Loud and then not clear
No doubt noise is a significant contributor to hearing loss, especially in our increasingly urbanized world. “If you’re in a Western developed country, there’s noise everywhere. You walk out on the street … in your home, it’s ubiquitous,” says Richard Salvi, founder and director of the University at Buffalo’s Center for Hearing and Deafness in Buffalo, New York. But the din of city life or exposure to everyday commotion and even booms or blasts on the job — from battlefields to factories (where noise is more regulated today) — aren’t the only causes of hearing loss. As it turns out, soundless risks — some common, others less so — can also quiet a person’s world.
Early exposures
In the U.S. today, babies are routinely screened for hearing loss. Fortunately, the vast majority don’t have any issues, but various factors can increase the risk for the child at birth or shortly thereafter. In addition to developmental problems, those include infections passed on from the mother to child like mumps or measles. “Babies exposed to the herpes simplex virus through birth can have hearing loss,” says Tricia Ashby-Scabis, an audiologist and director of audiology practices at the American Speech-Language-Hearing Association. Maternal diabetes — including gestational diabetes — can increase the risk of hearing loss for the baby as well. “Having good prenatal care, good maternal health programs,” Ashby-Scabis says, “can prevent hearing loss.”
Your genes
For at least half of the children with hearing loss, genes are the culprit, according to the Centers for Disease Control and Prevention. The agency reports that about 20 percent of babies with genetic hearing loss have a syndrome, such as Down syndrome or Usher syndrome — which is characterized by hearing loss that worsens over time. In the majority of people, though, genetics affect the onset of hearing loss over time — “kind of analogous to eyesight,” explains Dr. David Haynes, vice chair of the department of otolaryngology at Vanderbilt University Medical Center in Nashville. Some people will wear glasses and some don’t, “and it’s nothing environmental that’s causing that.”
You’re getting older.
The relentless march of time has a big impact, too. “As we age, our hearing worsens, but not at the same level for every person,” Ashby-Scabis says. Adds Salvi: “The older you get, the more likely you’re going to have hearing loss. Like every other organ system, your ear deteriorates.” Though scientists don’t yet know how — or if there’s a way — to prevent age-related hearing loss, or presbycusis, reducing exposure to other risk factors, like loud noises — such as by wearing ear plugs or ear muffs while using a lawnmower or leaf blower or discharging a firearm — can help.
Ear infections
Young children in particular are often prone to ear infections — which frequently accompany the cold, flu or other respiratory infections. Fluid builds up in the middle ear, the cavity behind the eardrum, and it can be painful for kids. For many, monitoring, TLC and — where appropriate — antibiotics are all that’s needed, and no lasting hearing loss occurs. But sometimes doctors recommend surgically placing ear tubes to drain fluid that persists. “Untreated chronic ear infections can lead to conductive hearing loss,” the American Academy of Otolaryngology-Head and Neck Surgery notes, “where the transmission of sound from the environment to the inner ear is impaired.”
Otosclerosis
A family history of otosclerosis, which involves abnormal bone growth in the middle ear, increases the risk a person will develop this condition. The condition disrupts the ability for sound to travel into the inner ear, causing hearing loss. While a hearing aid may amplify sound for those with mild otosclerosis, experts say the best option is typically surgery. “We can take that fixed bone — it’s an isolated bone called the stapes bone — we can remove it with a laser and replace it with a custom-made prosthesis that’s made just for that, and it restores the hearing,” Haynes says. “It’s a very effective surgical option.”
Meniere’s disease
This typically affects one ear, and it can cause symptoms ranging from pressure or pain in the ear to ringing and dizziness. “Meniere’s disease is an underlying inner ear disorder that causes fluctuating and eventually progressive hearing loss with vertigo,” Haynes notes. Experts say it’s important to see a doctor about symptoms to rule out other causes and ensure a proper diagnosis. Though there’s no cure for the disease, a timely diagnosis and treatment, such as medication to reduce vertigo and a hearing aid, can help address symptoms and severity.
Diabetes
While the precise reasons for the link aren’t clear, research finds hearing loss is twice as common in people with diabetes as in the general population. That’s especially problematic, experts say, given the rising rates of this chronic condition in children and adults in the U.S. “And diabetes is one of the things that will probably accelerate age-related hearing loss,” Salvi points out. “So healthy lifestyle is, I think, really important.” That includes being physically active and eating a well-rounded diet, with lots of veggies — to keep weight under control, and lower the risk of developing diabetes.
Autoimmune disorders
Usually your immune system protects you from threats like disease. But autoimmune disorders turn that typical reality on its head — and they can affect the ear. “Just like an autoimmune disorder can attack any other part of your system, an autoimmune disorder can attack the ear, which can cause some fluctuation in hearing and can cause permanent hearing loss,” Ashby-Scabis says — whether it’s Lupus or any other autoimmune disorder. Medication, like a steroid, may help, but it’s not always possible to stop hearing loss from occurring. The main line of defense is treating the autoimmune disorder itself.
Medications that are toxic to the ear
Some medications are ototoxic — or harmful to the ears. Those of most concern for causing permanent hearing loss include certain aminoglycoside antibiotics, like gentamicin (typically only given in the U.S. when less toxic options aren’t sufficient) and chemotherapy drugs, including cisplatin and carboplatin. These are drugs usually reserved for addressing a pressing or life-saving need. But even some over-the-counter medications can be ototoxic. “If you take aspirin in too high of a dose, you can develop hearing loss,” Ashby-Scabis says. “You can also develop really severe tinnitus — ringing in the ears.” Experts say it’s key to discuss these side effects with your doctor, or check with a pharmacist regarding OTC meds, in advance — and ensure hearing is monitored, as needed.
Unknown cause
Sometimes hearing loss occurs without warning or apparent cause. “It’s called idiopathic sudden sensorineural hearing loss,” Haynes says. And it may be erroneously assumed that a person has an issue like an ear infection. “We tend to see people diagnosed with having fluid in their ear when they don’t really have fluid, and they’re treated for a middle ear infection,” Haynes says. That’s why it’s critical, experts say, that patients with sudden hearing loss don’t delay in seeing a specialist who regularly treats hearing loss, such as an otologist, for a proper diagnosis — and undergo treatment. When administered promptly, “either steroids given by mouth or steroids injected into the ear [have the] ability to reverse that loss,” Haynes says.
A combination of factors
Over one’s lifetime, various factors, from genetics to noise to aging, have a cumulative effect on hearing. As such, experts advise taking a broad view of the risks, thinking preventively — where it’s possible to reduce those risks — and not waiting to get hearing checked and address hearing loss if or when it occurs. And while more data is still needed to understand the role a healthy lifestyle may play in potentially reducing hearing loss — with factors like smoking linked to a higher rate of hearing loss — clinicians say there’s certainly no harm in hedging your bets by eating well, exercising and kicking bad habits that might make you older sooner.
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Causes of Hearing Loss Beyond Loud Noise originally appeared on usnews.com
