Chronic deafness

Synonyms in the broader sense

  • deafness
  • deafness
  • Conductive hearing loss
  • Sensorineural hearing loss
  • Sensorineural hearing loss
  • hearing loss
  • hearing loss
  • Sudden Hearing Loss

Medical: Hypacusis

English: Chronic deafness

Definition of deafness

Deafness (hypacusis) refers to a reduction in hearing that can range from mild hearing loss to complete deafness.
The deafness is a widespread disease, which occurs both in young and much more common in the elderly. In Germany, about six percent of the population is affected by deafness. Conspicuously, the age at which hearing loss occurs decreases more and more. Naturally, the deafness progresses only with increasing age.

A reduction in hearing becomes aware only when familiar noises, sounds and voices are suddenly no longer perceived or understood. The deafness usually creeps in and can be perceived as a significant handicap if damage has already occurred.

In the foreground is less the therapy of a hearing loss but rather the prevention at a young age. For prevention, one can observe many measures that preserve our sense of hearing. Although legal regulations apply in the workplace, according to which a volume of more than 85 decibels (dB) may not be exposed without ear protection, this limit is reached in the leisure time. Discos, rock concerts, loud music on headphones, car racing, etc. generate such noise, which can permanently damage the ear inexorably.

Causes Chronic deafness

As with the acute, a distinction can also be made in the case of chronic deafness between a sound conduction (cause lies in the outer ear or middle ear) and a sound sensory disturbance (cause lies in the inner ear or the auditory nerve).
There is a clear difference in therapy depending on the location of the disorder.
For more information on studying hearing loss see:

  • hearing test

Genesis and therapy

How does the chronic conduction disturbance come about and how is it treated?

  • Earwax (cerumen)
    Earwax, dust and pieces of skin are natural in the external auditory canal and are usually transported to the outside or rinsed out while showering.
    Excessive accumulation or increased earwax formation, however, occurs in the narrow ear canal or in dusty conditions.
    Unfortunately, trying to remove the earwax with chopsticks results in more being transported towards the tympanic membrane and further obstruction of the ear canal. Other foreign bodies such as Wattereste can increasingly close the ear canal. Children sometimes run the risk of sticking small objects in the ear while they are playing without their parents noticing it.
    These foreign bodies or earwax become visible through an otoscope (ear mirror) and can already be removed from the family doctor with small instruments.
    If mechanical removal is not successful, earwax or debris is flushed out with water.
  • Increased bone growth (exostoses)
    In some people increased age or hormonal diseases cause increased bone growth. When the bone grows in the area of ​​the ear canal, it narrows. When less sound reaches the eardrum, gradually a hearing loss creeps in. Excess bone tissue can be surgically removed.
  • Narrowing due to scarring (stenosis)
    After every inflammation in the ear canal, be it by a fungal infection or by a hair follicle (inflammation), it comes to a small scar. The more often an inflammation and injury to the ear canal has taken place, the more scar tissue arises and narrows the gait. The increasing constriction leads to progressive hearing loss. An operative removal can expose the auditory canal again, but again it can lead to a scarring.
  • Chronic otitis media (otitis media chronica)
    In case of chronic middle ear infection, the inflammation is permanently present. The symptoms are characterized by changeable earache and ears running. The inflammation can spread to nearby bones and worsen the disease even further. Increasing hearing loss creeps in and can be difficult to treat later.
    In a therapy, the operative rehabilitation of the middle ear by a radical elimination of purulent and inflammatory tissue in the foreground. If possible, of course one tries to get residual hearing. Today it is possible to replace the ossicular chain by means of artificial implants (tympanoplasty).
    Further information on this topic is also available at: chronic otitis media
  • Chronic tubal aeration disorder (chronic middle ear catarrh)
    The Eustachian tube (Tuba Eustachii, Tuba auditiva) normally compensates for the pressure differences between the middle ear and the outside world.
    Through constant infections with common cold (runny nose, sinusitis, tonsillitis), the tube can be permanently closed and greatly impaired in their function. In addition to a latent feeling of pressure in the ear, which can not be resolved by swallowing and yawning, a hearing loss creeps in. The permanent closure also promotes a fluid accumulation (serotympanum) or an inflammation-induced mucus accumulation in the middle ear (mucotympanum).
    If the fluid additionally presses on the eardrum from the inside, its vibration is impaired and worsens the already existing deafness. If a therapy (see polyps, tonsillitis) is not initiated soon, the middle ear mucosa (tympanosclerosis) changes and severe hearing loss occurs.
    Chronic middle ear catarrh is usually due to enlarged pharynx, which should be removed in recurrent infections.
    In case of non-healing, aeration of the middle ear is ensured by a small incision (paracentesis) and insertion of a small tube (tympanic drainage) into the eardrum. The tube can be removed again after healing. The defect in the eardrum heals again after some time.
  • otosclerosis
    In otosclerosis there is a stiffening of the ossicular chain in the area of ​​the stirrup. This begins at the inner ear and ossifies there with the oval window, making him immobile and unable to pass sound. This fixation restricts the mobility of the entire ossicular chain and greatly reduces the transmission of sound. The hereditary disease is more common in women than in men and peaks between the ages of 20 and 40 years.
    During pregnancy, the disease process can be accelerated. The resulting deafness has the peculiarity that patients hear their interlocutor better than usual (Parakusis Willisisii) in strong noise.
    In addition to deafness, tinnitus also occurs. The Otosclerosis can be treated by an operative therapy (Stapesplasik). The stirrup is replaced by a prosthesis made of titanium or platinum in its function.
  • Tumor, tumors
    Also in the ear area can cancerous tumors (see also tumor) occur. They can be good or bad. What they all have in common is that they gradually worsen hearing and create a feeling of pressure with occasional tinnitus.
    You can find them from the external auditory canal via the middle ear to the inner ear in all areas of the ear. Fortunately, ear cancers are relatively rare and can be easily removed by microsurgical procedures.

Chronic sound sensory disorder

How does the chronic sound sensory disorder develop and how is it treated?

  • Permanently noise pollution
    Noise makes you sick! First and foremost, the ear itself is affected before it comes to mental reactions. A daily noise level of six hours with a volume of 75 dB or more can cause considerable inner ear damage after years. Factory workers, flight crew, disk jockeys and even regular visitors to noisy discotheques are in danger of being permanently affected by an inner ear hearing loss.
    The occupational health and safety laws absolutely provide for noise protection measures with a corresponding hearing protection for occupations with high noise pollution.
  • Presbycusis (presbycusis)
    In the course of aging hearing loss is still normal to some extent. Various aging processes such as circulatory disorders, drug intake, high blood pressure, diabetes and life-long noise pollution contribute to hearing impairment.
    The bilateral hearing loss can begin from the age of 50 and initially only affects the higher frequencies. For example, insects and birdsong can no longer be heard. Loud background noise such as at a birthday party, usually held in the lively conversations and maybe music is played, the speech understanding may be limited. Hearing loss can be compensated today with state-of-the-art hearing aids.
  • Tumor on the auditory nerve (acoustic neuroma)
    The acoustic neuroma is a benign and slowly growing tumor on the auditory and equilibrium nerves (vestibulocochlear nerve), which usually does not occur until the age of 50 years. Early symptoms are not only deafness but also balance disorders, dizziness and tinnitus (tinnitus). An operative removal can stop the increasing deafness.
  • Central damage
    Since hearing is not only in the ear and its structures, but is ultimately perceived in the brain, damage to the central auditory pathways can make a hearing loss to complete loss.
    A stroke (apoplexy) due to bleeding or atherosclerosis can be the cause of central hearing damage. Most of the time, other neurological symptoms appear and obscure hearing loss.

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