Hearing Loss

Anyone can experience hearing loss. It may be present from birth, be acquired later in life or occur suddenly. In this week’s Hopkins Happenings’ Ask the Expert, Jennifer Yeagle, a cochlear implant audiologist from the Johns Hopkins Listening Center, and Wade Chien, an assistant professor of otolaryngology-head and neck surgery, weigh in on topics including treatment options and common signs that an adult may be struggling with hearing loss.


Who is affected by hearing loss?

Anyone can experience hearing loss. It may be present from birth, be acquired later in life or occur suddenly. [a1] Hearing loss can be caused by anatomic malformations of the inner ear, infections, ototoxic medications, loud noise, trauma and aging. The cause of hearing loss is often unknown.

• About two to three of every 1,000 children are diagnosed as hard of hearing or deaf.
• Approximately 30 school children per 1,000 have a hearing loss.
• About 20 percent of adults in the United States—48 million—report some degree of hearing loss.
• At age 65, one out of three individuals has some level of hearing loss.


What are common signs that an adult may be struggling with hearing loss?
Hearing loss is an invisible handicap. We cannot see hearing loss; we only know its effects on communication. People with suspected hearing loss may:
• Often ask people to repeat what they say;
• Have difficulty hearing in groups or avoid group situations;
• Think others mumble;
• Have trouble hearing someone talking from behind;
• Turn up the volume on the television to uncomfortable listening levels; and
• Have difficulty talking on the phone.

Johns Hopkins research has found a correlation between hearing loss and the decline in brain function. Can you talk more about this?
Frank Lin, an assistant professor of geriatric medicine, has been working on a SMART study to look at this specific relationship. In general, epidemiologic studies over the last several years have increasingly implicated hearing loss in older adults as being independently associated with faster rates of cognitive decline and an increased risk of developing dementia. Researchers believe that hearing loss may contribute to dementia risk through placing a load on brain resources and/or directly affecting brain structure. This leads to accelerated rates of brain atrophy. A large clinical trial is currently being planned by Johns Hopkins researchers to definitively determine whether hearing rehabilitative and intervention therapies could reduce the risk of cognitive decline and dementia in older adults.

What treatment options exist for hearing loss?

First, an individual should have his or her hearing tested by an audiologist to assess the degree and type of hearing loss. If the audiometric testing suggests hearing loss, the individual should see an ear, nose and throat doctor to try and determine if the type of hearing loss can be medically treated and to learn about those options. There is no cure for sensorineural hearing loss, but there are many treatment options, including hearing aids and cochlear implants.

Do hearing aids really work?

Yes, they can make a big difference for individuals if they fit appropriately and are used soon after hearing loss is identified. However, their effectiveness will depend on the severity of the hearing loss. Today’s hearing aids are smaller and more appealing than the older, large, bulky hearing aids. Some hearing aids are practically invisible, and they also come in an array of colors to appeal to everyone. Hearing aids can improve quality of life so much that people don’t care what they look like. For more information and/or to set up an appointment about hearing aids, please visit http://www.hopkinsmedicine.org/hearing/index.html.
What is a cochlear implant?

A cochlear implant is a surgically implanted device placed in the cochlear with an external worn transmitter. The implant bypasses the natural hearing process and replaces the sound with electrical information. The brain interprets the electrical pulses, and, over time, the sound becomes more meaningful and intelligible. A cochlear implant is the next step for someone when hearing aids are no longer helpful. For more information and/or to schedule an appointment about cochlear implants, please visit http://www.hopkinsmedicine.org/otolaryngology/specialty_areas/listencenter/.

What is tinnitus?

Tinnitus is the perception of sound in your ears or head when there is no source for the sound. People more commonly refer to tinnitus as "ringing in the ears," but it can also be described as hissing, roaring, pulsing, musical and whooshing. Many people with and without hearing loss can experience tinnitus. It can occur in one ear or both, and it can be sporadic or constant, with volume ranging from subtle to debilitating. It can also start suddenly and disappear just as quickly. It may be triggered by medications, stimulants such as caffeine and/or changes in health. There is no cure for tinnitus, but there are management techniques that may help individuals find relief. Examples include tinnitus retraining therapy with or without the use of noise maskers. If hearing loss is also present, use of hearing aids can also bring relief. For problematic or sudden onsets of tinnitus, a visit with an ear, nose and throat doctor is recommended to rule out any underlying medical causes.

How can people who use headphones with music players protect their hearing?

Headphone users should practice safe listening habits, such as turning down the volume and taking listening breaks, when they use personal audio technology. Safe listening habits can help individuals protect their hearing and avoid permanent damage caused by listening to music that is too loud for too long. Learn more about this and noise-induced hearing loss visit at http://www.asha.org/buds/ or http://www.cdc.gov/healthyyouth/noise/.

Can noise exposure cause hearing loss?

Yes, prolonged exposure to loud noise can create temporary shifts in hearing. However, repeated exposure to loud noise can create permanent hearing loss. There is evidence in animal research that shows permanent damage to nerve cells, even though the hearing shift appears only temporary.

A few examples of loud noises/sounds that can cause hearing loss are:

  • Lawn mowers and other equipment;
  • Guns and shooting devices;
  • Fireworks and explosives;
  • Machinery in a factory, which can also include loud engines; and
  • Loud music through headphones and/or live concerts.

To reduce the effects of noise exposure, individuals should wear hearing protection such as ear plugs and/or earmuffs. Individuals should move away from the sound source or limit the time spent in the presence of loud sound. Lastly, if possible, turn down the level of the sound or music.



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