Decoding the Spectrum: Navigating Your Hearing Challenges

Diseases and disorders of the ear come in all shapes and sizes, degrees, and stages. While the most common cause of hearing loss and tinnitus is aging, the truth is, it is not your age, rather it is your genes. Most of us will inevitably suffer with hearing loss as we get older, not because of working in noise or going to too many rock concerts (not that they make matters any better!), rather most species of mammals (including us) carry genes coded for age-related hearing loss. Presbycusis is the official medical jargon used by specialists when diagnosing this type of hearing loss.

The next most common cause of hearing loss is exposure to loud noises. Unfortunately, proper hearing health is not a common topic in most ‘health classes’, therefore the public has no idea how noisy and how harmful most of our surroundings are. Another misnomer of hearing loss is that a ‘hearing hangover’ (i.e., when you go to a loud concert and your ears ring!) is something we can rebound from. Most scientists and clinicians once believed that this temporary ringing in the ears was something you could recover from and go right back to hearing normally. This is not true.

In the past 10-15 years, study after study has proven, repeatedly, that these ‘hearing hangovers’ have a permanent effect on the auditory system and cause massive damage that cannot be recovered or healed. You might be saying to yourself ‘is this for real…. my hearing was back to normal 2 days after that last wedding I went to.’ The facts are that the damage was real, but the damage will not manifest itself in the form of detectable hearing loss for up to 2-3 decades (20-30 years!). Hopefully, this has your attention now as you think back to all those loud restaurants you went to, the factory you worked in for 6 months, all the times you weed-wacked the lawn, and that rock band you were in when you were a teenager. When you combine your history of noise exposure (both big and small) plus your genetic predisposition to hearing loss as you age… you may have a perfect storm brewing that creates disabling hearing loss and tinnitus.

Rounding out the next most common forms of hearing loss and tinnitus are medication-induced, Meniere’s Disease and sudden-onset. While most prescription drugs that impact the ears are necessary and lifesaving/prolonging, many prescriptions have a side-effect of damaging cells in the ear (technically it is called ototoxicity—meaning it is toxic to the ear). Strong antibiotics such as Ciprofloxacin can be damaging to the ear. Many chemotherapies used for the treatment of cancers have a component that is deadly to the cells in the ear. Even commonly available OTC drugs such as Aspirin and NSAIDS can increase the likelihood of developing hearing loss and tinnitus. And too much quinine (found in tonic water) can damage the ears too!

One of the most disabling causes of hearing loss, which presents with the triad of symptoms, i.e., hearing loss, tinnitus, and dizziness, is Meniere’s Disease. The cause (or pathophysiology) of this disorder is the result of excess fluid trapped inside the inner ear. The overload of fluid will impact both the auditory and balance centers and send misguided information to the brain, rendering the patient deprived of sound input and the feeling of dizziness.

Currently there is no cure for Meniere’s, but there are effective treatments available to alleviate the hearing loss and balance issues. Treatments include the following:

Medical Treatment of Hearing Loss and Tinnitus. With advanced treatment technology, cognitive stimulation can restore sound, reduce the ringing, and provide auditory awareness to reduce the risk of falling.
Medications. The most disabling symptom of Meniere’s Disease ‘attack’ is dizziness. Prescription drugs are available to relieve dizziness and shorten the attack.
Salt Restriction and Diuretics. Limiting salt intake and use of diuretics (water pills) help some people control dizziness by reducing the amount of fluid the body retains, which may help lower fluid volume and pressure in the inner ear.
Nutritional & Dietary Changes. Some people report that caffeine, chocolate, and alcohol make their symptoms worse and either avoid or limit them in their diet. Not smoking may also help reduce the symptoms.

For most people who suffer with the instantaneous, life-altering experience of sudden-onset hearing loss, the inability to hear out of one or both ears is a crushing blow. Many times, the diagnosis of this sudden-onset hearing loss and tinnitus includes the medical term ‘idiopathic’, which is the nice way of saying ‘we have no idea why you woke up one day with this terrible hearing loss’. The most important advice for somebody who experiences a sudden change in hearing is to seek out the immediate assistance of a hearing healthcare specialist. It is possible, although not guaranteed, that immediate pharmaceutical intervention can recover some or all hearing.

For the most up-to-date information regarding hearing loss, please visit www.excellenceinaudiology.org.