Hearing loss is one of the most common reasons for in-office consultations with an Ear, Noise & Throat specialist. A conductive hearing loss can result from any process that prevents transmission of sounds waves through the outer ear (canal) or middle ear. This includes impaction of the ear canal with ear wax, dead skin or foreign material, and fluid or other disease in the middle ear, interfering with ear drum or middle ear bone vibration. A sensorineural (or “nerve deafness”-type) hearing loss is present when there is a loss of function of the inner ear, nerve from the inner ear, or association areas of the brain that ultimately perceive sound. These main types of hearing loss can be accurately diagnosed after the performance of a complete Ear, Nose & Throat examination and a comprehensive hearing test (audiogram), although additional forms of testing may be required.
Subjective tinnitus is a sound perceived by a patient that only the patient can hear. Tinnitus is most often high pitched, but can also have almost any quality, including humming, whining, hissing, chirping, and roaring. The physiology of tinnitus is not completely understood, but frequently is an additional manifestation of a sensorineural hearing loss (“nerve deafness”-type loss). Many clinicians believe the sound comes from malfunctioning of the hair cells of the inner ear, but could also represent a “phantom” sound arising from the auditory nerve or auditory areas of the brain, similar to phantom sensations perceived by amputees. Treatment of tinnitus can be as simple as masking the sound with white noise at night, by using a fan, radio or white noise generator. For patients with substantial enough hearing loss to justify hearing aids, the added stimulation afforded by the aids has been shown to reduce tinnitus, even after removal of the aids (up to 2 weeks). The latest generation of hearing aids have included the option to incorporate sound therapy technology to further extinguish tinnitus. Other treatments can include biofeedback training or antidepressant medication to treat the emotional effect of the tinnitus on selected patients.
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