HEARING LOSS

• Loss of the ability to hear sound frequencies in the normal range of hearing is called hearing impairment
• Frequencies capable of being heard by humans are called audio or sonic. The range is typically considered to be between 20 Hz and 20,000 Hz (Hertz)

Types

• Conductive hearing loss– Results from any disruption in the passage of sound from the external ear to the oval window. It can be caused by pathologies involving the external and middle ear (external auditory meatus, tympanic membrane, ossicular chain)
• Sensorineural hearing loss- Results from disruption of the passage of sound beyond the oval window. Such pathologies can be located to the auditory receptor cells of the cochlea and the eighth cranial nerve
• Mixed hearing loss – Represents a mixture of both conductive and sensorineural hearing loss

Classification

• Normal Hearing -10 to 15 dBHL
• Slight Hearing Loss-16 to 25 dBHL
• Mild Hearing Loss-26 to 45 dBHL
• Moderate Hearing Loss-46 to 55 dBHL
• Moderately-severe Hearing Loss- 56 to 70 dBHL
• Severe Hearing Loss-71 to 90 dBHL
• Profound Hearing Loss-91 and more dBHL

Congenital hearing loss

• Genetic factors
• Non-genetic factors
  • Maternal infections during pregnancy, such as rubella (German measles), Cytomegalovirus, or herpes simplex virus
• Prematurity
• Low birth weight
• Cranio-facial abnormalities
• Birth injuries
• Toxins including certain drugs and alcohol consumed by the mother during pregnancy
• Complications associated with severe jaundice in the newborn baby often due to maternal- foetal blood type incompatibility
• Maternal diabetes
• Lack of oxygen (anoxia)

Conductive hearing loss

• Fluid in the middle ear from colds or allergies
• Ear infection (otitis media)
• Poor eustachian tube function
• Hole in the eardrum
• Too much earwax (cerumen)
• Swimmer’s ear (external otitis)
• Foreign body in the ear canal
• Malformation of the outer ear, ear canal, or middle ear

Sensorineural Hearing Loss(SNHL)

• Drugs that are toxic to hearing
• Hearing loss that runs in the family (genetic or hereditary)
• Aging
• Head trauma
• Malformation of the inner ear
• Exposure to loud noise

• Difficulty following verbal directions
• Difficulty with oral expression
• Difficulties with social/emotional or interpersonal skills
• Language delay
• Often follows and rarely leads
• Will usually exhibit some form of articulation difficulty

• Inspection of the external ear - Note for deformity, scars from previous surgery, infections or skin problems
• Otoscopy
• Pneumatic otoscopy or the Valsalva manoeuvre – to assess the tympanic membrane mobility

New borns and Infants Diagnosis

• Oto Acoustic Emissions (OAE) and Auditory Brainstem Response (ABR) - detect hearing loss averaging 30 to 40 decibels (dB) or more in the frequency region important for speech recognition
• Oto Acoustic Emissions (OAEs- can detect blockage in the outer ear canal, as well as the presence of middle ear fluid and damage to the outer hair cells in the cochlea

• Children and Adult - pure-tone audiometer in children aged over four years
• Tympanometry - diagnostic of certain middle ear pathologies

Tuning fork tests-

Rinne

Normal- AC >BC(Rinne positive)

• Conductive deafness- BC>AC(Rinne negative)
• SN deafness- AC > BC

Weber

• Normal- Not lateralized
• Conductive deafness- Lateralized to poorer ear
• SN deafness- Lateralized to better ear

Absolute bone conduction (ABC) test

• Normal- Same as examiner’s
• Conductive deafness- Same as examiner’s
• SN deafness- Reduced

Prevention Measures

• Preventing excessive exposure to noise
• Preventing hearing loss due to infectious diseases
• Raising awareness of users of ototoxic medications
• Genetic counselling

Therapies

• Audiologic Rehabilitation
• Early use of hearing aids or cochlear implants

Ayurvedic Treatment

Internal medicines

Conductive hearing loss

• Guggulu tikthaka Kashaya
• Pancha tikthka Kashaya
• Guggulu panchapala choorna
• Guggulu tikthaka Gritha

Sensori neural hearing loss

• Dhanadanayanadi kashaya
• Ksheerabala taila
• Aswagandharishta
• Dhanwanthara Gritha
• Rasnadashamoola Gritha
• Vaiswanara Choorna
• Aswagandha Choorna

Procedures

• Virechana - Gandharva Eranda
• Nasya - Eranda Sigruadi Taila
• Jaloukavacharana - Karnamoola
• Karna poorana - Eranda sigruadi taila
• Siro dhara - Dhanwanthara taila , Eranda sigruadi taila