Deafness is term used to describe complete or partial loss or absence of the ability to hear.
There are three major types of deafness
Conductive deafness is caused by a defect in the outer or middle ear, which prevents normal transmission of sound. It may be present at birth as the result of an inherited defect, an abnormality in development, or an infection of the fetus in the womb. It may be produced by an injury that perforates the eardrum or that breaks up the linkage of three tiny bones—hammer, anvil, and stirrup—that normally transmit sound from the eardrum through the middle ear to the inner ear. Inflammation of the middle ear, a condition known as otitis media, is another important cause of conductive deafness. Infection from an upper respiratory tract ailment, such as strep throat or the flu, can produce a buildup of pus in the middle ear so great that it ruptures the eardrum. Also, a plugged eustachian tube (the tube leading from the back of the throat to the ear) mat trap fluid in the middle ear, creating temporary deafness. Conductive deafness in the middle and later years is most often caused by otosclerosis. In this inherited condition, new spongy bone grows over the stirrup bone, preventing it from vibrating when sound travels to it through the hammer and anvil bones.
Sensorineural deafness is a type of hearing loss that occurs because of damage to the structures of the inner ear, to the auditory nerve carrying sound messages to the brain, or the hearing center of the brain itself, located in the temporal lobe. It may be due to a head injury during birth, the effects of a woman’s rubella infection on her unborn baby, a skull fracture affecting the inner ear or the auditory nerve, fever, bacterial or viral infections (such as mumps or meningitis), tertiary (final stage) syphilis, Meniere’s disease, tumors, multiple sclerosis, a hemorrhage or blood clot in the inner ear, drug side effect, normal aging, prolonged or repeated exposure to intense noise, or edema(fluid buildup) caused by a thyroid deficiency. Most sensorineural deafness is not nerve deafness, the popular term for it. It is usually sensory deafness, caused by defects in the structure of the inner ear, especially in the cochlea and its organ of Corti. The cochlea contains sensory cells that convert sound waves into electrical impulses, which are transmitted via the auditory nerve to the brain.
Mixed deafness is a relatively common condition. It is a combination of conductive and sensorineural deafness.
People with pure conductive deafness simply need louder volume to hear all sounds. Those with defects in the inner ear usually can hear low-pitched sounds more easily than high-pitched sounds, and some sounds may be distorted. When there is damage to the hearing center in the brain, the person may be able to hear sounds, but has trouble recognizing them and understanding words (this problem can also occur with the other types of deafness).
When hearing loss is suspected, a complete examination of the ears, nose, an throat is necessary to identify infections or abnormalities that may be present. Infections of the adenoids or tonsils, as well as sinus of nasal infections, may be linked to ear infections.
Testing of hearing is important for all ages, but especially for infants. Many times, partial deafness in a baby is not discovered until the child fails to learn to talk, a direct result of the hearing loss. Babies who were born prematurely or ill or whose mothers had certain viral infections, such as rubella, during pregnancy are in special need of testing.
Although inborn hearing defects usually cannot be corrected, deaf children can be helped to deal with their handicap. Starting very early, they can be fitted with hearing aids and can be instructed in lipreading, speaking, and sign language.
Surgery to correct conductive hearing loss includes operations to replace the stirrup bone or all three tiny bones with tissue or synthetic material, to repair a punctured eardrum, and to clean a chronically infected middle ear.
A hearing aid can often help to restore hearing. However, one should be purchased only after thorough testing by a specialist in audiometry, who can suggest the most appropriate type. Classes in lipreading and listening can also be helpful.
It is far easier to prevent deafness than to cure it. Antibiotics have made it possible to eradicate most of the middle ear infections that have been the major source of conductive hearing loss in children. Middle ear problems are also sometimes eliminated by treating allergies that cause the eustachian tubes to close up or by removing infected adenoids. Nerve deafness caused by continued exposure to intense industrial noise, gun shots, rock music, or aircraft engines may be avoided by wearing earplugs or other ear protectors. Some lost hearing may return after several months of relief form intense sound. Medications that can cause hearing loss, including some antibiotics and certain diuretics (drugs that stimulate the production of urine), need to be used with caution, and signs of hearing loss should be brought to a doctor’s attention as soon as they are noticed.
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(Chasnoff, Ira J, Jeffrey W. Ellis, Zachary S. Fainman. Family Medical & Health Guide .Publications International, LTD (1991) : 139-141)
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