The human ear is composed of several parts. Each of these components has a particular role to play in order for a person to be able to hear. The way it works, sound waves go into the ear canal. When the waves go through the external ear into the canal it causes a vibration in the eardrum (tympanic membrane).
Waves of sound then travel into the center of the ear where three small bones can be found. These bones are called the anvil (incus), the hammer (malleus), and the stirrup (stapes). All three are in charge of ensuring that the vibration signals are transmitted from the eardrum to the inner ear where the chamber is filled with fluids. Movement in the bones of the middle ear results in the fluids making waves. In turn, these waves activate the inner ear’s hair cells. Stimulation of the cells then causes the auditory nerves to carry the signals to the brain. This entire process is what allows hearing.
Hearing loss and its causes
Good hearing relies on all components of the auditory system functioning healthily. When it works well, the sound is able to pass through all sectors of the ear all the way for the brain to process it without experiencing any sound distortion. Whenever a person suffers from hearing problems, the cause will depend heavily on which part of the system is not functioning correctly.
For those who are noticing issues related to sound volume, such as when it appears not loud enough, the problem can stem from inefficient transfer into the cochlea. This specific ear concern generally occurs in the outer or in the middle portion of the ear.
Some of the most common causes of hearing loss are blockages in the ear canal from wax or a punctured eardrum. Such an issue is referred to as conductive hearing loss. Simply put, this means that vibrations of sound are inefficiently conducted. Although the inner ear or cochlea continues to work as normal, it however is unable to receive info that is transmitted through the middle part.
On the other hand, sensorineural hearing loss is an issue that occurs between the inner ear and the brain. While sound gets to the cochlea, the processing is abnormal due to some damage to the auditory nerves or the sensitive hair cell. In some cases, defects in the pathway that leads to the brain can cause problems with hearing. Agin and over-exposure to excess noise are the most common reasons that result in sensorineural hearing issues.
Can surgery treat hearing loss?
Individuals diagnosed with sensorineural, conductive, or both hearing losses can seek medical attention. Typically, a checkup will determine what kind of hearing problem a person is suffering from. Once this is diagnosed, a doctor will discuss the next course of action. Surgical consult is often called upon where all treatment options will be discussed with the patient. Aside from the procedure, all concerns including any potential risks are conferred.
Conductive hearing loss surgery
Blockage in the ear canal or in the middle portion stops sound from going through. Often times, the blockages are a result of a damaged outer ear, middle ear, or ear canal structure. Those with conductive hearing loss suffer from conductive hearing loss that can be remedied with the following surgical treatments.
Canalplasty
External blockage of the ear canal is sometimes an acquired health issue or a congenital one. When this happens, surgery is done in order to create a new ear canal. The process can help improve the hearing of a person.
Tympanoplasty
Eardrum perforation drastically reduces the middle hearing bones’ ability to properly vibrate. Thus, this results in a loss of hearing. Trauma and infection are typically the reasons perforations occur. Repairing punctures in the canal is the primary action. Another method involves creating an incision behind the eardrum. This method will however be determined by the location or the size of the puncture, as well as the potential presence in the mastoid of an infection.
Ossicular Reconstruction
Partial damage or a lack of middle ear bones for hearing can possibly be a congenital condition or a chronic infection. Surgery can be done via the ear canal – this is called ossicular reconstruction. A titanium prosthesis is used to make the necessary repairs. Operations can include the positioning of prosthesis for one or all three bones. An outpatient surgical procedure has a recovery period of just a few days.
Stapedectomy
Hardening at the bottom of the stapes is a metabolic issue called otosclerosis. Hearing loss happens when there is a notable vibration sound decrease in the inner part of the ear. This hearing condition is one that is inherited and is a trait that is dominant. In a number of patients otosclerosis manifests itself in both ears. Local or general anesthesia is needed to perform this ear canal correction. Just like ossicular reconstruction, stapedectomy is also an outpatient treatment. It takes several days to recover from this surgery.
Sensorineural hearing loss surgery
Those who are diagnosed with nerve deafness or sensorineural loss of hearing should know that it is the most common hearing problem that affects adults across the globe. There are many reasons that can cause sensorineural hearing issues, for most it is a result of old age, an exposure to extremely loud noise, infections in the ear, diseases, tumors, trauma in the head, and sometimes a side effect of medication.
Unfortunately, those who are suffering from sensorineural hearing problems should know that the loss is a permanent one. While surgery cannot repair any existing damage to the hair cells, it can however circumvent the damaged sensory cells. Due to the damaged pathway connecting the brain and inner ear, the interpretation of auditory sound becomes a major issue. Some of the solutions for this hearing issue are as follows:
Bone Anchored Hearing Aid
An individual with near-normal or normal hearing on one ear and hearing loss on the other will not benefit from the usage of a traditional hearing device. In its place, surgeons can place a BAHA or bone-anchored hearing aid. It is important to understand that BAHA placement will not restore hearing in the affected ear. Instead it vibrates the sound to the ear with better hearing. An outpatient surgical operation that requires local or general anesthesia, the process includes the implantation of titanium in the bone at the back of the ear. After several months (3-4 months) an external device that resembles a hearing aid is attached to the first implant installed (titanium).
Cochlear Implants
For the most part, loss of hearing can be corrected with the assistance of a hearing aid. Of course, there are instances when hearing is so bad that the aid barely provides any benefits. Surgeons will then suggest a cochlear implant. All viable candidates for cochlear implants will be scheduled for an operation. The surgical treatment is then done with general anesthesia. The back of the ear is cut open to house the device. An array is then inserted into the mastoid via an incision in the cochlea. Recovery will require a couple of days with some minor visible swelling in the area. Because of the evident swelling which takes a while to subside, the receiver is installed 4 weeks post surgery. Intense rehabilitation is necessary to help a patient learn how to use the implant correctly.
Cochlear implants contain two sections. One is the internal device that acts as a receiver and array. The other device is an external one that functions as a speech processor. The external portion receives the sound which is then converted into an electrical transmission. The signal then passes through the skin behind a person’s ear to the installed receiver. The array situated inside the cochlea gets the signal. The individual begins to hear sounds thanks to the stimulation received by the nerve endings. An extensive evaluation is conducted on a patient prior to the procedure. Some medical examinations will include X-rays, CT, and MRI scans.
Hearing loss diagnosis and treatments
Anyone who suspects they are suffering from hearing loss should immediately seek the attention of a medical professional. Though a general physician can help provide a diagnosis, the best medical worker to seek is a specialist – ENT (ear, nose, and throat) doctor.
Several tests will be conducted to specifically figure out what the exact problem is. An ENT can prescribe basic treatment solutions. For example, those found to have wax blockages can have the obstruction removed by the ENT. In order to make the examination flow smoothly, patients can list down all symptoms prior to the visit. Medication for manageable ear infections can also be prescribed. When non-invasive treatment is no longer an option, a physician will bring in a surgeon to help discuss all procedural options available to the patient.
