Health Care & Hearing Loss
There are two important health care concerns unique to people who are deaf or hard of hearing.
- Communication access while receiving medical care is a common concern, particularly among those who communicate with American Sign Language.
- Specific health conditions may cause hearing loss and there are related syndromes (or patterns of symptoms) that are more common within the population of people who are deaf or hard of hearing.
- Communication Access
- Specific Health Conditions
- Types of Hearing Loss
- Causes of Conductive Hearing Loss
- Causes of Sensorineural Hearing Loss
- Hereditary Causes
- Complicating Factors
- Mental Health
Visitors to DeafMD.org can search an online list of diseases, illnesses, medical tests, and current news events, with each page providing a clear, easy to understand video translation of the selected topic. Additionally, DeafMD.org is compiling a list of “Deaf- friendly doctors” – medical professionals who meet criteria in satisfactorily serving Deaf and hard of hearing people. To be included on this list, medical providers must be deaf or sign ASL fluently, at least one member of the provider’s staff must be deaf or be fluent in ASL, the provider’s office must use video relay services for phone calls, and hire qualified interpreters for office visits as required by the Americans with Disabilities Act. Specialties include mental health providers, physical therapists, and primary care physicians, along with many others. Visit www.DeafMD.org
Many of us are uncomfortable in medical settings. The fear and discomfort related to illness is only one aspect. Many people feel intimidated by doctors and other professionals. Add hearing loss to the mix, and anxiety and discomfort may be amplified.
Patients have a right, and a need, to understand everything that is said by medical professionals. Patients must also be able to ask questions and communicate concerns. In an office setting, communication may be improved by making sure the environment is quiet, using an interpreter, or by taking extra time. Some people prefer to bring a spouse or friend to make sure things go smoothly. But getting a doctor to schedule a longer appointment or to hire an interpreter may not be easy. In hospital settings, where there is more noise and many people to interact with, the situation is even more complicated.
See the American Academy of Family Physicians for their list of: Tips for Working with Your Doctor.
Medical facilities, and individual physicians, regardless of the size of practice, are required to make communication accessible according to the Americans with Disabilities Act. Two articles from the National Association for the Deaf explain the facts and issues for both patients and health providers. These may be viewed by clicking the titles below:
The Midwest Center for Law and the Deaf will serve as a resource to help doctors and hospitals with these communication needs.
A note about the sudden onset of deafness:
Sudden deafness may cause a traumatic disruption in communication. Sudden deafness is a medical emergency and must be treated rapidly. There are many possible causes. See NIDCD for more…
Hearing loss may be considered either Conductive, Sensorineural, or Mixed. A conductive loss means that a problem in the outer or middle ear is interfering with the transmission of sound to the inner ear. Sounds may be faint, distorted or both. In most cases, conductive hearing loss is easier to treat than sensorineural loss, which is usually permanent. A sensorineural loss refers to impairment of the inner ear nerves that transmit sound to the brain. Sounds may be garbled and speech may be difficult to understand, no matter how loud it is. Some hearing loss is considered ‘mixed,’ meaning there are aspects of both types of hearing loss.
To better understand hearing loss and the ear, visit the Interactive Anatomy of the Ear.
For a detailed explanation of hearing loss (and fascinating electron microscope pictures of the inner ear) see the article on Physical Deafness.
There are many reasons that partial or profound hearing loss occurs. The following are some of the more common causes and a bit about them. As always, be sure to check with your doctor for a diagnosis and treatment options.
The following are some of the possible causes of conductive hearing loss.
- Blockages in the outer ear – Almost anything can block an ear and cause hearing loss. Common blockages include earwax, objects like pencils and paper, as well as injuries, birth defects and infections. Allergies and colds can create seasonal and temporary swelling and blockage.
- Ear infections – Generally, ear infections cause swelling in the middle ear, which in turn causes a build up of fluid behind the eardrum. For more information see the (NIDCD) Fact Sheet
- Fistula – A fistula is an abnormal opening between the middle and inner ear that causes fluid to leak from the inner ear. Symptoms include dizziness, as well as hearing loss.
The following are some of the causes of sensorineural hearing loss.
- Noise – The single most common cause of hearing loss is exposure to loud noise. It is estimated that seven to 10 million Americans experience noise–related hearing loss. Loud music, industrial noise, gunfire, power tools, snow blowers, or anything loud may cause hearing loss over time. For more information see: National Institute on Deafness and Other Communication Disorders (NIDCD)
- Aging – Hair cell loss from the nerve endings in the cochlea, stiffening of the cochlea, or loss of nerve endings on the acoustic nerve, may be age related causes of diminished hearing. For more…
- Head injury – A head injury can damage nerves in the hearing centers of the brain. This causes a distortion in the way sound is received by the brain.
- Meniere’s Disease – Pressure in the inner ear may cause fluctuating hearing loss, tinnitus (ringing sensation), dizziness and nausea. Visit MEDLINE plus for more information and resources.
- Tumors – Like elsewhere in the body, tumors can be benign or malignant. Depending on where the tumor is located, the loss may be either conductive or sensorineural. Tumors most commonly form on the nerve that goes from the inner ear to the brain.
- Medication – Some prescription medications can cause hearing loss. This article provides more information.
Hearing loss is often hereditary. If other members of the family have a hearing loss, this is fairly simple to figure out. Sometimes, the genes related to hearing loss are recessive, meaning they are passed on from the mother or father, even though they do not have a hearing loss themselves.
The story of Martha’s Vineyard is an interesting instance of hereditary hearing loss impacting a community in United States history.
- RH Factor – Incompatible RH factors in the mother and child can cause a wide variety of problems, including hearing loss.
- Usher’s Syndrome – According to the National Eye Institute, Usher’s Syndrome is an “inherited condition that causes 1) a serious hearing loss that is usually present at birth or shortly thereafter and 2) progressive vision loss caused by retinitis pigmentosa.” For more information about Usher’s Syndrome see the following: National Eye Institute Fact Sheet on Usher’s Syndrome
- Waardenburg Syndrome – This is genetic syndrome involving varying degrees of hearing loss and changes in skin and hair pigmentation. For more information…
- Otosclerosis – This is a hereditary disease. New bone grows around one of the small bones that transmits sound from the outer ear to the inner ear. This new growth of bone disrupts sound transmission. See the NIDCD info on Otosclerosis
- Birth defects – Various malformations can occur and may cause either conductive or sensorineural hearing loss.
Although not the cause of hearing loss, the following symptoms may be experienced by people with hearing loss.
Tinnitus – Tinnitus is a ringing, buzzing, or whistling noise from within the ear that is commonly called “ringing in the ears”. Most people, even those with otherwise normal hearing, experience tinnitus on occasion. For some people with hearing loss, the constant or frequently recurring sounds can be a major problem, making it even more difficult to hear. The following two web sites provide more information on this frustrating condition:
Balance problems – Some people who have a hearing loss also have difficulties with balance, especially in the dark. The inner ear is part of the vestibular system. The vestibular system gives the sensation of standing firmly on solid ground even though our planet is spinning its way through the universe. When there are problems in the inner ear, balance can be disturbed. This may be due to the cause of hearing loss, such as with Meniere’s disease, or may be completely unrelated. If you have problems with vertigo (dizziness), it is best to see a doctor for evaluation. Visit NIDCD for more information.