Sudden sensorineural hearing loss

Sudden sensorineural hearing loss (SSHL) is defined as a rapid- onset subjective sensation of hearing impairment, resulting in 30 dB loss at three or more frequencies .

The majority are unilateral hearing loss , and they may occur with tinnitus and vertigo or dizziness. The most effective treatment is oral and/or intra-tympanic injections of steroids. If a person presents for treatment within 2 weeks of the onset of symptoms, the chance of a full or partial recovery of hearing is much improved.  

What to do!

1. See an audiologist for a hearing assessment ASAP to confirm diagnosis of sudden sensorineural hearing loss (SSHL) versus conductive loss.
2.See your GP/ ENT specialist to start on oral steroids, typically Prednisone .

3. Evaluate for retrocochlear pathology by MRI.
4. See an ENT specialist for intratympanic steroid therapy when incomplete recovery from sudden SNHL .
4. Follow-up audiometric evaluation at the conclusion of treatment.
5. Audiologic rehabilitation for patients who have residual hearing loss and/or tinnitus who may benefit from treatment.

Hearing loss and Diabetes

The relationship between hearing loss and diabetes has long been debated. Recent research now concludes that hearing loss is more prevalent in adults with diabetes even when the major factors known to affect hearing, such as age, race, ethnicity, income level, noise exposure , and use of certain medications have been accounted for.

One research study included data from participants ranging in age from 20 to 69. Important information they found:

• People with diabetes were 2x more likely to have hearing loss than people without.

• People who are pre-diabetic are 30% more likely to have hearing loss.

How does diabetes cause hearing loss?

Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear, the researchers suggest.

High blood sugars may damage the very small blood vessels that support and feed the inner ear. This is similar to how high blood sugars can affect vision and kidney function. The blood vessel system that feeds the ear is very similar to the systems that support the eyes and kidneys. As this system is damaged, hearing is compromised.

Fight back

Diabetes may play a role in hearing loss, but you can fight back by helping reduce your overall risk of hearing impairment. Some prevention tips:

• Manage your diabetes if you have the disease, using strategies created with your medical doctor.

• Reduce exposure to excess noise, one of the most preventable causes of hearing loss.

• Eat a balanced, nutritious diet, which contributes to better ear functioning.

• Avoid tobacco use, a risk factor for cancer, hearing loss, and many other problems.

• Stay physically active, reduce blood sugar level.

• Regular hearing check monitor your hearing.

Why you feel so tired after a conversation

(Fig. 1, Kral et al., 2016)

Hearing and listening are not the same. We may use the wording interchangeably, but in terms of underlying processes, the two differ. Listening is defined as hearing with intention and attention (Kiessling et al., 2003). Listening thus involves both auditory and cognitive processing. Therefore, mechanisms such as attention, working memory and speed of processing are relevant themes when exploring the topic of listening. Listening begins peripherally, but it actually involves a mosaic of different cognitive functions working together in order to achieve fast and efficient perception of sounds. This ensemble of cognitive functions is called the listening connectome (Fig. 1, Kral et al., 2016).

Listening effort

Listening effort can be described as mental exertion required to attend to and understand an acoustic input.

The diagram below explains two different pathways how we understand acoustic inputs

First, in a quiet environment, the auditory signal is clear and can easily be recognized and understood. This is a fast process that requires low cognitive effort.

Second is in a more difficult , complex situations( or when the hearing threshold gets worse). Auditory signal is degraded and is difficult to recognize. Instead of instant recognition, the distorted input signal is compared to already stored information in the memory before understanding is possible. This requires a lot of effort and leads to fatigue.

Everyone has finite amount of cognitive resources. Cognitive resources can be used to compensate for the hearing difficulties. The greater the hearing problem, the more effort is required to listen and understand, hence feels fatigued quicker.

References

Kiessling J, Pichora-Fuller MK, Gatehouse S, et al. (2003). Candidature for and delivery of audiological services: Special needs of older people. Int J Audiol, 42(Suppl 2), S92–S101.

Kral A, Kronenberger WG, Pisoni DB, et al. (2016). Neurocognitive factors in sensory restoration of early deafness: a connectome model. Lancet Neurol, 15, 610-621.