Hearing Loss

More than 50 million Americans experience some type of hearing loss, yet only 1 in 5 uses a hearing device. Hearing loss becomes increasingly common with age, although growing older isn’t the only reason that people experience a loss in hearing.

The audiology team at The University of Kansas Health System specializes in treating all types of hearing loss. As an academic medical center, we can connect you with the latest treatment options through clinical trials. With the right support, your hearing loss doesn’t need to limit your daily life.

Sensorineural hearing loss, or nerve deafness, is among the most common afflictions of the ear causing hearing loss. Nerve deafness is a bit of a misleading name, as doctors are frequently unable to tell whether the hearing loss is due to nerve disorder or sensory cell disorder.

The damage in nerve deafness is actually either in the nerve leading to the brain itself or the cells deep within the inner ear. In most cases, doctors are not able to tell which element is damaged, which is why we use the term sensorineural hearing loss, or SNHL.

SNHL, particularly the age-related variant, is one of the most common types of hearing loss in adults. It often develops between the ages of 50 and 70. The different types of SNHL are grouped according to whether one or both ears are affected, hearing loss progression and severity and if a specific part of the inner ear is affected.

Hearing loss doctors categorize loss of hearing into 3 types:

SNHL and conductive hearing loss also affect an estimated 3 million children under the age of 18.

SNHL is permanent. Half of all cases result from genetic factors. The other half may be caused by infection, such as meningitis or congenital cytomegalovirus, head trauma, noise trauma, anatomic abnormalities or certain medications. Sometimes, we are not able to identify a cause.

If your child has conductive hearing loss, this is usually temporary and caused by fluid in the middle ear or an abnormality of the eardrum or hearing bones.

Symptoms of pediatric hearing loss include:

• Speech and language delay
• Not babbling, or babbling has stopped
• By age 1 does not understand simple phrases such as wave bye-bye or clap hands
• By age 2 should know 50 words and put 2 words together
• Not turning head in direction of sound
• Difficulties in school

The earlier we diagnose hearing loss the sooner we can discuss appropriate treatment and implement a plan to help your child hear and speak as well as possible. With temporary hearing loss, we can often correct the problem by simply removing earwax, placing ear tubes or other medical treatment. For permanent hearing loss, we may recommend hearing aids, bone anchored hearing aids, assistive listening devices and/or cochlear implants, depending on the type and severity of hearing loss.

Another type of SNHL hearing loss is autoimmune inner ear disease (AIED). AIED is an inflammatory condition caused by an uncontrolled immune system response that attacks the inner ear. It causes progressive SNHL that usually starts in one ear and then affects the other ear.

Early detection of AIED and prompt steroid treatment may help reverse your SNHL. If your doctor suspects that you may have AIED, you may respond well to medical therapy – steroid and immunosuppressive medication – if started early.

Corticosteroid is the main treatment to suppress the immune response to reduce inner ear swelling and inflammation. If you cannot tolerate steroid treatment, there are alternative medications, such as cyclophosphamide, methotrexate, azathioprine and rituximab.

AIED is rare and diagnosed only when all other causes have been ruled out. The estimated prevalence of AIED is about 15 out of 100,000 people. AIED is believed to be responsible for less than 1% of all SNHL cases.

Symptoms of hearing loss include:

• Misunderstanding conversation
• Needing to ask people to repeat words
• Poor hearing performance in noisy backgrounds
• Poor speech clarity or the perception of mumbling by others
• Turning the TV on too loud for others

These symptoms arise based on the type of hearing loss present. Typically, those with hearing loss hear worst in the high-frequency (treble) end of hearing while the low-frequency hearing is normal or nearly so. In English, the vowels (A,E,I,O,U) are low-frequency sounds while the consonants, the main information, are high-frequency sounds.

In normal conversation, a person with standard nerve hearing loss will only get part of each word, missing the consonants that contain the information. To the affected person, normal speech sounds muffled or like the speaker is mumbling.

There is also a problem with loudness of sounds such that the range of comfortable listening from just barely hearing to painfully loud is contracted. Merely raising voice volume may not help much at all, as the sound quickly becomes so loud as to produce pain.

Individuals experiencing this kind of hearing loss also frequently have problems with the portion of the brain (and/or ear) that translates sounds heard into language.

The hearing level and discrimination of sounds as well as other aspects of hearing are measured when you have a hearing test.

Taking a hearing test is the simplest way doctors can diagnose hearing loss. During a hearing test, doctors will check your hearing response to:

• Different noise environments
• High and low pitches
• Soft and loud volume
• Speech and word recognition
• Tuning fork tests

Your hearing loss doctors may also check your ear drum movement and your middle ear muscle reflex (MEMR) response to loud sounds.

Nerve deafness is treated with hearing aids if it causes problems with social interactions. The type of interactions will influence the type of hearing aids required. For example, the type of hearing aid would differ for a public speaker as compared to a person who mainly interacts in small groups.

Whatever type of hearing aid is selected, it is designed specifically for the type and degree of hearing loss present, much like a pair of eyeglasses. The fitting is done by an audiologist, a professional with graduate school training and specific education dealing with hearing aids. At The University of Kansas Health System, our audiologists are licensed by the state of Kansas and certified by the American Speech and Hearing Association.

The University of Kansas Health System in Kansas City is a world-class academic medical center and destination for complex care and diagnosis. We offer more options for patients with serious conditions because of our expertise and leadership in medical research and education. Our audiologists have experience you can trust to provide the right treatment for your audiological condition. All of our audiologists have earned a doctorate in audiology – so you can be assured of receiving the latest, leading-edge care, treatment and devices. In addition, our ENT experts are regularly recognized as Top Doctors by 435 Magazine. They maintain leadership positions with leading professional organizations across the country.

Together, we help people of all ages improve their quality of life and overcome the consequences of hearing loss, tinnitus and dizziness.