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 auditory nerve or (and) in the auditory centers at all levels, which is called deafness or hearing loss. To use an analogy, like a common electric light, there is a power plant that delivers power, a complete conductive wire and a good light bulb to get the light. 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, 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, for example, 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 grades according to the degree of hearing loss in deaf patients.
1.Mild hearing loss (hearing threshold 26~40dB HL): feeling a slight hearing loss, small voice difficulty, but generally does not affect language communication;
2.Moderate hearing loss (hearing threshold 41～55dB HL): feel hearing loss, general conversation difficulties, conversation requires the other party to repeat or raise the voice to hear clearly;
3, moderate to severe hearing loss (hearing threshold 56 ~ 70dB HL): hearing loss is very obvious, loud difficulty, need to shout the other party to hear clearly when talking;
4.Severe hearing loss (hearing threshold 71～90dB HL): the other party needs to shout in the ear when talking, and at the same time, we need to look at the mouth in order to understand each other’s meaning.
5.Extreme hearing loss (total deafness, hearing threshold ≥91dB HL): hearing is severely reduced, and the person does not respond 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 caused by external ear disease such as cerumen embolism, otitis externa, foreign body entry, etc. The primary external ear disease must be resolved as soon as possible, and most of the deafness can be recovered after treatment;
2. Most of the deafness caused by middle ear infection can be recovered or partially recovered by surgical treatment. If the ear cannot be fully recovered, hearing aids can be worn to meet the needs of daily life;
3. Deafness caused by noise environment should be resolved within three weeks. If the exposure to noise is too long or if the exposure is not treated for a long time (more than three weeks), the cochlea and the auditory nerve will be irreversibly damaged by nerve degeneration and necrosis, and the hearing function will be completely lost, 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 treatment time 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 intoxication deafness, once it occurs, is often difficult to treat and finally only hearing aids can be worn;
6.Elderly deafness, which is difficult to treat, and wearing hearing aids is the best choice.
V. Prevention of deafness
As mentioned 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 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 sharply reduced. Therefore, take appropriate measures to protect hearing in daily life, try to avoid or reduce the interference of noise is an important link to protect hearing; often use earbud headphones to listen to mp3, mp4 or mp5, etc., remember not to adjust the volume too much, and do not use for a long time, each time can not exceed 30 minutes, can not exceed 60 decibels, because this will make hearing decline, if you want to use 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 the drug, we should clarify whether the drug has ototoxicity, and strictly grasp the indications for the use of drugs. 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. Especially for people with family history of ototoxic drug allergy, renal insufficiency, pregnant women, infants and children or patients with neurological deafness, these drugs should be used with caution;
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 depressed, anxious, anxious, irritated, fatigued, lack of sleep, etc., it will lead to the loss of the normal regulation of the plant nerves in the body, and the ischemia and edema of the inner ear organs, which is an important cause of sudden deafness and can easily lead to a sharp loss of hearing. Therefore, you should try to keep yourself in a relaxed and happy state of mind;
6. Actively prevent congenital deafness. Eliminate consanguineous marriage, consciously use genetic diagnosis, must complete newborn hearing screening; actively prevent and control pregnancy diseases, reduce birth injuries, early detection of deafness in infants and children, early treatment or early auditory speech training;
7. Active prevention of age-related deafness. Promptly treat hypertension, hyperlipidemia, cerebral arteriosclerosis and diabetes. Elderly people with these diseases, especially those with combined arteriosclerosis, are very prone 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.