Quite surprisingly, 95 percent of hunters and 38 percent of target shooters reported that they did not wear hearing protection while shooting in the past year.

Researchers from the University of Wisconsin found that men, aged 48 to 92, who regularly participated in hunting were more likely to experience high-frequency hearing loss. This risk increased by seven percent for every five years that a man had been hunting.

Hunting is a sport that comes with an inherent number of risks, including hearing loss. Steps you can take to protect your hearing are listed below.

Use a silencer

Using a gun suppressor, or a silencer, can reduce the amount of sound made by the firearm. A silencer works by stabilizing the loud propellant gases normally given off when a shot is fired. Be sure to check state regulations regarding the legal status of silencers in your hunting range.

Take long breaks between sessions

Be sure to take 15 minute breaks during hunting. The noise level involved with rifle shots can damage your ears if the exposure lasts more than 15 minutes. The resulting ear damage can make it especially difficult to communicate with teammates during hunting sessions.

Alternate between different rifles

Using a relatively low-volume rifle with a silencer on a regular basis will reduce the chances that you will suffer from hearing loss. A 7mm Magnum with a 20-inch barrel can make significantly less noise than a .375 Ruger with an 18-inch barrel and muzzle brake.

Limit shots taken

Be sure to shoot sparingly. In addition to scaring away game and wasting ammo, excessive shooting can expose you to repetitive noises that can damage the hair cells in your ears.

Always use the proper ear guard protection

Make sure to use earmuffs when operating a rifle. Hunting earmuffs come in a variety of sizes for men, women, and children. Choose the size that’s right for you, as picking a wrong size can cause ineffective shielding and unintended exposure to gunshot noise.

Alternate shooting arms

Asymmetric hearing loss can occur when one ear is exposed more frequently to loud noise than the other. This is a common condition that not only affects hunters, but can also be found in people of all ages, regardless of their physical activities.

Asymmetric hearing loss also occurs when hunters hold their rifles to one particular side of their body while hunting. One of the best methods for prevention is to alternate positions. Learning to alternate between your right and left hands can help to expose your ears to similar noise settings.

Rifles far exceed the noise level of most objects that you may encounter on a regular basis, even fireworks and jet engines. Taking the necessary precautions to guarantee safety will make your experience all the more enjoyable.

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Motorcycles

Riding bikes can be an incredibly exhilarating pastime: nothing but you and the expanse of endless open road. Motorcycles can also be risky: there are millions of crashes every year. Many riders have protective gear, but they often forget to minimize an obvious by often overlooked risk—hearing loss. Ambient wind noise can occur at levels of 100 decibels or the equivalent of average highway speeds.

Though earplugs can easily mitigate this risk, many riders eschew wearing them, citing their concern that they won’t be able to hear other more pressing noises, like approaching cars or sirens. Let’s clear up a few misconceptions about motorcycles and get on the road to protecting your hearing.

You only need to wear earplugs on a very loud bike.

Incorrect. The sound of your bike is absolutely nothing compared to the volume of wind noise, which you’re exposed to constantly and at a high-frequency. After hours on the road, it’s easy to completely forget you’re exposed to this kind of sound. Though 85-90 decibels of exposure for eight hours a day is within hearing safety limits, the safe exposure time can drop down to only 15 minutes at 115 decibels. This means that even a single trip down a long expanse of highway can cause irreparable damage to your hearing.

You won’t be able to hear traffic hazards or other important sounds while wearing earplugs.

Incorrect. By buffering your ears from high-frequency sound, like the wind, you’re able to more easily tune into important and low-frequency sounds like cars, engine RPM, and approaching sirens. If not taken seriously, constant exposure to wind noise can create a condition called temporary threshold shift in which a rider will go partially deaf. Over time, this adds up to real, permanent hearing loss.

What kind of earplugs are best?

As long as they have an attenuation level of 26-33 decibels, you should be good to go! Whether you buy them in bulk packs, or go the route of custom fit plugs (made by a doctor), you’ll be riding easy and protecting your hearing.

Some lesser known causes of hearing loss

Loud toys and hearing loss

A squeaky rubber toy or toy siren may seem harmless, but according to the American Speech-Language-Hearing Association (ASHA), they can expel sounds up to 90 decibels. This noise level is so extreme that those exposed to it at the workplace would need to protect their ears. Some noisy toys can even emit 120 decibels of sound, which can be damaging, especially to children.

The ASHA suggests that parents and guardians be wary of loud toys, including “cap guns, talking dolls, vehicles with horns and sirens, walkie-talkies, musical instruments, and toys with cranks.”

Infected ear piercings and hearing loss

It’s rare, but hearing loss due to infected ear piercings is possible. When a piercing becomes infected (typically one that is close to the ear canal), fluid can leak into the canal and the resulting blockage can cause hearing loss.

In order to avoid this, it is important to make sure a piercer is certified, and that you follow their after-care instructions.

Obesity and hearing loss

Obesity can lead to many illnesses, including diabetes and heart disease. There is a link between obesity and hearing loss in adults. Another study, published by the Laryngoscope, suggests that there is a link between obesity and hearing loss in teenagers as well.

The researchers discovered that obese teenagers had poorer hearing at all frequencies. Furthermore, teenagers who are obese are nearly twice as likely to suffer from low-frequency hearing loss in one ear.

Ototoxic medications and hearing loss

Ototoxic medications may cause hearing loss or tinnitus. A variety of drugs, including some antibiotics, diuretics, and chemotherapeutic agents can be ototoxic.

Hearing loss resulting from such a medication is typically temporary, but can be permanent. If you are experiencing hearing loss and are not sure of the cause, talk to a physician and check to see if any of the medications you are taking are potentially ototoxic.

In summary: How to avoid causes of hearing loss

Take preemptive measures to protect your ears and significantly decrease your risk for hearing loss and disorders related to hearing loss, such as dementia and depression:

  • Wear earplugs or earmuffs in extremely noisy environments. You can experience significant hearing damage when you are exposed to loud noises for an extended period of time.
  • Stay away from amplifiers during musical performances and wear earplugs or earmuffs that can insulate against the noise are good safety measures for protecting your ears.
  • Take 15-minute breaks in between loud noises. Sounds measured at 100 decibels (the same noise level as a motorcycle, jack hammer, or garbage truck) can prove to be dangerous if the exposure lasts for more than 15 minutes.
  • Maintain proper diet and exercise. Recent studies have shown that women with a BMI of 25 or higher are at an increased risk for hearing loss. Women with a BMI greater than or equal to 40 are at the greatest risk for hearing loss. Excess weight may limit blood supply to the cochlea, which is necessary for functional hearing.
  • Discriminate between different kinds of therapeutic drugs. Drugs like cisplatin and aminoglycoside antibiotics are ototoxic, meaning they can be harmful to the inner ear. Speak with your doctor about the side effects of and alternatives to ototoxic drugs.

Signs of hearing loss

One common sign of hearing loss is straining to hear the television or young children. Other common signs include:

  • Difficulty understanding words during conversation:
  • Struggling to hear others speak in quiet settings and asking people to repeat themselves multiple times may indicate hearing loss. Restaurants can be particularly difficult places for someone with hearing loss.
  • Difficulty hearing loud sounds:
  • Alarm clocks and movie theaters are designed to be loud. Difficulty waking up to an alarm or understanding movie dialogue may point to hearing loss.
  • Difficulty hearing children and people with higher-pitched voices:
  • Aging people often lose the ability to hear high frequencies first. This translates into difficulty hearing and understanding higher pitched voices like those children or people with higher-pitched voices.
  • Decrease in extroversion:
  • Hearing loss can make social interactions difficult, especially in noisy environments. Avoiding social situations or feeling isolated in groups may indicate hearing loss.

What are the different types of hearing loss?

Hearing loss can be diagnosed under three different categories.

Sensorineural hearing loss

This occurs when there is damage to the inner ear or auditory nerve. Sensorineural hearing loss is most commonly associated with aging. It’s usually permanent, but it can typically be corrected with hearing aids.

Conductive hearing loss

This occurs when sound waves cannot reach the inner ear and may be caused by earwax, fluid buildup, or a punctured eardrum. Conductive hearing loss may have treatment options besides hearing aids, such as surgery or medication. Usually, this type of hearing loss requires a visit to an ear, nose, and throat (ENT) doctor.

Mixed hearing loss

This occurs when someone experiences both sensorineural and conductive hearing loss.

Sudden hearing loss

Sudden hearing loss is a rapid loss of hearing in one or both ears over the course of less than 72 hours. Though sudden hearing loss will always occur within 72 hours, the individual’s experience will change on a case by case basis. Sudden hearing loss can develop at different frequencies, pitches, and different levels of severity. With sudden hearing loss, it is common for one ear to be primarily affected, but it is not unusual for both ears to be affected.

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Why does sudden hearing loss occur?

Sudden hearing loss is mainly attributed to infections or problems within the ear canal and/or inner ear. Meniere’s disease and traumatic, neoplastic, or metabolic issues in the inner ear have all resulted in sudden hearing loss.

Symptoms

Many people report that they lose their hearing all at once while others notice a loss of hearing over a few days. People with sudden hearing loss often notice that they can’t hear when they wake up or when they try to use the affected ear, such as when talking on the phone or listening to headphones. They might also experience tinnitus or dizziness.

Diagnosis

Sudden hearing loss is typically the diagnosis if the patient experiences a hearing loss of 30 decibels or greater. Because sudden hearing loss can be caused by many things, including infections, autoimmune diseases, circulatory disorders, injury and more, the diagnosing physician will likely order blood tests and a MRI.

Though it can happen to anyone, sudden hearing loss affects mostly adults, aged 30-60 years. People who are often exposed to loud noises are also at risk. Many people who experience sudden hearing loss have preexisting conditions, such as Meniere’s disease, otosclerosis, tumors, autoimmune disorders, and more.

Treatment

If you experience sudden hearing loss, you should seek treatment immediately. The longer treatment is delayed, the less likely it is that your hearing will be restored to normal. If a physician can identify the cause of your sudden hearing loss, they will offer appropriate treatment. When a cause cannot be identified, a physician usually prescribes steroids, either to be taken orally or via injection into the middle ear.

Can you prevent sudden hearing loss?

Currently, there are no identified preventive measures for sudden hearing loss.

Tinnitus

Tinnitus is a ringing or swishing sound in the ear or head that appears in the absence of any external sounds. Have you ever been to a loud concert? When you finally made it back to your quiet home, did you suddenly realize there was an annoying ringing sound in your ears? That’s tinnitus. In many cases, it’s a temporary form of hearing loss and it fades away after a few hours or days. However, for a lot people, it can become a permanent and serious condition. It is important to note that tinnitus is not a disease but rather a symptom of the perception of sounds.

What does tinnitus sound like?

The most common way to describe tinnitus is a ringing in the ear. People who have tinnitus describe it in varying ways, some may call it a hissing, while others may call it a roaring or screeching. There is no universal sound that can describe tinnitus, especially when it is subjective tinnitus. Tinnitus can range from mild to severe, depending on the particular person and their ears. The tinnitus sound experience may be continuous or, in some cases, intermittent, in either one or both ears. The decibel range of the sound may be low or high.

Who gets tinnitus?

More than 50 million Americans have experienced or currently experience some form of tinnitus, including adults, children, and people with other types of hearing loss. Men and older individuals tend to experience tinnitus more than other populations, though it can affect everyone. Tinnitus can vary immensely on a case-by-case basis. In some instances, tinnitus may be so mild that the person who experiences it does not need medical attention, and in other cases, it may be the opposite.

What causes tinnitus?

The pathological causes of tinnitus are still not entirely understood. When the hair cells in the cochlea become damaged, perhaps by exposure to loud sounds, information might be relayed to the brain that an externally audible sound is present when it is not. Some studies attribute tinnitus to disorders within the auditory nerve, where certain nerve cells tend to continuously be overexcited.

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Some common trends in tinnitus diagnoses are as follows:

  • Exposure to loud sounds, especially repeatedly
  • Infection or disease in the middle ear (three tiny bones or the ear drum)
  • Impairment of the hair cells due to normal hearing loss that comes with ageing
  • Excessive stress levels that affect or weaken the overall nervous system
  • Meniere’s disease
  • Certain ototoxic medications, such as Aspirin
  • Very rarely, tinnitus can be an indicator of a more serious condition, such as a brain aneurysm or nerve tumor

The U.S. Centers of Disease Control conducts research on tinnitus annually. Some of their conclusions are listed here:

  • 15 percent of all survey respondents experienced some form of tinnitus
  • 67 percent of people reporting tinnitus had regular symptoms for over a year
  • 26 percent of people reporting tinnitus had constant or near constant tinnitus
  • 30 percent of people reporting tinnitus classified their condition as a “moderate” to “very big” problem in their lives

Symptoms

The symptoms of tinnitus are best described by a ringing of the ear. This ringing is unique to every individual who experiences it. For example, you might have a small buzzing in both ears that does not bother you, or it may be an inconsistent rhythm that causes you migraines and concentration problems. In both cases, these sounds can be symptoms of tinnitus.

Diagnosis

The diagnosis of tinnitus is often brought on by the patient themselves, as subjective tinnitus is the most common type. When you start to hear ringing in the ear, you should make an appointment with an Ear Nose & Throat doctor (an ENT). Once someone arrives at the ENT doctor and explains the ringing in their ear, the following will usually take place. First, the doctor will ask specific questions about the ringing in order to better understand the severity of tinnitus that is occurring. Next, the doctor will take a look inside the ear canal to assess the current situation of the ear canal. The following test may also be done to test for Tinnitus: Head CT scan, Head MRI scan, Blood vessel studies, and a basic audiology test to test for hearing loss.

It is important to note that there is no way to objectively test for tinnitus as it is most often only truly heard by the person who experiences it. The various tests that doctors administer to gain a better understanding of the tinnitus that someone has are used as general protocol to best address the patient’s perception of their own tinnitus. Depending the patient’s symptoms of tinnitus, there may be additional tests that a medical professional will administer to gain a more comprehensive understanding of the specific case.

Subjective diagnosis

This is the most common type of tinnitus and most often reported to an ENT doctor. In cases of subjective tinnitus, only the person who has the condition can hear the noises. People with subjective tinnitus commonly describe it as a ringing, wooshing, buzzing, or roaring sound in one or both ears. Because people on the outside cannot hear the tinnitus, doctors typically take various diagnostic steps to understand the severity and frequency of the ringing.

Objective diagnosis

In cases of objective tinnitus, an outside third party may hear the noise of ringing in the subject’s ears from the outside. Though rare, objective tinnitus may be diagnosed by an ENT doctor during hearing screenings or regular appointments.

Acute and chronic tinnitus

Tinnitus may be categorized as acute or chronic based on how long the symptoms are present. Acute tinnitus usually lasts less than 90 days, while chronic tinnitus occurs for more than 365 days. The time that lies between the two is a grey area, though. Chronic tinnitus affects roughly 35 million people in the United States, and one in five people between 55 and 65 claims to have it.

Can you prevent tinnitus?

If you think you may have a continuous form of tinnitus, contact your doctor for an assessment and further directions. Currently, there is no medically proven cure for tinnitus, even though various studies have shown positive results with drugs, surgery, or neural and external sound simulators (often achieved with white noise generators).

The best way of addressing tinnitus is prevent it in the first place. This can be done by following the advice below:

  • Reduce your intake of alcohol and nerve stimulants (e.g. caffeine), as well as common but toxic substances like nicotine.
  • Be mindful of loud everyday noises from the blow dryer to the lawnmower.
  • Wear earplugs at loud concerts, clubs, or performances.
  • Take precaution if you have a noisy work environment; use earplugs or earmuffs when necessary.
  • Pay attention to nutrition; control your blood pressure and decrease your salt intake. There is a clear correlation between tinnitus and obesity, as well as related cardiovascular problems.
  • Reduce stress and anxiety levels, and get an adequate amount of rest.
  • Do not use cotton swabs to clean your ears as you can damage your eardrums and trigger tinnitus. If you feel that you have excessive ear wax buildup, consult your doctor.

Treatment for tinnitus

There are no cures for tinnitus, but there are several different treatments and therapies that help people with this type of hearing loss.

Can hearing aids help with tinnitus?

Often, people use hearing aids to help drown out the ringing associated with tinnitus. People suffering from tinnitus may also use hearing aids to make the sounds they might be missing—the noises lost because of the tinnitus—louder.

Hearing aids can also be used to mask tinnitus by directly projecting high and low sound frequencies into the ear canal to hide the tinnitus ringing. Hearing loss and tinnitus often go hand-in-hand. For example, if someone has high-frequency hearing loss, they will more likely experience high-frequency tinnitus sounds.

Will Audicus hearing aids help with tinnitus?

Yes! Audicus hearing aids are FDA-approved, programmable hearing aids. If someone has mild to severe hearing loss, Audicus hearing aids will help drown out the ringing sounds of tinnitus by making their missing frequencies heard again. Not only will Audicus hearing aids provide a mask for people who experience tinnitus, they will also help the wearer have a clearer understanding of all frequencies that they are missing. Audicus hearing aids are top-of-the-line. Our high-quality hearing aids project clear and crisp sound to help with tinnitus.

The tinnitus matchbox

A tinnitus matchbox, also known as a neuromodulator, is equipped with a set of high-pitched beeps that can help reduce the episodes of tinnitus and hearing loss. Treatment with the matchbox is supposed to down-regulate the active nerves that are normally associated with tinnitus.

Music therapy

Music therapy stimulates the ear with different frequencies to overcome the ringing of tinnitus over time. In practicing music therapy for tinnitus, most people chose to listen to classical music as it tends to maintain volume and pitch.

Music therapy was introduced by a group of German researchers who aimed to reorganize the auditory cortex to help a patient’s brain filter out the ringing sounds of tinnitus over an extended length of time. Researchers allowed subjects with tinnitus to select a piece of music which was then centered to mimic the frequency of the ringing that they were experiencing. The subjects listened to the music for approximately 12 hours a week for one year. The subjects reported an overall decrease in their symptoms of tinnitus. The study was published in the Proceedings for the National Academy of Sciences.

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Coffee’s effect on tinnitus

study from Brigham and Women’s Hospital in Boston, Massachusetts showed that coffee is strongly associated with lower rates of tinnitus. Although coffee hasn’t been shown to cure tinnitus, women who drank four and a half to six cups of coffee a day reported having tinnitus at a rate 15 percent lower than women who drank less than one and a half cups.

Medicinal gels

The intensity of tinnitus can be severely decreased with the use of a therapeutic gel along with hearing aids. The gel contains a drug called AM-101 that helps prevent the type of nerve damage that commonly results from chronic, long-term tinnitus, which affects about one percent of the population.

The gel can be administered by injection through the eardrum. Early clinical trials of the gel have been very promising, with 40 percent of patients reporting that the intensity of their tinnitus decreased by half.

Tinnitus retraining therapy

Tinnitus retraining therapy can be used to reduce the frequency of tinnitus episodes and adjust patients to their hearing loss. Specific therapies can include the use of narrowband noise, mixed band noise, and broadband noise.

The therapy works by habituating a person to the ringing sound associated with tinnitus, and it can help reduce the irritability that is so common to the condition.

Additional help for tinnitus

For those with tinnitus, there are many different therapies available. In addition to therapies, many people find that it is important to maintain a balanced diet with tinnitus. This along with keeping an active lifestyle is a commonly recommended treatment for people with tinnitus and hearing loss. Other approaches to tinnitus range from hypnosis to acupuncture.

Tinnitus can have an impact on personal and social happiness, and support groups not only help people feel less alone in their symptoms but also hear about new types of therapy. Tinnitus support groups are also one of the best ways to share and discuss the frustrating sounds and emotions that typically come with tinnitus.

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Is everyone’s hearing loss different?

In short, yes. As is the case with eyesight, everyone’s hearing is different and can degenerate at different times in life. To give a better description of this, Beth Connolly, a young professional living in New York City, shared her story about how she discovered she had hearing loss as a teenager:

“People have asked, but it is difficult for me to exactly pinpoint when my hearing loss began. I know that as a child, I was often in my own world, intensely focused on playing or studying alone, undisturbed by others and unresponsive to them even when they called out my name. Of course, I am an only child, so I grew up learning to entertain myself.

I remember in middle school, those important bonding moments, whispered conversations in study halls or hallways or sleepover parties, seemed to exclude me, in effect. Not being able to understand the information passed along in hushed tones, I could not contribute to them. Whispered asides in movie theaters proved disruptive to everyone, taking attention from the screen to my asking, “What? I can’t hear you.”

In high school, I dropped out of choir and other singing groups, though I had loved singing as a child. I found it impossible to blend my voice with those singing around me, because I could not hear the notes they sang. Time after time, I had to endure the humiliation of hearing my music teacher single out first the Alto section, and then just the first row, and then just me to determine that I was the cause of discord. Gradually, I learned to move my lips in time with the conductor without actually venturing to sing in order to avoid the embarrassment of being called out in front of all my friends and classmates. Thankfully, though, I was surrounded by peers who never really bullied me over my hearing loss.

Unfortunately, it wasn’t until years later that I realized the true cause of my loss of singing ability.

In high school, I believe I was considered too slow socially, and always ‘out of it,’ though I was consistently at the top of my class academically. My friends grew accustomed to the fact that I wouldn’t ‘catch on’ very quickly to their rapid fire dialogue of inside jokes and asides. I was also quite sheltered and innocent, relatively ignorant of popular culture and R-rated concepts, which added to my confusion. Throughout my adolescence, it was a common occurrence that someone would have to tap me in order to get my attention, even though they’d been calling out my name for minutes. This contributed to the perception that I didn’t really pay attention to other people, or that I ignored people I didn’t want to talk to when they said hi to me.

Despite those signs, which seem in retrospect to be rather significant indicators of hearing loss, I had no inkling of the situation until my second year of college. Of course, people commonly joked, ‘You should have your hearing checked,’ ‘Clean your ears,’ and the favorite, when I’d asked them to repeat themselves multiple times, ‘Are you, like, deaf or something?’ I never took the ribbing to heart. I had my vision checked every year at my annual physical, but not my hearing.

When my friends and classmates heard the news that I was diagnosed with hearing loss, they were not surprised. ‘Everything makes so much more sense now,’ was the general response. Before hearing the news, they just thought I was always spaced out, on another planet, or too sleep-deprived to figure out what was going on around me. Ironically, if smartphones existed when I was a teenager, I believe my ‘spaced-out’ state would have been far more acceptable to my peers. Who really focuses on a real-time face-to-face conversation today, when they have their phones out at the ready to stay up to date on the latest texts, emails, and tweets?”

—By Beth Connolly