Treatment

Conductive Hearing Loss

  • Surgery may correct conductive hearing loss that is due to the congenital absence of ear canal or failure of the ear canal to be open at birth, congenital absence, malformation, or dysfunction of the middle ear structures (i.e. from head trauma), and otosclerosis
  • Amplification may be a solution with the use of a bone-conduction hearing aid, or a surgically implanted device (for example, the Baha), or a conventional hearing aid, depending on the status of the hearing nerve.
  • Antibiotic or antifungal medications are used to treat chronic ear infections, or chronic middle fluid. Tumors usually require surgery.
  • Sensorineural Hearing Loss
  • Sensorineural hearing loss can occur from head trauma or abrupt changes in air pressure (e.g., airplane descent), which can cause inner ear fluid compartment rupture or leakage, which can be toxic to the inner ear. There has been variable success with emergency surgery when this happens.
  • Bilateral progressive hearing loss over several months, also diagnosed as autoimmune inner ear disease, is managed medically with long-term corticosteroids and sometimes with drug therapy. Autoimmune inner ear disease is when the body’s immune system misdirects its defenses against the inner ear structures to cause damage in this part of the body.
  • Fluctuating sensorineural hearing loss may be from unknown cause or associated with  Ménière’s disease . Symptoms of Meniere’s disease are hearing loss, tinnitus (ringing in the ears), and vertigo. Ménière’s disease may be treated medically with a low-sodium diet, diuretics, and corticosteroids. If the vertigo is not medically controlled, then various surgical procedures are used to eliminate the vertigo.
  • Sensorineural hearing loss from disease in the central nervous system may respond to medical management for the specific disease affecting the nervous system. For example, hearing loss secondary to multiple sclerosis may be reversed with treatment for multiple sclerosis.
  • Irreversible sensorineural hearing loss, the most common form of hearing loss, may be managed with hearing aids. When hearing aids are not enough, this type of hearing loss can be surgically treated with cochlear implants.

Mixed Hearing Loss

Audiologists recommend taking care of the conductive component first. There have been times when the addition of the conductive component made the person a better hearing aid candidate, by flattening out the audiogram for example, while the underlying sensorineural component presented a high-frequency loss. However, the emphasis would still be on treating medically what can be treated. Generally, positive results can be expected.

Hearing Aids

What is a hearing aid?

A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations.

A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.

How can hearing aids help?

Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.

A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.

Styles of hearing aids

Cochlear Implant


Ear with cochlear implant
Source: NIH/NIDCD

A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin (see figure). An implant has the following parts:

  • A microphone, which picks up sound from the environment.
  • A speech processor, which selects and arranges sounds picked up by the microphone.
  • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.
  • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.

An implant does not restore normal hearing. Instead, it can give a deaf person a useful representation of sounds in the environment and help him or her to understand speech.

Auditory Verbal Therapy

Auditory Verbal therapy is a highly specialist early intervention programme which equips parents with the skills to maximise their deaf child’s speech and language development. The Auditory Verbal approach stimulates auditory brain development and enables deaf children with hearing aids and cochlear implants to make sense of the sound relayed by their devices. As a result, children with hearing loss are better able to develop listening and spoken language skills, with the aim of giving them the same opportunities and an equal start in life as hearing children.

Auditory Verbal therapy enables parents to help their child to make the best possible use of his or her hearing technology and equips parents to check and troubleshoot it in collaboration with their audiology team. This will maximise a child’s access to sound so that listening and spoken language skills can be developed to the fullest extent possible.

Through play-based sessions using the Auditory Verbal approach, the child develops a listening attitude so that paying attention to the sound around him or her becomes automatic. Hearing and listening become an integral part of communication, play, education and eventually work. All learning from the sessions carries over into daily life. This means that at home, parents can make everyday activities such as setting the table or reading a story into a fun listening and learning opportunity.

There are 5 stages of AVT:

  • Detection
  • Discrimination
  • Identification
  • Comprehension
  • Auditory memory and Sequencing