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14.02.2015

Conductive hearing loss and tinnitus, ringing in ears after hitting head - Within Minutes

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Author’s Note: Much of the information for this article was garnered from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF), especially the book “Primary Care Otolaryngology” by Gregory Staffel, MD, who donated the book to the AAO-HNSF. Tinnitus is most frequently the result of hearing loss and most people who experience hearing loss will have tinnitus as one of the symptoms.
There are two basic types of hearing loss: conductive hearing loss, and sensorineural hearing loss. Sensorineural hearing loss occurs when there is damage to the inner ear, or cochlea, or to the nerve pathways from the inner ear to the brain.
During the research for this article I was intrigued to discover how the various tests for hearing loss, audiograms and tympanograms, can narrow down the type of hearing loss and provide very precise information on exactly what problems may have developed and how well the ears are functioning. Hearing threshold levels are determined between 250 and 8000 hertz (Hz) and measured in decibels (dB). Figure 6.2 shows a typical audiogram for someone with age-related hearing loss (presbycusis).
Author’s Note: This is the type of hearing loss that many tinnitus sufferers and I display. There are many contributing factors to conductive hearing loss, many of which impact directly on tinnitus. Otitis media refers to inflammation of the middle ear and may be thought of in terms of eustachian tube dysfunction. The ear canal may be blocked by wax when attempts to clean the ear push the wax deeper into the canal and cause a blockage. In the event the home treatments are not satisfactory, or if the wax has accumulated to the extent that it blocks the canal and reduces hearing, a physician may describe eardrops designed to soften wax, or he may wash or vacuum it out.
Despite that opinion, there are many treatment options that, while not a cure, will result in a lessening of the tinnitus associated with hearing loss. Disease conditions such as Meniere’s disease can lead to sensorineural hearing loss and tinnitus.
There are over 200 prescription and over-the-counter medications that can cause or worsen hearing loss. This is a very common cause of hearing loss and tinnitus and is the cause of my hearing loss, as mentioned in the previous article. Below are the maximum noise levels on the job to which you should be exposed without hearing protection and for how long. Commonly referred to as age-related hearing loss, Presbycusis is by far the most frequent cause of hearing loss in the elderly.
Presbycusis can be prevented but once it occurs it joins the stable of other causes of sensorineural hearing loss and becomes permanent. Numerous reports in the literature indicate that head trauma, which includes concussion and whiplash, causes hearing loss and tinnitus. Arches Tinnitus Formulas were developed to help people suffering from tinnitus due to sensorineural hearing loss, regardless of the cause. Our brain works out what type of sound it is according to the volume and the pitch of the vibrations. The rate at which a sound vibrates is called its frequency and the higher the frequency the higher-pitched the sound, such as a piccolo or birdsong.
Loudness varies from person to person and as such it would help to mention here how loudness is described: inaudible, very soft, soft, moderate, loud, very loud or too loud. The outer ear includes the pinna (also called the auricle), the ear canal and the eardrum (also called the tympanic membrane).
The middle ear is an air-filled chamber connected to the nasal and throat passages by the Eustachian tube which equalises air pressure on both sides of the ear drum. The inner ear is filled with a fluid and consists of the spiral shaped Cochlea, named from the ancient word for the shell of a snail.
Whilst there are many reasons for hearing loss, the condition itself falls into two main categories: Conductive and Sensorineural. Conductive hearing loss is caused by any obstruction that prevents sound waves from reaching the inner ear.
It is quite possible for a conductive hearing loss to occur together with a sensorineural hearing loss. A common cause of hearing loss is caused through prolonged exposure to harmful sound (noise) or a sudden brief but intense noise like an explosion to the ear. One way we can prevent hearing loss is by staying in environments with safe sound limits. Occupations particularly at risk of hearing loss due to exposure to noise include fire fighters, police officers, factory workers, farmers, construction workers, military personnel, heavy industry workers, musicians, and entertainment industry professionals. Your hearing healthcare professional will usually begin by asking you questions about the health of your ears and general health and your lifestyle. Amongst all the tests that can be performed on your hearing, pure tone audiometry is the most common.
This piece of specialised equipment produces tones at specific frequencies and levels to each ear independently. At the end of a hearing test you may be told that you have normal hearing or a mild, moderate, severe or profound loss of hearing. How people classify themselves relative to hearing loss is a very personal decision and reflects much more than just their ability to hear. At a basic level a hearing instrument or hearing aid is an electronic, battery-operated device that amplifies sound. In recent years hearing professionals have seen large changes, not just in what hearing devices can do, but how they are worn.


This device is housed in a small, usually curved case behind the ear and the sound is delivered into the ear canal via a custom-made earmould or tubing system.
Along with ITCs and ITEs, CICs are considered to be more modern and cosmetically appealing CICs fit so deep in the ear canal that they are practically invisible.
Tinnitus is most commonly referred to as ‘ringing in the ears’, but there are many different types of tinnitus.
Tinnitus is actually heard by most people at some point in their lives, even those with normal hearing. Tinnitus is very real, as it is a ‘sound’ that is heard by the person experiencing it, regardless if someone else can hear it. Other material came from the Mayo Clinic and the American Speech-Language-Hearing Association. While exact numbers are difficult to determine, the American Tinnitus Association estimates that 70% of tinnitus is due to hearing loss. In normal hearing, sound vibrations are funneled by the outer ear into the ear canal where they cause vibrations in the eardrum. These children will often benefit from a pressure equalization tube inserted through the eardrum to vent the middle ear and prevent negative pressure. The average hearing loss in otitis media with effusion is 24 dB, equivalent to wearing earplugs, however thicker fluid can cause hearing loss up to 45 dB. The primary symptom is slowly progressing hearing loss that can begin anytime between the ages of 15 and 45 but it usually starts in the early 20’s. This involves removing the immobilized stapes bone and replacing it with a prosthetic device. Other common causes are explosions, skull fractures, objects piercing the eardrum and untreated acute otitis media.
The doctor will apply a chemical to the edges of the tear to promote growth and then place a thin paper patch over it.
This involves placing living tissue over the perforation and letting it grow into the rest of the tissue.
In the hands of an inexperienced doctor, this can lead to a worsening condition and tinnitus can be dramatically increased.
These treatments range from diet and exercise, to supplements, sound therapy and some prescription medications. The condition results in a decrease in thyroid hormones that can also cause Fibromyalgia and Chronic Fatigue Syndrome. We have heard from countless people who complained of hearing loss and tinnitus after taking a new medication. Most experts agree that continual unprotected exposure to more than 85 decibels is dangerous and leads to hearing loss. As we age, the outer hair cells in the cochlea gradually deteriorate causing bi-lateral hearing loss, primarily in the higher frequencies.
Michael Seidman, MD has done pioneering work in this area and has obtained a US patent for a product that prevents mitochondrial damage to the inner ear.
Seidman has also written a book called “Save Your Hearing Now” that details the progressive damage done to the inner ear by free radicals and outlines a complete plan for preventing damage and prolonging acute hearing ability.
This is a very rare, slow-growing, non-malignant tumor that occurs on the 8th cranial nerve controlling hearing and balance. While not a cure, the formulas have helped thousands of people reduce the sound level and continue with an enjoyable life. The following is a guide to hearing that covers many of the questions I receive on a regular basis about all things hearing. Sound waves travel through each part of the ear to the brain where they are analysed and interpreted into meaning. The passageways of the cochlea are lined with over 15,000 microscopic haircells (called inner and outer hair cells) that convert sound vibrations from the ossicles into nerve pulses which are then sent to the brain. The nature of noise-induced hearing loss is sensorineural, and at present, can only be helped and not cured.
Results are instant, and you will know immediately if you do have a hearing problem and what steps to take. If you can hear sounds across a range of frequencies at 0-20dB you are considered as having normal hearing. This could cause depression or cause people to withdraw from group or social situations due to a sense of lack of control and intimacy with friends and family.
In a digital device, sound is received through a microphone and then converted into electrical signals. These changes can be attributed to a reduction in the size of components, increased durability and cosmetic concerns on the part of the wearer. Thin tubings are a relatively recent design change; and are referred to within the industry as ‘open fits’ as they tend to fill less of the outer ear and ear canal than a custom made earmould. As tinnitus can be a sign of certain medical complications, it should never be dismissed or underestimated. This overview will discuss the various types of hearing loss, the causes and available treatments, when applicable. These vibrations transfer to the three small bones of the middle ear, the malleus (hammer), incus (anvil), and stapes (stirrup), which amplify the vibrations as they travel to the inner ear.
Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the small bones of the middle ear.
Sensorineural hearing loss is considered by the medical establishment to be permanent because there is no medically recognized treatment or surgery that will cure the condition.


During the audiogram, independent hearing thresholds are determined for both air conduction and bone conduction. Amplifying garbled speech with a hearing aid has very little benefit for someone with poor speech discrimination.
The 0 dB level is normalized to the minimum hearing level of young healthy adults and does not mean there is an absence of sound. The device allows the bones of the middle ear to resume movement, which stimulates the fluid in the inner ear and improves or restores hearing.
If the perforation is due to a sudden traumatic or explosive event, the hearing loss and resultant tinnitus can be severe.
Surgery is usually very successful in permanently closing the perforation and improving hearing.
It involves a fluid build-up in the vestibular system that will eventually damage the hair cells of the cochlea leading to permanent hearing loss and tinnitus. Anyone who already has hearing loss should exercise caution when taking new prescription medications. It is common in certain industries and is closely regulated by the Occupational Health and Safety Administration (OSHA). Patients with presbycusis may also have difficulty with speech discrimination and complain of tinnitus. In many cases these are left alone, especially if the patient is elderly and the tumor small.
I am constantly adding to the information featured here based on your feedback and questions.
The ear converts vibrations into electrical signals sent to the brain, where they are translated into meaningful information such as speech and music. The human ear is designed to be a receiver of sounds but also plays a major role in balance and body position.
A set of headphones is worn over the ears or foam earphones placed in the ear canal; and you may be required to sit in a sound-proof test room. As the test progresses, the hearing professional will plot results on an audiogram where the frequency is on the horizontal axis and the loudness is on the vertical axis. Hearing impaired people with partial loss of hearing may find that the quality of their hearing varies from day to day, or from one situation to another or not at all. Individuals can report intermittent episodes that are not very bothersome, to a constant tinnitus that can negatively influence daily life.
It can also happen spontaneously without any reason, and then disappear as strangely as it began.
The hearing loss mimics the hearing loss due to noise exposure, with a typical downward notch at 4 KHz. Speech, for example, consists of vibrations at different volumes and numerous frequencies and most are between 250 and 8000Hz.
These bones or ‘ossicles’ are commonly referred to as the hammer (or Malleus), the anvil (or Incus) and the stirrup (or Stapes) that connect the eardrum to the inner ear. The inner ear also contains our ‘vestibular system’ which is critical for maintaining balance and body position. Once they have sought that initial help they find the subsequent process straightforward and altogether life changing. Once each frequency has been tested and plotted, the points are joined by a line so that you can easily see your results and compare them to what is considered to be within normal limits. BTE designs have become smaller and smaller over the years, and the introduction of so-called receiver-in-the-canal products have contributed to this development. If left to grow too large they will eventually impact on the brain and can be life threatening.
These tiny ossicles amplify the vibrations and direct the waves of sound into the inner ear. But you are not alone - although aging causes our ears to deteriorate, 20% of all 40 to 60 year olds also have some form of hearing loss.
The good news is that if you are worried about a hearing loss, solutions that will enable improvements are now available. It is when tinnitus starts to negatively affect one’s life that further consultation may be necessary.
Bone conduction bypasses the middle and outer ear by sending sound waves through the mastoid bone directly to the cochlea. The infection is usually the result of Streptococcus pneumonia and is treated with antibiotics. The wax often accumulates, dries out and falls out of the ear, carrying dirt and dust with it. Our ears are most sensitive at the 2000-5000Hz range which is important for speech and where continuous exposure to noise causes the most damage. However, a lack of knowledge and social stigma prevent many from being helped by simple, effective solutions. This is healthy in normal amounts and also coats the skin of the ear canal and acts as a water repellant. Treatment for otitis media without infection can be as simple as a prescription nasal spray, such as Flonase, and taken with an antihistamine.



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Comments to “Conductive hearing loss and tinnitus”

  1. ELSAN:
    Noises, try masking the sound with especially common in people over age.
  2. Lala:
    Allcases of tinnitus are not improved when the objective tinnitus is something that can rain falling or wind.