I. What is deafness?
In the auditory system, hearing loss occurs when there is an impairment in the ability to perceive sound due to a lesion in the transmitter, sensor, auditory nerve or (and) its auditory centers at all levels, which is called deafness, also known as hearing impairment or hearing loss. To use an analogy, like a common electric light, there is a power supply coming from the power plant, a complete conductive wire and a good light bulb to get the light at the end. If there is a problem at any point from the power plant to the light bulb, you will not get the light or you will not get the best lighting.
Second, the common types of deafness
There are many ways to classify deafness, such as: congenital deafness and acquired deafness according to time; organic deafness and functional deafness according to the nature of the lesion, and so on. In clinical practice, the common classification method is to divide deafness into three categories according to the location and nature of the lesion, namely, so-called conductive deafness, sensorineural deafness and mixed deafness.
1. Conductive deafness, as the name suggests, is deafness caused by a lesion in the sound-transmitting mechanism that prevents the effective transmission of sound waves to the inner ear, e.g., cerumen embolism, otitis media, etc.; just as in the previous analogy, there is a problem with the conduction of the wire before the bulb.
2. Sensorineural deafness is caused by the lesion of the sensorineural structure or the nerve after the sensorineural structure, which cannot transmit the neural excitation generated by sound stimulation to the brain; or the auditory center of the brain cannot distinguish the linguistic information and causes deafness, such as sudden deafness, Meniere’s disease, ear drug poisoning, labyrinthitis, noise damage, auditory neuroma, cerebral infarction, etc.; in short, it means that although the power reaches the bulb, the bulb appears to be a problem and definitely does not get illumination.
3. Mixed deafness refers to the presence of simultaneous lesions in the sound-transmitting and sound-sensitive structures of the ear. For example, chronic purulent otitis media, advanced otosclerosis, and blast deafness. Something is wrong with both the wire and the light bulb.
III. Grading of deafness
Deafness is clinically classified into five levels according to the degree of hearing loss in deaf patients.
1. Mild hearing loss (hearing threshold 26 to 40dB HL): perceived slight hearing loss and difficulty in whispering, but generally does not affect speech communication.
2, moderate hearing loss (hearing threshold 41 to 55dB HL): perceived hearing loss, general difficulty in conversation, conversation requires the other party to repeat or raise their voice in order to hear clearly.
3, moderate to severe hearing loss (hearing threshold 56 ~ 70dB HL): hearing loss is very obvious, loud difficulties, conversation requires the other party to shout loudly to hear.
4.Severe hearing loss (hearing threshold 71-90dB HL): the conversation requires the other party to shout in the ear, and at the same time, with the help of reading the mouth, in order to generally understand the other party’s meaning.
5.Extreme hearing loss (total deafness, hearing threshold ≥91dB HL): hearing is severely reduced, and there is no response to most of the external sounds, and the speech will be slurred in the long run.
D. Treatment of deafness
Generally speaking, conductive deafness can be treated surgically, while sensorineural deafness can only be treated with medication or hearing aids.
1. Deafness due to external ear diseases such as cerumen embolism, otitis externa, foreign body entry, etc. The primary external ear disease must be resolved as soon as possible, and most deafness can be recovered after treatment.
2.Most deafness caused by otitis media can be recovered or partially recovered by surgical treatment, and if the ear cannot be fully recovered then hearing aids can be worn to meet the needs of daily life.
3. Deafness caused by noise environment should be resolved within three weeks. The first thing is to get away from the noise source, go to the hospital immediately and be treated symptomatically, there exists a chance of recovery or partial recovery; if the exposure to noise is too long or if the exposure to noise is not treated for a longer time (more than three weeks), irreversible damage such as nerve degeneration and necrosis will occur in the cochlea and auditory nerve affected, complete loss of hearing function and finally only hearing aids can be worn.
4.For sudden deafness, you should go to hospital immediately for examination and treatment, the earlier the effect the better, the best time for treatment is within 3 days of onset. 2/3 of patients can recover or partially recover after treatment, 1/3 of patients are difficult to recover no matter how to treat, which is currently a world problem.
5. drug-induced deafness, which is often difficult to treat once it occurs and ends up with hearing aids.
6.Senile deafness, which is difficult to treat, and wearing hearing aids is the best choice.
V. Prevention of deafness
As above, most deafness, especially sensorineural deafness, is very difficult to recover completely through treatment, so the only way to prevent deafness is to actively prevent it before it happens.
1. Don’t blindly pull out your own ears, don’t stuff foreign objects into your ears, and get into the habit of seeing your doctor regularly to remove cerumen. The skin of the external ear canal is delicate, and it is closely connected to the cartilage membrane, with little subcutaneous tissue and poor blood circulation. You can also take vitamin B, C and cod liver oil internally.
2. Prevent colds or control the symptoms of colds as early as possible, because some people will develop secretory otitis media and sudden deafness after a cold.
3. Avoid contact with noise or do a good job of noise shielding. Staying in noisy places for a long time, such as prolonged exposure to various noises such as roaring machines, noisy workshops and noisy people, will cause the microscopic blood vessels in the inner ear to be in spasm frequently, and the blood supply to the inner ear will be reduced and hearing will be drastically reduced. Therefore, taking appropriate measures to protect hearing in daily life and avoiding or reducing noise interference as much as possible is an important part of hearing protection; when listening to mp3, mp4 or mp5 with earbud headphones frequently, remember not to adjust the volume too much, and not to use them for a long time, not more than 30 minutes each time, not more than 60 decibels, because this will make hearing decline, if you want to use them for a long time can not use headphones.
4, caution or prohibit the use of drugs that have damage to the auditory nerve. Before using drugs, we should clarify whether they are ototoxic or not, and strictly grasp the indications for their use. Aminoglycoside antibiotics, such as gentamicin, streptomycin, kanamycin and neomycin, are the most ototoxic drugs that cause damage to the cochlea, so avoiding the abuse of these antibiotics is an important measure to reduce drug-related deafness. In particular, these drugs should be used with caution in patients with family history of ototoxic drug allergy, renal insufficiency, pregnant women, infants and children or patients with neurological deafness.
5. Maintain a good mental state and living habits. Actively participate in social activities and maintain an optimistic and unhurried mood. If you are often in a state of depression, anxiety, impatience, irritation, fatigue, lack of sleep, etc., it will lead to the loss of normal regulation of the plant nerves in the body, ischemia and edema in the inner ear organs, which is an important cause of sudden deafness and can easily lead to sharp hearing loss. Therefore, it is important to try to keep oneself in a relaxed and good state of mind.
6. Actively prevent congenital deafness. Eliminate consanguineous marriage, consciously use genetic diagnosis, must complete newborn hearing screening; actively prevent and treat diseases during pregnancy, reduce birth injuries, detect infant deafness early and treat it as early as possible or do auditory-verbal training as early as possible.
7. Active prevention of age-related deafness. Timely treatment of hypertension, hyperlipidemia, cerebral arteriosclerosis and diabetes. Elderly people with these diseases, especially those with combined arteriosclerosis, are highly susceptible to sudden deafness caused by impaired blood flow to the inner ear. Active treatment of these diseases is very important to improve microcirculatory disorders and slow down hearing loss in the elderly.
8. Regular ear massage can promote blood circulation in the inner ear. For example, massage the auricle, pinch the earlobe, massage the Fengchi point in the recesses on both sides of the hairline at the back of the neck.