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“НАШЕ ЖИТТЯ”, ЛИСТОПАД 2014 WWW.UNWLA.ORG 33 ARE YOU LISTENING? by Ihor Magun, MD, FACP We will be literally “hearing” more about hearing loss as technology keeps providing devic- es that contribute to the problem. I am certain that many of you have listened to the music blar- ing "outside" the headphones of someone sitting next to you. Loud noises from such devices cause approximately half of all the cases of hearing loss. Although noise damage is usually cumula- tive, these types of louder sounds also produce damage in shorter periods of time. Many of us are unaware of environmental sounds that are char- acterized as injurious to our hearing, but their sources include the aforementioned headphones, stereos, transportation areas such as subways and train stations, and even our own hair dryers. Hearing occurs by air and bone conduc- tion. In air conduction, sound passes through the ear canal and causes a movement which stimu- lates the auditory nerve in the brain. Hearing by bone conduction occurs when the base of the skull vibrates. This vibration is subsequently transmit- ted to the inner ear. Damage to any part of this complex auditory system could result in a deficit in one’s ability to perceive sound. Any number of sources could be culprits of this damage: loud noises, trauma, misuse of medications, aging (also referred to as presbycusis), some form of obstruc- tion such as wax, or a number of other medical reasons which are beyond the scope of this article. The National Institute on Deafness and Disorders has found that the vast majority of in- dividuals over the age of fifty already have a hear- ing issue and are not addressing the problem. This may be because the symptoms of hearing loss are subtle: for instance, sufferers often blame their inability to hear speech on people’s failure to enunciate properly instead of understanding and openly admitting that they cannot hear. In addition, recent epidemiological stud- ies have shown that individuals with various hear- ing loss issues may have a greater risk of develop- ing dementia from social isolation, an increased cognitive load, and the loss of cortical processing, or the brain’s ability to process auditory infor- mation. Studies are still inconclusive, but these hypotheses seem reasonable. One should also mention that younger age groups are quickly join- ing the ranks of the elderly with hearing prob- lems. Some medications can irreversibly dam- age the ear, but fortunately, they are only administered intrave- nously and monitored in a hospital setting. Other medications’ nega- tive effects on hearing are reversi- ble: these drugs include certain types of water pills (diuretics), aspirin, and non-steroidal anti- inflammatory medications such as ibuprofen. For instance, a recent study has shown that the inges- tion of ibuprofen more than six times per week can cause a reversible hearing loss, and this loss seems to be greater in women than men. If you have no hearing loss issues and need to regularly take any of these medications on the instructions of a physician, do not change your regimen. Just keep this information in mind should issues arise, and please remember that just because a medication is available over the counter does not mean that there is no restriction in dosing regimens. So what are the recommendations in cases of hearing loss? Undergoing an audiological exam is a good start. Not everyone will need to wear a hearing device, but, of course, in some cases, such a device will be helpful. Cochlear implants, which are electronic devices implanted directly into the cochlear nerve for stimulation, can improve hear- ing for some individuals and eliminate the need for a more conventional hearing aid. If your hearing does require an electronic hearing device, avoid purchasing devices from websites and certain disreputable locations be- cause they are not helpful. Conversely, devices provided by a reputable audiologist or physician can make a big difference. Indeed, the use of hearing devices requires cooperation with profes- sionals, feedback to maximize their benefits, and patience. Although most aids are expensive and are not covered by insurance plans, many indi- viduals with hearing difficulties are very pleased with their devices, and feel that the monetary in- vestment, in the long run, is money well spent. (Of note, many custom-made devices are provid- ed on a trial basis for several months. If your free trial does not work out, a reputable audiologist will take back the instrument, minus a reasonable fee). Alas, no hearing aid or any other treat- ment can fully restore normal hearing. Thus, im- plementation of strategies to prevent hearing loss is imperative. We should be cognizant of the fact that this new, silent (but loud) epidemic is pre- sent in all age groups. Let us all be more aware of our hearing. This is definitely the kind of advice that you need to heed before it is too late.
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