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DEAR MAYO CLINIC: My husband is 68 and has some hearing loss but won’t go to see the doctor. He says it’s a normal part of aging and thinks there’s not much that can be done for it anyway. How is age-related hearing loss treated, other than a hearing aid? Is there a benefit to having his hearing evaluated now as opposed to waiting until it gets even worse?
ANSWER: This is a great question and something we frequently hear from our patients. It is often because of concerned family members and friends — rather than the patient — that people come to a doctor for hearing loss evaluation. There are two main reasons why it is important to have hearing loss evaluated as soon as it is recognized: first, to determine the cause and second, to review possible treatment options. Early intervention may be associated with a better outcome, depending on the cause of the hearing loss.
Perhaps the first and most important point to make is that while hearing loss does occur in many people older than 50, it is not always from so-called “age-related hearing loss,” or presbycusis. In a small percentage of patients, hearing loss may be the first recognized symptom of a more serious underlying condition, such as a tumor. This may be particularly true in patients with a more sudden decline in hearing, or in cases where hearing loss is worse in one ear compared to the other. When ear drainage, facial paralysis, headache, slurred speech or weakness develops along with hearing loss, it should be evaluated by a doctor as soon as possible.
Hearing loss often is a part of aging. But in almost every case, there are effective ways to manage it. To decide on the best course of treatment, it is critical to identify the type and severity of hearing loss a person has. This can be determined by a hearing test called an audiogram.
There are two basic kinds of hearing loss: conductive and sensorineural. Conductive loss usually involves problems of the ear canal, eardrum, or the three bones of hearing. Common causes of this pattern of hearing loss include a buildup of earwax, infections, a ruptured eardrum, and stiff or absent bones of hearing.
Sensorineural loss usually involves damage to the organ of hearing, called the cochlea, or the nerve of hearing, called the auditory nerve. In adults, age-related hearing loss and a history of loud noise exposure are common causes of sensorineural hearing loss.
Age-related hearing loss is usually gradual and most commonly affects both ears equally. Many people first notice this type of hearing loss when they start to have trouble hearing others speaking in a noisy environment or when using a telephone.
If hearing loss is associated with aging, hearing aids are usually the most effective way to manage it. Although some people may dislike the idea of wearing a hearing aid, current models are small and discreet. Some can be placed entirely in the ear canal, making them almost invisible.
Many types of conductive hearing loss can be effectively improved with surgery. For mild to moderate conductive and sensorineural hearing loss, hearing aids also are very effective. As an alternative to conventional hearing aids, implantable hearing devices may be an option for some patients. For severe losses, hearing aids are generally less useful and a cochlear implant may be an option to consider.
Research has shown that the treatment of age-related hearing loss has many benefits, such as improving the ability to hear in social situations and to communicate with others. This makes it easier for older adults to continue in their normal routines and to interact with friends, family members and other people they come in contact with each day. I would encourage your husband to have his hearing evaluated soon. — Matthew Carlson, M.D., Otorhinolaryngology, Mayo Clinic, Rochester, Minn.