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How Chronic Conductive Hearing Loss Has Been Linked To Speech Recognition Deficits

Imagine dining in a bustling restaurant. In the background you hear the clashing of the dishes, someone drags a chair, voices and laughter and waiters that go from one side to another. You strive to understand what is happening at your table and you are increasingly exhausted.

As with vision, age affects the functioning of the ear. The deterioration of vision makes it gradually more difficult for us to read the fine print. However, hearing loss works differently, and it can make it harder for us to hear certain syllables and sounds. For example, fricative consonants, such as “f” and “s”, or occlusive ones such as “t” are easily drowned out by vowels such as “a”, “o” or “u”. As a result, people with hearing loss may complain that they hear others speak but do not understand what they say.

If you can answer YES to one or more of these questions, you may have a hearing loss.

  • Do you think that the people around you mutter or speak very low?
  • Do you find it difficult to hold conversations in restaurants or places with many people?
  • Do you have to increase the volume of the television, radio or telephone?
  • Do your friends and family complain that they have to repeat everything they tell you?
  • Do you have to look people in the face to understand what they say?
  • Have every day sounds like a bird chirping, steps or the ticking of the clock disappeared?

Conductive Hearing Loss (Hearing loss in the outer and middle ear)

Conductive hearing loss is caused by problems in the outer and middle ear that prevents sounds from reaching the inner ear. The most common causes are the accumulation of earwax in the ear canal, perforation of the eardrum, the presence of fluid in the middle ear and damage or defects in the ossicles of the middle ear.

Conductive hearing loss is a pathological condition manifested by a hearing impairment that occurs against the background of difficulty in conducting sound waves to a sound-receiving apparatus in the human ear.

The main causes of this type of hearing loss are impaired conductivity of the sound signal from the outer ear to the sound-sensing system. This form of pathology arises as a result of the distortion of sound waves during their passage through the external and middle ear, endolymphatic space and cochlear membranes, which can be caused by various etiological reasons.

ear inside image

Damage of the patency of the outer ear can occur as a result of the formation of sulfur plugs, the presence of foreign bodies, tumour formations, otitis externa, exostosis, traumatic injury and congenital atresia of the auditory meatus. Such obstructions do not allow the sound signal to penetrate the eardrum, which causes hearing loss.

Damage of the integrity of the tympanic membrane due to its perforation against the background of acute acoustic trauma, tympanosclerosis, sudden changes in atmospheric pressure, is accompanied by difficulty transmitting mechanical vibrations to the auditory ossicles and leads to the development of conductive hearing loss.

Damage to the middle ear that occurs against the background of exudative or purulent otitis media, otosclerosis, tubo-otitis, cholesteatoma, blockage of the pharyngeal opening of the Eustachian tube by adenoid vegetation or other pathological formations can manifest as a   violation of the mobility and conductive function of the auditory ossicles.

Diseases of the inner ear, such as obstruction of the round or oval window of the cochlea and dehiscence of the anterior semicircular canal, can interfere with the normal movement of the endolymph, which transfers vibrations to the Corti’s organ.

Other causes of conductive hearing loss

Hearing loss is usually associated with the passing of the years, but it is not always the case. It can affect people of any age, but it is more common to manifest after the age of 65. However, it can also be caused by infections, injuries or birth defects.

Conductive hearing loss by age

As we grow older, we may lose the ability to hear faint or high-pitched sounds. Living without hearing the birds sing is quite easy, but when we lose some of the blocks that make up speech, it is much more difficult.

Hearing loss because of ageing is due to wear and tear caused by daily use of the hearing system for a lifetime. The most common symptoms are difficulty hearing soft voices and hearing speech when there is background noise. Sometimes, family members identify the hearing loss before the person suffering from it realises.

hearing loss due to noise

Conductive hearing loss due to noise

Usually caused by exposure to excessive noise. It is a threat to the auditory systems of military personnel, police officers, construction workers, industrial workers, farmers, dentists and nursery teachers among many others. Rock concerts and MP4 players can also damage hearing. Continued exposure to intense sounds accelerates hearing loss. That is why it is important to always wear hearing protectors when exposed to loud noises.

Symptoms of Conductive Hearing Loss

The disease is manifested by a gradual or sharp loss of hearing acuity, which is due to the manifestation of a decrease in the perception of colloquial and whispering speech, the inability to correctly identify the interlocutor’s words from external noise. Those who experience conductive hearing loss complain of a feeling of stuffiness in the ears, while others describe this condition as if they had their ears covered with fingers or earplugs. In this case, the person who suffers from conductive hearing loss can perceive their own voice louder than the surrounding sounds. Various causes of hearing loss can cause both unilateral and bilateral lesions. If there is a hearing loss in the presence of inflammatory lesions, hearing loss may be accompanied by hyperthermia of the body, pain in the ear, which may increase with sneezing or chewing. Most often, after the correct treatment, the hearing is fully or partially restored.

How conductive hearing loss affects speech recognition

An increasing number of facts indicate that conductive hearing loss in old age accelerates a steady decline in cognitive skills (memory, attention, spatial orientation, mental activity, speech, the ability to reason, etc.), and majorly speech recognition.

Hearing can be represented as the result of the interaction of the ears with the brain. When someone speaks, the ears pick up sound signals and transmit them to the brain, which processes them, and as a result, we recognize what has been said. Recognition of human speech requires mental effort and is an integral part of the cognitive (cognitive) load. In the presence of conductive hearing loss, weakened and/or distorted sound signals enter the brain, which requires much greater effort for their correct processing. Thus, there is a redistribution of brain resources, due to which its functions such as memory and mental activity suffer.

According to a study conducted by the National Institute of Health, in older people with conductive hearing loss, speech recognition decline was 41% more pronounced than their peers with relatively normal hearing. Fortunately, hearing aids can largely offset the negative effects that hearing loss has on the brain.

check the ear

A hearing aid can really help.

The hearing aid takes a significant part of the load on the processing of sound signals, thereby relieving the brain and facilitating sound perception and enhancing speech recognition. Thus, the overall cognitive load is reduced, and a sufficient amount of resources is saved to perform other functions, such as remembering, attention, intellectual activity. Benefits of a hearing aid for a person suffering from hearing loss include:

  • Decrease in mental fatigue.
  • Improving mood and eliminating depressive symptoms.
  • Lack of feeling of social isolation.
  • The ability to do several things at once.
  • Improving memory, concentration, attention.
  • Improving communication skills.

diagnostics of conductive hearing loss

Diagnostics of Conductive Hearing Loss

The diagnosis of the conductive form of hearing loss is based on identifying the causes of the disease, an objective and instrumental study of the sound-conducting ear system. The main role in the diagnosis is to identify if a person has suffered earlier diseases and injuries which can contribute to the hearing loss. For the most accurate determination of diagnosis, you will need an appointment with an Audiologist or Ear, Nose and throat (ENT) Specialist.

Treatment of conductive hearing loss

With conductive hearing loss, treatment is aimed at eliminating the main etiological factor that disrupts sound conduction.

To eliminate the symptoms of the disease, you may be prescribed drug therapy based on the use of antibacterial agents in the initial stages of hearing loss, which occurs against the background of an inflammatory lesion. In case of damage to the ear canal, ear washing with antiseptic solutions can be prescribed, as well as non-steroidal anti-inflammatory or glucocorticoid drugs.

In severe cases, surgical treatment may be required. Surgical tactics may include removing a foreign object from the ear, restoring the functions of the eardrum, draining the tympanic cavity, replacing the auditory ossicles, removing purulent masses from the mastoid process.

If there are disorders in the external or middle ear that are not amenable to treatment, hearing prosthetics based on the use of hearing aids may be recommended by your Audiologist.

Prevention of conductive hearing loss is based on the timely diagnosis and treatment of pathologies that can lead to hearing loss by a hearing health specialist. Seek solutions with one of our Audiologist today. Find your nearest Attune clinic and book an appointment now.

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