Management of Hearing Loss

The first step in treating hearing loss is an accurate diagnosis – finding out exactly what’s causing the hearing loss. When a specific cause is found, treatment options can include:
Ear wax: It can be removed by flushing the canal with water, using suction, or using forceps. This is done by an ear doctor {advice on doing it on your own?}
Cerumen (earwax) in the canal is removed by flushing the canal or scooping out the wax with special instruments. If the wax is too hard to remove, the doctor may prescribe softening drops (also available over-the-counter) and have you return in a week to try to remove it again. {To be under supervision?}

If infection is found, antibiotics will most likely be prescribed. Middle ear infections usually require pills, while infections of the ear canal can usually be treated with eardrops. Perforated ear drum, long standing ear infection, fixation of middle ear bones may need ear surgery.These decisions are made by the ENT doctor.

Virtually no condition in medicine can have as profound an effect on quality of life as even moderate hearing loss in some people.

Hearing loss makes even routine communication difficult. High frequency hearing loss (insert simple definition in bracket) often involves loss of ability to hear consonants such as s, f, t, and z, even though vowels can be heard normally. Consequently, people hear some parts of speech but cannot make out what is being said.

This may result in frustration, withdrawal from social activities, depression, and marital discord. People lose the ability to catch environmental sounds like bird songs, rustling of leaves and the voices of children. In general, these infringements on the quality of life can be overcome through medical or surgical treatment or with hearing aids.

Any one who has a significant hearing loss can now be fitted with the hearing aid to suit his needs. A child from the age of as young as three months to a 100 yrs old can be fitted with a hearing aid. Audiogram is the key to decide who has to be fitted with the hearing aid and in which ear or both the ears.

Care and maintenance of hearing aids

When you remove the hearing aids at night, the first thing you should do is carefully clean them with a dry soft cloth. Next, check the portion of the hearing aid that fits in the ear canal. If you see earwax accumulating at the end of the aid, remove this. Most manufacturers will provide you with a cleaning tool, which may be in the form of a brush, wire pick or combination of both. Carefully, remove the wax. Using the brush provided for you, carefully brush around the plastic tube to clear the wax. Finally, open the battery door and place the hearing aids in their case. Many hearing aids have an independent on/off switch. It is still advisable to open the battery door to allow air to enter the hearing aid and assist in reducing the effects of moisture that may accumulate when the aids are in the ear canal. It also helps to prolong battery life.

Those who use molds may wash the earmold with a mild soap and water. Actually disconnect the earmold from the hearing and place in a soapy bath for a few minutes. Make sure the earmold is dry and pay special attention to the earmold tubing to be sure no water is trapped. If it is, simply blow on the end of the tubing to clear the water before reattaching the earmold to the hearing aid. Remember to have the tubing replaced every 3-6 months, as it begins to loose its flexibility.As the tubing gets harder and harder the acoustic properties of amplified sound changes. Sound may become weaker and weaker. Do not use solvents or alcohol on the hearing aids as there is a possibility that they can breakdown the hearing aid.

Don’t allow the hearing aid to become wet. Avoid showering, bathing, or going into the swimming pool with the hearing aids in your ears.

Don’t place the hearing aids in direct heat. To dry the hearing aid, simply open the battery door and allow it to dry out on its own or hold a hair dryer 18 to 24 inches from the hearing aid and direct warm air toward the aid for approximately 5-10 minutes. There are also special dehumidifiers that do a wonderful job in drying out the hearing aid. Talk to your hearing health care professional about these items.

Don’t drop the hearing aid. If the hearing aid falls on a carpet, it usually will not cause the aid any harm. Hard floored surfaces have the potential of damaging the hearing instruments. Many individuals would prefer a pillow on their laps while they are learning to insert the hearing aids in their ears. The wax can clog the microphone or receiver of the hearing aid and thereby block sound to the ear. A large accumulation of earwax can also cause the hearing aid to start whistling. The amplified signal from the hearing aid bounces off the wax and back to the hearing aid where it is reamplified and causes the whistling. Hearing care professional should examine your hearing aids and check the ear canals for wax at least every 6 months.

What is Cochlear Implant? Who is a candidate? What is the management of Cochlear Implant?

For some who can’t hear or understand words even with the help of hearing aids, there is a device called a cochlear implant. This is a very tiny piece of electronic equipment that is put into the cochlea(inner ear) during an operation. It takes over the job of the damaged or destroyed hair cells in the cochlea by turning sounds into electrical signals that stimulate the hearing nerve directly.

Any person who has severe to profound hearing loss and not benefiting with a hearing aid can be fitted with a cochlear implant. The candidacy has to be carefully assessed a series of tests would decide about the candidacy. A candidate for implant has to undergo Audiometry test, impedance test, if required ABR and OAE tests, Aided & unaided responses have to be obtained before deciding upon the candidacy. It is extremely important to demonstrate that an individual is not benefitting with amplification. And lastly a CT and MRI to confirm that the cochlea is well formed and there is ample space for the implant to fit in.

Usually children with congenital hearing loss are thought to be the best candidates for cochlear implant. With an implant the speech & language development would be appropriate and much faster if implanted at the earliest. Post implant a child with hearing loss may attend a regular school or a special school, and/or special classes within a regular school.The key factor is child with cochlear implant should receive a structured aural rehabilitation or habilitation program. Ultimately normal speech and language development would be everybody’s dream.

Cochlear implant can be considered for individuals who have developed profound hearing loss at later stage of life. Cochlear implant has no age limit, even senior citizens can think about cochlear implant. These individuals receive significant benefit with cochlear implant. It is certainly a good investment to enjoy sounds of life.


  • Partial hearing loss in children and speech and language disorders

Children learn speech and language from listening to other people talk. The first few years of life are especially critical for this development. If a hearing loss exists, a child does not get the full benefit of language learning experiences.

A partial hearing loss is hard to identify. Therefore, weeks and even months can go by before parents suspect a problem. During this time, the child may miss out on some of the information that can influence speech and language development.

  • How can I tell if my child might have partial hearing loss?

Even if there are no identifiable signs, there are other signs you can look for that may indicate partial hearing loss:

  1. Inattentiveness
  2. Wanting the television or radio louder than usual
  3. Misunderstanding directions
  4. Unexplained irritability
  5. Inappropriate response for questions asked.
  6. Language delay and misarticulation
  7. Avoidance to attend telephone conversation
  • What should I do if I think that partial hearing loss is causing a hearing, speech, or language problem?

If hearing loss is secondary to ear infections then it might require immediate attention, most likely from a pediatrician or otolaryngologist (ear doctor). If your child has hearing loss, two additional specialists should be consulted: an audiologist and a speech-language pathologist.

An audiologist’s evaluation will assess the severity of any hearing impairment, even in a very young or uncooperative child, and will indicate if hearing loss is present.

A speech-language pathologist measures your child’s specific speech and language skills and can recommend and/or provide remedial programs when they are needed.

  • Will my physician refer my child for these special evaluations?

As a parent, you are the best person to look for signs that suggest poor hearing. “Any child whose parent expresses concern about whether the child hears should be considered for behavioral audiometry without delay”.

Signs of partial deafness can be easier to spot at home where child is most comfortable and spends maximum time with parents .. Nevertheless, when any of the following signs are repeatedly noticed, it should alert parents that there may be an undiagnosed hearing problem: Tilting head when trying to listen

  • Difficulty hearing some sounds but not others (hearing loss at different pitches or in only one ear)

Not startled for any sudden, loud noise.
Not responding for name call.
Presence of other individuals not acknowledged until within sight range
Delayed, garbled speech
Asks for instructions to be repeated
Prefers to work alone, withdrawn behavior
Prefers face reading when listening to others
Children who are hard of hearing will have to grow to become productive, content members of society. To help them achieve this goal, parents must identify hearing problems early by paying close attention to symptoms of hearing loss in the youngsters they care for. Early intervention is the key to providing hard of hearing children with the help and developmental support they require for success.