Hearing Loss (Deafness), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
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About this ebook
Hearing Loss (Deafness) is a medical disorder that consists of partial or complete loss of hearing, also known as hearing impairment.
The normal lower minimum of the hearing range is 0-20 decibels (dB), where 0 dB is the threshold for the discernment of sound at a given frequency for people with normal hearing.
Normal dB levels are around 30 dB for a whisper, 50 dB for average home noises and 60 dB for conversational speech.
The hearing pain threshold is at about 140 dB (which is about the sound of a jet engine).
Hearing loss is calculated in decibels hearing loss (dB HL).
1. 20-40 dB HL: mild, cannot hear whispers.
2. 41-70 dB HL: moderate, cannot hear conversational speech.
3. 71-95 dB HL: severe, cannot hear shouting.
4. >95 dB HL: profound, cannot hear sounds that would be painful to listen to for a hearing person.
There are two forms of deafness:
A. Conductive hearing loss - this occurs when there is a problem in the transmission of sound waves from the external ear, through the middle ear.
The disease processes can happen at any level along this part of the ear.
1. The external ear canal
a. Obstruction caused by wax
b. Blockage caused by foreign body
c. Obstruction caused by infection (otitis externa)
d. Blockage caused by ear polyps
2. Eardrum
a. Perforation caused by trauma
b. Perforation caused by infection
c. Scarred eardrum from injury or infection
3. Middle ear bones
a. Dislocation of the bones from injury or infection
b. Damage to the bones from injury or infection
c. Fixed bones or osteosclerosis (hardening of the bones from aging)
4. Middle ear infection
Infection of the middle ear happens with fluid in the middle ear cavity stopping sound from passing through
The causes of conductive hearing loss can often be prevented and treated.
B. Sensorineural hearing loss - this indicates problems occurring in the cochlea (the most frequent site of disease), cochlear nerve or brain stem, leading to abnormal or absent neurosensory impulses.
Sensorineural problems are more frequent in adults.
1. Acoustic neuroma
2. Age-related hearing loss
3. Childhood infections, such as meningitis, mumps, scarlet fever, and measles
4. Meniere's Disease
5. Regular exposure to loud noises (such as from work or recreation)
6. Usage of certain medicines
There may be:
a. Damage to hearing organ or cochlea which transmit nerve impulse to the hearing nerve and on to the brain
b. Injury to the hearing nerve (auditory nerve) from loud sounds, infection or injury
Diagnosis
The whispered voice test and tuning fork tests (Weber's and Rinne's tests) can be carried out simply and effectively.
Hearing test (audiogram) can confirm the presence and severity and type of hearing loss
Treatment
1. Remove foreign body or wax
2. Eardrum perforation restoration
3. Using tubes in the eardrums to remove fluid
4. Repair of the small bones in the middle ear (ossiculoplasty)
Hearing aids and cochlear implants
Learning sign language
TABLE OF CONTENT
Introduction
Chapter 1 Hearing Loss (Deafness)
Chapter 2 Cause
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Ear Wax
Chapter 8 Perforated Eardrum
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Hearing Loss (Deafness), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
Hearing Loss
(Deafness),
A
Simple
Guide
To
The Condition,
Diagnosis,
Treatment
And
Related Conditions
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2016 Smashwords Edition
Published By Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes the disease Hearing Loss (Deafness), Diagnosis, Treatments and Related Diseases or in vernacular terms
(What You Need to treat Hearing Loss)
This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.
This autobiolographical account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Conditions
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
Hearing Loss (Deafness)
What is Hearing Loss (Deafness)?
Hearing Loss (Deafness) is a medical disorder that consists of partial or complete loss of hearing, also known as hearing impairment.
The normal lower minimum of the hearing range is 0-20 decibels (dB), where 0 dB is the threshold for the discernment of sound at a given frequency for people with normal hearing.
Normal dB levels are around 30 dB for a whisper, 50 dB for average home noises and 60 dB for conversational speech.
The hearing pain threshold is at about 140 dB (which is about the sound of a jet engine).
Hearing loss is calculated in decibels hearing loss (dB HL).
It can be graded as follows:
1. 20-40 dB HL: mild, cannot hear whispers.
2. 41-70 dB HL: moderate, cannot hear conversational speech.
3. 71-95 dB HL: severe, cannot hear shouting.
4. >95 dB HL: profound, cannot hear sounds that would be painful to listen to for a hearing person.
What are the causes of Hearing Loss (Deafness)?
Risk Factors are:
1. Genetic factors (50%): may or may not be part of a documented genetic syndrome – (e.g., Turner syndrome, Klinefelter's syndrome).
2. Family history of deafness
3. Intrauterine factors (8%): happens in the uterus during pregnancy
a. Congenital infection - e.g., TORCH (toxoplasmosis, rubella, CMV, herpes),
b. HIV;
c. Maternal drugs/toxins - e.g., alcohol, cocaine, streptomycin.
4. Perinatal factors (12%): occurs during pregnancy
a. Prematurity and low birth weight,
b. Birth asphyxia,
c. Severe hyper-bilirubinaemia (jaundice)
d. Sepsis.
e. Low birth Apgar scores,
f. Prolonged mechanical ventilation
5. Postnatal factors (30%): Occurs after birth
a. Childhood infections – (e.g., meningitis, encephalitis, mumps)
b. Meningitis
c. Head injury
d. Neurodegenerative disorders
6. Craniofacial anomalies or any syndrome associated with sensorineural hearing loss
7. Developmental delay in hearing, speech, language
8. Unknown factors: 20-30% of deaf children have no definite known cause.
Causes
The causes of Hearing Loss (Deafness) are:
There are two forms of deafness and patients may present with one or both of these:
1. Conductive hearing loss - this occurs when there is a problem in the transmission of sound waves from the external ear, through the middle ear.
The disease processes can happen at any level along this part of the ear.
2. Sensorineural hearing loss - this indicates problems occurring in the cochlea (the most frequent site of disease), cochlear nerve or brain stem, leading to abnormal or absent neurosensory impulses.
Sensorineural problems are more frequent in adults.
Mixed hearing loss has parts of both conductive and sensorineural hearing loss.
Even though conductive hearing loss is more common, the greater amount of permanent childhood hearing loss is sensorineural.
A. Conductive hearing loss
Conductive hearing loss (CHL) happens due to a mechanical problem in the outer or middle ear.
This may be because:
1. The three tiny bones of the ear (ossicles) are not conducting sound properly.
2. The eardrum is not vibrating in reaction to sound.
The sound waves cannot be sent from the external environment to the cochlea.
The problem may lie in
1. The external ear canal
a. Obstruction caused by wax
b. Blockage caused by foreign body
c. Obstruction caused by infection (otitis externa)
d. Blockage caused by ear polyps
2. Eardrum
a. Perforation caused by trauma
b. Perforation caused by infection
c. Scarred eardrum from injury or infection
3. Middle ear bones
a. Dislocation of the bones from injury or infection
b. Damage to the bones from injury or infection
c. Fixed bones or osteosclerosis (hardening of the bones from aging)
4. Middle ear infection
Infection of the middle ear happens with fluid in the middle ear cavity stopping sound from passing through
The causes of conductive hearing loss can often be prevented and treated.
They are:
1. Collection of wax in the ear canal
2. Injury to the very small bones (ossicles) that are right behind the eardrum
3. Fluid left behind in the ear