Hearing Loss: Does Gender Play a Role?

, University of Washington Medical Center; , University of Washington Medical Center, Virginia Merrill Bloedel Hearing Research Center


Medscape General Medicine. 1997;1(2) 

In This Article

Hearing Rehabilitation

Speech reading.Speech reading is "the integration of lip movement, body gestures, facial expressions, situational clues, and linguistic factors."[2] The more hearing-impaired the individual, the more he or she must rely on visual cues. Speech reading is considered to be a supplement to hearing--not a substitute for it."[2] Most people function best with the combination of speech reading and some form of hearing aid (personal listening devices or amplification).

Personal listening devices . Some hearing-impaired individuals use assistive listening devices, such as telephone amplifiers, infrared television listening systems, closed-caption television adapters, and light systems that flash when activated by a telephone, doorbell, alarm clock, or smoke detector.

Amplification. The 1990-1991 US hearing survey revealed that only 18% of persons who reported having hearing trouble use a hearing aid.[1] Approximately 1.6 million American women require the use of a hearing aid.[1] Gates and colleagues[12] found that 10.3% of study subjects had worn a hearing aid, but 22% of those wearing hearing aids no longer used them.

There are 4 main types of hearing aids: body, behind the ear, in the ear, and in the ear canal. About 80% of hearing aid fittings are for use in the ear or in the ear canal.[2] It is generally recommended that hearing aids be fitted for both ears.

The new digital technology has improved the sound quality and fidelity of hearing aids. Many devices are now programmable, allowing the hearing-impaired person to change settings for different environments via a remote-control unit.

Cochlear implants. In selected patients, cochlear implants are an effective treatment for SNHL. Approximately 90,000 to 200,000 persons with hearing loss are candidates for cochlear implantation.[2]

Common etiologies for SNHL that would be amenable to treatment with cochlear implantation include cochlear otosclerosis, Meniere's disease, infection (measles, mumps, meningitis, viral labyrinthitis), ototoxic drugs (Table III), trauma, and vascular disease.

Cochlear implants provide direct electrical stimulation to the auditory nerve fibers, bypassing damaged hair cells in the organ of Corti. The cochlear implant includes a microphone that picks up sound information and sends it to a processor located external to the body; a processor that converts the mechanical acoustic wave into an electrical signal; and an implanted electrode placed near the auditory nerve, which passes the electrical signal from the processor to the auditory nerve.

Cochlear implants have proven to be a successful treatment for profound SNHL in properly selected patients. Postlingually deafened adults, especially those with a recent onset of deafness, have benefitted the most from cochlear implants. Clinical selection criteria continue to be cautiously expanded.

Hair-cell regeneration. The ultimate "cure" for profound SNHL is regeneration/replacement of damaged hair cells. While this is an active area of investigation at numerous locations, the clinical application of this promising treatment is 1 to 2 decades away.