Hamish Sillars - Otolaryngologist

Hearing Loss Including Pathologies of the Middle Ear as Well as More Deeply Seated (Including Meniere’s Disease )

Hearing Loss
Hearing loss can be divided into two types: conductive hearing loss (caused by some sort of mechanical problem in the external or middle ear) or sensorineural hearing loss (caused by disorders of the inner ear, hearing nerve or associated brain structures).

Conductive hearing loss is often reversible and can be due to:

• blockage of the ear by e.g. wax, inflammation, infections or middle ear fluid
• poor sound conduction because of e.g. holes or scarring in the eardrum or  the bones of the middle ear (ossicles) becoming fixed and rigid.

Sensorineural hearing loss is generally not reversible and can be caused by:

• genetic make-up (this could include congenital conditions i.e. those you are born with, or late-onset hearing loss)
• head injury
• tumours
• infections
• certain medications
• exposure to loud noises
• the aging process (a significant hearing loss is experienced by about one third of people aged over 70 years). 

Some of the signs you might notice that indicate you have a hearing loss include:

• having to turn up the volume on the TV or radio
• finding it hard to hear someone you are talking with
• finding it hard to hear in a group situation where there is background noise e.g. in a restaurant
• having to ask people to repeat themselves
• you find people’s speech is unclear – they are ‘mumbling’

Hearing loss can be partial (you can still hear some things) or complete (you hear nothing) and may occur in one or both ears.

Treatment

Treatments for hearing loss range from the removal of wax in the ear canal to complex surgery, depending on the cause of the loss. One of the most common treatments for hearing loss is the use of a hearing aid. The type of aid you get depends on the cause of your hearing loss and how bad it is, as well as what your preferences are in terms of comfort, appearance and lifestyle.

If your hearing loss is severe to profound, you may be suitable for a surgical procedure known as a cochlear implant. In this procedure, a small cut (incision) is made behind your ear and a device is implanted that can bypass the damaged parts of your ear. The surgery usually takes 2-3 hours and is performed under general anaesthesia (you sleep through it). You may be able to go home the same day or have to spend one night in hospital.

 

Meniere’s Disease
Meniere’s disease is a disorder in which there is an abnormality in the fluids of the inner ear resulting in increased pressure in the inner ear. There is no general agreement as to what causes this abnormality, but there are probably many different causes including injury (immune, infectious, trauma, allergic etc) to the ear. Symptoms of Meniere’s include episodes: of vertigo (you feel you are spinning), hearing loss that comes and goes, tinnitus (ringing/clicking/buzzing noises in your ear), a feeling of fullness around your ear. Episodes may last for hours or days. The condition will be diagnosed using hearing tests and possibly an MRI or CT scan.

Meniere’s disease usually occurs in one ear only and typically appears between the ages of 20 and 50 years.

Treatment

The initial treatment approach is usually a lifestyle and diet change, including a low salt diet; avoidance of alcohol, tobacco, caffeine and stress; and increased exercise and rest. The majority of patients find that these changes can help control their symptoms. Diuretic medication (reduces the amount of fluid in your body) may also be introduced.

In severe cases where dietary/lifestyle changes have not been successful, surgery may be considered.

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