Physician Focus: Protect your hearing

Theodore P. Mason, M.D. (left) and Jeffrey S. Brown, M.D.
Photo/submitted

By Jeffrey S. Brown, M.D. and Theodore P. Mason, M.D.

Hearing loss is one of the most prevalent medical conditions affecting Americans of all ages, with more than 30 million Americans age 12 and older having some level of impaired hearing, according to the National Institute on Deafness. Among Americans 45 and older, hearing impairment is one of the most common chronic conditions and can lead to social isolation, functional decline, and even depression.

Hearing loss, unfortunately, is something we can’t avoid. As we age, our hearing naturally declines, beginning at about age 30.  Other factors besides aging affect our hearing, including ear infection or injury; head injury, genetics, and – perhaps most of all – exposure to loud noises.

Hearing loss from exposure to loud noises — a major cause of impaired hearing for people of all ages – can be prevented. Unfortunately, noise-induced hearing loss is becoming much more common, as noise becomes more pervasive in all aspects of our lives – at home, at work, and especially in our recreational activities.

Sound is measured in decibels, and the higher the decibel level, the louder the noise.  A refrigerator, for example, has a level of 40 decibels; conversational speech around 45-50; city traffic about 80; a leaf blower or power saw, 110; a jet engine, 140; and loud car stereos, 145.  Some professional sports stadiums and racetracks have been known to approach 140 decibels during a game, concert, or other event.

As sound gets louder, the human ear can tolerate it less and less. The important thing to remember is that the louder the sound, the less time it takes for damage to occur.  Hearing damage can begin to occur around 85 decibels, depending on the duration of exposure. Even a single blast of sound at a very high level can cause permanent damage.

Without protection, loud noises gradually destroy the nerve endings in the inner ear, resulting in permanent damage that cannot be medically or surgically reversed.

For some people who experience hearing loss, a few remedies are available.

There is a tendency for people to assume that hearing aids are a bad option for remedying hearing loss. Fortunately, major new developments in technology have dramatically changed them for the better. They are smaller, more efficient, and provide better quality and more pleasing sound. Many are now unnoticeable. The key to finding the right hearing aid is to find an audiologist who knows them well and can fit the right device to the patient.

For patients with severe to profound hearing loss, a cochlear implant – an electronic device that is surgically placed into the inner ear – can provide enormous benefit.   The procedure, which is covered by insurance, takes about an hour and is done on an outpatient basis.  These devices are well-tolerated by most patients and have transformed the lives of many people, especially the elderly, who had become isolated or depressed because of their severe lack of hearing.  Unfortunately, many people who could benefit from such a procedure may not even know about it or that they are eligible for it. An appointment with an otolaryngologist (ear, nose, and throat physician) will help to determine which hearing intervention is best for any individual.

The best step to take to protect against hearing loss is one that’s recommended in most other areas of medicine: prevention.  People exposed to loud noises at work or play should use hearing protection on a regular basis. Common protective devices, such as ear muffs worn over the ears or foam ear-plugs that are inserted into the ears, are inexpensive, small, and easily transported.

Those who are exposed to loud noise on a regular basis and can’t use protection for a variety of reasons should try to limit exposure and have a thorough, comprehensive hearing test on a regular basis to monitor their hearing.

For more information on hearing loss, visit the patient health section of the American Academy of Otolaryngology-Head and Neck Surgery at www.entnet.org. For a video discussion, visit www.physicianfocus.org/hearingloss.

Jeffrey S. Brown, M.D., a physician with ENT Consultants in Winchester, is President of the Massachusetts Society of Otolaryngology-Head and Neck Surgery.  Theodore P. Mason, M.D., a physician with Ear, Nose, and Throat Surgeons of Western New England in Springfield is President-Elect of the Society and the Founder and Director of the Cochlear Implant Program at Baystate Medical Center.  Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Send comments to PhysicianFocus@mms.org.