Hear, hear

The ears are one of our five sense organs but most of us take very little care of them. And a lot of us are gradually losing our hearing owing to neglect, misuse and wilful damage. The inability to hear properly and the consequent misinterpretation of what is heard can lead to misunderstandings with friends and social isolation. It can also be dangerous, as motor horns, bells, sirens and even warnings shouted may be missed.

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Some babies are born deaf as an isolated defect or part of a complex plethora of congenital defects and syndromes. Sometimes the mother contracts measles, mumps or chicken pox during the first few months of pregnancy and deafness occurs in the baby as a result.

Hearing should be checked soon after birth. Some babies can hear, but develop post-lingual (after speech develops) hearing loss. Minor hearing loss can begin by age 20, with difficulty in hearing whispers and soft speech. By the time one reaches 65, 30 per cent have significant hearing loss while 50 per cent are quite deaf by the time they cross 75. Age related gradual degenerative deafness is called presbycusis.

The ear consists of the outer ear, middle ear and inner ear. Sound waves enter through the outer ear and cause vibrations at the eardrum. Three small bones of the middle ear amplify these vibrations as they pass to the inner ear, which contains a fluid-filled snail shaped structure called cochlea. Sound waves make the tiny hairs attached to the nerve cells in the cochlea move in different directions. This transforms the sound waves into electrical signals that are transmitted to the brain.

Continuous exposure to loud sound can damage the fine hair on the nerve cells, leading to progressive loss of hearing. This can be occupational in people who work with loud machinery. It is becoming common in teenagers who use “in ear” earphones to listen to loud music prolonged periods. Even soft piano music should not be listened to for more than two hours at a stretch.

Difficulty in hearing can also occur because of the external ear canal being blocked with wax. This can also lead to severe ear ache. It can be tackled with wax dissolving eardrops. A physician can clean it out. Ear buds tend to push hard wax further inwards, blocking the canal further. Pins and other sharp objects should never be inserted into the ear as they can damage the eardrum.

The middle ear is prone to viral and bacterial infections. Fluid and pus can collect, causing temporary hearing loss. Viral infections are unavoidable but immunisation is available against H. Influenzae and pneumococcus, the two common bacteria that cause ear infections in childhood. These injections are not part of the free national immunisation schedule; they are classified as “optional” vaccines and have to be paid for.

If left untreated, middle ear infections can result in hearing loss. The infection can spread outwards damaging the eardrum or inwards causing brain fever and meningitis. It can also damage the nerves conducting sounds to the brain.

Childhood infections such as measles, mumps and chicken pox could cause deafness as a complication. This too is preventable with immunisation. Vaccinations for all these diseases should be completed by the age of two.

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Hearing loss can develop because of a defect either in the conduction pathways or in the nerve cells. It can also be a side effect of medication such as chloroquine, quinine and aspirin as well as antibiotics like gentamicin and kanamycin.

A sudden blow to the head, or a poke with a sharp object can also rupture the eardrum. Sudden loud noises can have the same effect. In war zones, there are “epidemics” of deafness where large numbers of the population cannot hear. Children are particularly vulnerable.

Once hearing loss has set in it should be evaluated professionally to assess the severity, whether one or both ears are affected and if it is reversible and curable.

Small holes in the eardrum can heal spontaneously or with medication. Larger holes require surgical repair, with skin grafts. In permanent hearing loss, a hearing aid should be considered, particularly in older individuals. Hearing aids vary in price, size and usability. The individual has to be fitted with the aid that suits him best. Cochlear implant surgery is also an effective but expensive solution.

Tips to preserve hearing:

• If occupational exposure to loud noise is inevitable, use ear mufflers.

• Turn TV and music volumes down.

• Do not place foreign objects in the ear.

• Children should be immunised against measles, mumps, German measles, chicken pox, H. influenza and pneumococcus.

• Women should complete their immunisation schedule before marriage.

Source: The Telegraph ( kolkata, India)

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