Dr. Hazenfield -- Ear, Nose, and Throat Doctor in Hawaii

Hearing Loss and Hearing Aids

Hugh N. Hazenfield, M.D., F.A.C.S.

Hearing loss is a condition that may develop insidiously and frequently affects the daily life of the person who suffers with it.  Many hearing-impaired individuals do quite well in their enjoyment of life.  However, good hearing certainly augments our communication, our safety, and our enjoyment of music and other forms of entertainment, of which we have many opportunities in Hawaii.  Dr. Hazenfield has extensive experience in the diagnosis and treatment of hearing loss in children and adults.

Anatomy of the Right Ear

How sound reaches the brain:

Who develops hearing loss? 

Anyone can have hearing loss.  It may be present at birth or may develop later in childhood or adulthood.  Congenital hearing loss is present at birth but may not be suspected until the child is one or two years old.  Acquired hearing loss in children usually develops due to an ear infection or fluid behind the ear drum.  It is extremely important to detect pediatric hearing loss very early so that speech and mental development is not delayed.  If you suspect that your child - even in infancy - might have hearing loss, see an otolaryngologist as soon as possible.  We now have screening techniques which give enough information even in newborn children to determine if there is hearing loss.

Teenagers and young adults may develop hearing loss due to noise exposure from loud music and rock music concerts, loud stereos or earphones, fireworks, firearms, or any loud noise.  Hearing loss may also occur at this age due to fixation of one of the small bones in the ear (otosclerosis). 

In older adults, hearing loss is usually due to the normal aging process and/or noise exposure at work or in other situations.   In any age group, hearing loss may be due to ear wax or perforations of the ear drums.

Can hearing loss be corrected?

Hearing loss can be due to various problems.  Dr. Hazenfield can help determine what type of hearing loss a patient has and whether it can be corrected.

Types of hearing loss:

• Conductive hearing loss occurs with cerumen, or wax, in the external canal, a perforation or hole in the ear drum, negative pressure in the middle ear due to the Eustachian tube not functioning well, fluid in the ears, a cholesteatoma (sac of dead cells), or problems with the small bones.  It may be improved or cured with removal of the wax, medication, or surgery -- sometimes very simple surgery.   In the above diagram, conductive hearing loss occurs in the ear canal, ear drum, or middle ear.

• "Nerve type" hearing loss, usually called sensorineural, is due to problems of the cochlea, or inner ear, the nerve from the ear to the brain (cochlear nerve), or in the brain.  In this case, tests may be required to be certain that a tumor is not present and to determine if there might be other associated problems.   Treatment is usually with a hearing aid and occasionally with surgery.  Some patients with poor speech discrimination (not understanding words even if the sound is loud enough) will not benefit from hearing aids.

• Mixed hearing loss, or a combination of the conductive and sensorineural types, sometimes occurs and may require various treatment modalities.

Why do children have tubes placed in their ears?  

Children frequently develop a chronic collection of fluid behind their ear drums, which prevents them from hearing normally and makes them develop ear infections more frequently.  Only after observation and/or medication fail, Dr. Hazenfield may perform a minor operation to remove the fluid from behind the eardrum.   A small tube is then inserted through the ear drum so that air can go from the outside to the inside, preventing fluid build-up and hopefully preventing frequent infections.  The child usually hears normally as soon as the operation is completed.    Dr. Hazenfield allows most children to swim while the tubes are in place.

Tube in right ear drum

Will hearing aids help?

• Hearing aids are expensive, so you should be certain that you will benefit from them.  Most insurance plans either do not cover the cost of hearing aids, or only a small portion of the cost.  Be aware that Medicare does not cover hearing aids.  Dr. Hazenfield suggests the following cautions:

   

  • You should be evaluated by an otolaryngologist for medical clearance for a hearing aid prior to purchase to be certain that hearing aids are appropriate for you.  Reputable dealers and dispensing audiologists will ask you for this in writing.

  • Compare prices at a minimum of two dispensing audiologists or dealers.  Retail prices vary greatly for similar hearing aids.

  • Ask what services are included.

  • Ask what the warranty includes.  Does it include replacement if your hearing aid is lost or if your dog chews it into pieces?

  • For some people, the best choice is the least expensive hearing aid.  These are usually larger, easier to insert and remove, and easier to find if misplaced.

  • Even if a patient has hearing loss in both ears, most do very well with amplification on one side only.  This also has the advantage of being less costly than two.

  • Trial period:  If you purchase a hearing aid, be certain that you may return it within a reasonable time period if you do not like it. 

• Hearing aids work for most people with hearing loss, whether the hearing loss is conductive or of the nerve type.  However, some patients do not understand words well, even when the sounds are amplified.