Keep hearing loss at bay
Dr. SHAILAJA NIKAM
There are many causes for losing one's hearing. Early identification is crucial to prevent or minimise loss of hearing.
PREVENTING loss of hearing must constitute a major programme for the well being of an individual. Efforts on the part of the State as well as the individual are required towards prevention primary, secondary and tertiary.
Primary prevention requires the State to initiate programmes like immunisation against diseases, providing prenatal care, initiating neonatal screening programmes in the hospitals and hearing screening in schools.
Legislation to keep noise levels within prescribed limits and a mandatory hearing conservation programme in industries are other measures. Efforts at the individual level must supplement the State initiatives.
Nature has provided glands that produce wax to keep foreign bodies like insects from entering the ear. The wax moves on its own towards the opening of the ear canal. Using sharp objects to remove wax harms the ear canal wall and the eardrum. Swimmers must ensure that the pool is clean. Use of earplugs can prevent contact with contaminated waters.
The Eustachian tube is the link between the middle ear and the back of the throat. It opens during yawning and swallowing. The exchange of air during this process helps in maintaining a proper balance of air pressure on both sides of the eardrum, which is essential for good hearing
Not many know that fluid accumulation in the ear is detrimental to good hearing and can also damage the ear structures. So, ears must be kept free of discharge, which is caused by poor ventilation of the middle ear.
Fluid secreted by the mucous lining of the middle ear fills the vacuum. Fluid fills the space normally occupied by air in the middle ear. Thus ensuring good ventilation of the ear through a patent Eustachian tube is a potent preventive measure.
Otitis media or inflammation of the middle ear can be acute, secretory or chronic. Acute otitis media is caused by general infection such as measles, chicken pox, or infection conveyed to the ear through blood stream.
More commonly, it is due to infection spreading through the nose, nasopharynx, and sinuses via the Eustachian tube. Due to inflammation, the swollen Eustachian tube does not drain the pus. So, the fluid or pus is retained in the middle ear cavity. The pus may escape or drain through a ruptured or incised tympanic membrane, the eardrum.
In case the thin partition between the middle ear and the brain is unable to obstruct the pus, it may break through the partition and cause meningitis.
Treatment for otitis media should not be looked upon as complete until the tympanic membrane appears normal and hearing is fully restored.
Hearing loss may continue if the treatment is inadequate and if the infection comes through the Eustachian tube. Hence, the source of infection in the sinus and the nasopharynx must be treated fully.
Measures aimed at primary prevention call for elimination of the causal agents, especially the viral and bacterial diseases known to cause hearing loss. Examples are typhoid, mumps, and measles. Hearing loss may also be secondary to chicken pox.
Treatment for the infectious diseases must be sought and completed fully. Inadequate doses taken for an insufficient period leads to further complications.
Some drugs are ototoxic i.e., poisonous to the ears. Hence drugs must be taken under proper medical advice and supervision. Any change in hearing consequent to drug therapy must be promptly reported. The harmful effects of drugs may also affect the vestibular system situated close to the hearing organ. In such instances, giddiness may occur. The ears and/or the skull may sustain injuries in accidents, assaults, during fights and physical violence. Conditions such as bleeding from the ear, sudden hearing loss, unconsciousness, disequilibrium, any neurological deficiency, facial paralysis must be a cause for concern.
Exposure to noise for prolonged periods is known to cause hearing loss, which sets in insidiously. A single loud blast is also harmful. These could be during burst of crackers, during target practice, or during hunting. Trauma-related damage to the ears may be prevented through use of protective devices and/or helmets.
Where primary prevention i.e. ensuring that hearing loss does not set in, has not been possible, secondary prevention i.e. early detection and treatment is necessary. Secondary prevention would eliminate the disorder or its progression leading to further complications. Examples are diagnosis and treatment of otitis media and early identification of noise-induced hearing loss.
Tertiary prevention is the reduction of disability by restoring effective functioning when the disorder cannot be eliminated. Examples are use of hearing aids when hearing loss, primary and secondary, have not been possible.
Instances could be hearing loss due to advancing age or due to hereditary factors. Professional guidance must be sought in the assessment and choice of suitable devices to amplify the sound reaching the ear.
The ear is developed completely during pregnancy. Hence preventive steps must be in operation even before birth. Maternal illness, use of drugs or trauma, premature birth, low birth weight, complications at the time of birth put the infant at high risk for incurring hearing problems.
Undergoing periodical and simple hearing tests are essential for early identification. Systemic diseases such as diabetes are known to be associated with hearing loss.
In conclusion, prevention of hearing loss is desirable. It reduces anxiety, frustration and hardship to the individual and family. Prevention stops in its tracks the sequelae of communication difficulties, scholastic under achievement, emotional and behavioural problems.
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