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Hearing Testing and Loss Prevention

Now that we have discussed hearing loss, let’s discuss what can be done to prevent a certain type of hearing loss, noise induced hearing loss. Have you ever gone to a concert/ gathering where the music is too loud and the next day you have a ‘ringing sensation’ in your ears? This ringing is referred to as tinnitus, and is the result of your ears being ‘overworked’. In most cases, this ringing sensation goes away, and you are able to hear normally again. However, in some unfortunate instances, this ringing sensation never goes away and the person’s hearing is never the same.

The rule of thumb to remember when trying to determine if the music is too loud: If you have to shout to be heard by a person standing 3 feet or less from you, the music is too loud.

Testing for Hearing Loss

Hearing sensitivity is determined through the use of a battery (group) of tests; with these tests commonly occurring: pure-tone sensitivity, speech reception threshold, speech discrimination ability and middle ear function and otoacoustic emissions.

Otoacoustic emission testing consists of sounds being introduced into the ear canal via a probe. These sounds cause the hair cells within the cochlea to be activated. The hair cells moving causes a special ‘echo’ to be sent back out the ear canal which is recorded by the probe which sits in the ear canal. The strength of the echo determines how healthy and numerous the outer hair cells are within the cochlea.

• Pure tone sensitivity consists of a patient listening to several different pitches of sound (one ear at a time) and is asked to respond whenever the sound is heard, even if it is barely audible. A person’s threshold (softest level in which a stimulus can be heard) is obtained this way. This is what most people think of when asked how hearing is tested and is done on most public school children several times during their educational track from K-12.
• Speech reception threshold consists of a patient repeating a two-syllable word (such as headlight, football, cowboy, etc.), even if the word is barely audible. The person’s threshold is obtained for speech.
• Speech recognition ability consists of a patient repeating one syllable words (such as yard, carve, etc.) at a comfortable listening level with no visual cues (the patient cannot see the examiner’s face). This measurement is considered important, because if a patient cannot recognize words, then the benefit that can be received from wearing a hearing aid may not be as much as expected by the patient.
• Middle ear testing consists of a soft rubber probe tip being placed in the patient’s ear canal. The patient hears a steady ‘humming’ sound with varying pressure. The result gives the examiner an idea of how well the ear drum is moving back and forth. Any problems with the ear canal or middle ear are exposed at this point.

How can you defend your ears?

Noise induced hearing loss is the most preventable type of hearing loss. Use hearing protection now, and you may save yourself from wearing a hearing aid in the future. For starters, if you know that you are going to be exposed to levels of music that are dangerous, use hearing protection (ear plugs). There are several disposable types of earplugs available for purchase at your local pharmacy.

• Soft, foam plugs, sometimes used by recreational gun shooters. When inserted properly, these plugs can take away 30 dB of sound, enough to take the damaging edge off the offending sound or music. These plugs come in small, discrete packages and can be easily put in a purse or a pocket before heading out to the concert/bar/club/shooting range.
• For those who are active in the music appreciation circuit, I would recommend using a pair of custom made hearing protection plugs (made by an audiologist/hearing aid dispenser), as these plugs are better suited to stay in the ears for a longer period of time without causing discomfort. They also can provide more options in terms of acoustics, allowing for a more natural reduced level of sound to pass through. Also, for those of us who have noisy hobbies (skeet shooting, hunting, woodworking, etc.), proper hearing protection is necessary to prevent the possibility of noise-induced hearing loss.
• For those in jobs which are noisy (printing presses, assembly lines, factory, foundry, airport, etc.) the same information applies to you. If the noise levels where you work are in the ‘danger zone’, your employer must have an education/prevention program in place, as well as provide hearing protection should the worker be exposed to potentially damaging levels of noise. Custom hearing protection can also be an excellent benefit to these workers.

Defense Against Swimmer's Ear

Noise is not the only thing your ears may need protection from. Swimmers can get an infection known as otitis externa (commonly known as swimmer’s ear). This infection is usually accompanied by a white-colored buildup, which does not smell pleasant by any means. Also, it has been reported that surfers can have a bony growth (known as extoses) occur inside their ear canal with repeated exposure to cold ocean water. Custom made swim plugs can be made for those ‘water people’, however, one should take note that these plugs are good at keeping water from splashing into the ear canal, and should not be used for diving.