BMN Blog

MAY 25

Hearing loss is a common problem. 15% of American adults aged 18 and over report trouble hearing. Over the age of 65, one third of the population has significant hearing loss. Most people with Hearing Impairment suffer some social, psychological and physical problems. Social consequences of hearing loss include reduced social activity and problems communicating with family and at work.  Particularly in the elderly Hearing Loss can be isolating.

            There are two types of hearing loss: Sensorineural (SNHL) and Conductive.  Conductive hearing loss occurs when there is obstruction or damage to the outer ear or middle ear that prevents sound from being conducted to the inner ear. Common examples of Conductive hearing loss are ear wax, middle ear infections, or Tympanic Membrane perforations. Conductive hearing loss can be treated and largely rectified. 

            Sensorineural hearing loss is however much more common (particularly in Adults).  It is a permanent hearing loss that occurs when there is damage to the Cochlear nerve cells in the inner ear. The most common causes of Sensorineural Hearing loss in adults are Aging and Noise (though there are a number of other causes).  SNHL can only rarely be treated medically. Treatment is most often with Hearing Aids or Cochlear Implants.  However use of hearing aids is not as common as we should hope. Among adults 70 and older with significant hearing loss, fewer than one in three use them.  Hearing aids have historically not been covered by Medical Insurance policies, leading in large part to their relatively low acceptance rate.

            Cochlear implants are indicated in patients with a severe Bilateral hearing loss (>80%). These patients cannot understand spoken conversation and are unable to use the phone.  A Cochlear Implant is a surgically implanted device that bypasses the normal hearing process. The CI has a microphone and some electronics that reside behind the ear; this external processor transmits signals to the internal device which sends signals to the electrode placed into the Cochlea, directly electrically stimulating the Cochlear nerve. Hearing results are generally good with over 2/3rds of patients being able to use the phone. Cochlear implants have historically been placed in one ear only; more recently patients have had both ears implanted with even better hearing results. As of December 2012, approximately 324,200 cochlear implants have been implanted worldwide. In the United States, roughly 58,000 devices have been implanted in adults and 38,000 in children.

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