Hidden Hearing Loss
Hidden Hearing Loss, yet another reason to protect your ears!
They say “knowing is half the battle”. If you don't know what the problem is, how can you address it? In medicine, this axiom is especially true, and our ears are a perfect example.
Unsurprisingly, over the years, lots of people have come to my office complaining of communication problems, especially difficulty understanding in noisy situations. A common thread for many is a positive history for loud noise exposure (concerts, construction, gunfire, etc.). Most were found to have some degree of hearing loss, but some were found to have hearing within normal limits. I would counsel those patients about the anatomy of the inner ear (“cochlea”), with its little nerve 'hair' cells, and how damage to them causes hearing problems. One of those problems being, you guessed it, difficulty hearing in noisy environments. I didn't know specifically what the mechanism of the problem was, but it had to do with something in there that researchers weren't seeing/finding.
With the advent of advanced imaging techniques and electrophysiological measurements, new research seems to point to an explanation for this problem, termed “Hidden Hearing Loss”. The problem lies not in the sensory (or 'hair') cell itself, it's the connection (“synapse”) of that cell to the neural 'wiring' sending the nerve impulse to the brain that shows damage. The cell may be trying, but it's signal never gets received. This is referred to as “auditory synaptopathy”. The latest research indicates that exposure to sound loud enough to cause hearing loss is directly related to auditory synaptopathy. Here was (at least part of) the answer!
Those patients I tested and could find 'nothing wrong', their issues in noise were real. What I've seen and heard from my patients over the last 20+ years, the latest research now corroborates and confirms. And until there's a cure, what we lose, we don't get back...
My take-home message is this, when it comes to your ears, an ounce of prevention is worth more than a pound of cure! Whether you are an engineer/contractor on a job site or music lover (like myself) going to a show at the Fox or UC Theater, obtain and consistently use hearing protection. There are lots of options, from the inexpensive standard foam plugs you can get in a pharmacy (as effective as anything out there when used properly) to specialized, custom fit ear molds ('musician' and 'shooter' earplugs, in-ear monitors, etc.) that are obtained from audiologists like myself.
Our deeper understanding of our body systems has led to truly amazing medical cures and treatments for a great many health issues, so that we are living longer and healthier lives. Though hearing aids are amazing nowadays (and they really are), it is an imperfect answer to a medical problem that can't be “corrected”, only mitigated. Protect your ears and prevent hearing loss, rather than having to treat if after the fact.