Hard of hearing

Hearing loss (hypacusis) is a partial reduction of hearing. Approximately 5% of the population in the Czech Republic is affected by hearing loss, mostly older individuals with presbyacusis. Both severe and mild degrees of hearing loss can bring with them significant handicaps in the professional (e.g. musicians) and social fields. It significantly reduces the quality of life; in some cases, hearing loss can result in the patient's psychosocial isolation. It can also be a 'symptom of a more complex and serious disease (e.g. a brain tumor). Sudden hearing loss is a condition in ENT that needs to be addressed urgently.

Hearing disorders can be of central or 'peripheral origin. Peripheral hearing loss is much more common than central hearing loss.

Central hearing loss
Central hearing loss arises as a result of damage at the level of '''II.-IV. neuronin auditory pathways'''. The nature of the damage is varied, it always depends on the location and size of the lesion, most often it is a trauma or a tumor. That is why we often observe a focal neurological deficit with hearing loss. The clinical picture can sometimes lead us to a "false" trace of a phatic disorder or an intellectual disorder.

Peripheral hearing loss
Peripheral hearing loss can be conductive' or perceptual.

Conductive hearing loss
The cause may be an obstruction in the outer or middle ear; it can be a sebaceous plug or inflammation in the external ear canal, perforation of the eardrum, acute or chronic otitis media, Eustachian catarrh tube, otosclerosis etc.

Perceptual Deafness
Perceptual hearing loss occurs as a result of damage to the inner ear or auditory nerve. It can be further divided into cochlear' and 'retrocochlear. Hearing losses are usually uneven, patients have difficulty understanding even after increasing the intensity of speech. They often suffer from diplacusis:


 * diplacusis dysharmonica - the tone is heard at a different pitch in each ear;
 * diplacusis echotica - in one ear he hears sound delayed.

Sensorineural cochlear hearing loss
This is damage to the cochlea (hair cells); etiologically, it can be presbyacusis, socioacusis, Ménière's disease, ischemic or toxic damage to the inner ear. In this case, the transmission system is fine, in the differential diagnosis it is necessary to distinguish between supracochlear damage.

Perceptive retrocochlear hearing loss
The most common cause is tumors of the pons of the cerebellum'. 70&thinsp;% of cases are vestibular schwannoma. The remaining 30&thinsp;% is due to meningioma, dermoid cyst, neurofibromatosis, toxic or parainfectious involvement.

Related Articles

 * Classification of Hearing Disorders
 * Examination methods in ENT/overview
 * Hearing test
 * Examination of the balance system
 * Audiometry (Physiology)

Source

 * BENEŠ, Jiří. Study materials  [online]. ©2007. [feeling. 2009]. < http://jirben2.chytrak.cz/materialy/orl_jb.doc >.