According to Dr. Agrawal, simply recognizing that the problem exists is the first step. She observed that routine screening for hearing loss is not currently implemented on a wide scale, but this may be worth looking at. She suggested that recognizing the risk factors gives us the opportunity to identify individuals with a higher index of suspicion for developing progressive hearing loss. Controlling some very common comorbidities can decrease the risk of hearing loss or risk of further hearing loss, she continued.
Explore This IssueOctober 2008
Marc B. Kramer, PhD, a diagnostic and forensic audiologist on the faculty of Weill Cornell Medical College in New York, concurred, saying, It should be recognized that hearing loss is not something that affects only the elderly. Hearing should be evaluated and baselined much earlier in life. Individuals who show early signs of hearing loss, even below the benchmark, should be counseled on lifestyle changes and risk reduction.
While patients can’t change their race or gender, other contributing risk factors can be controlled. Physicians can counsel patients and offer medical interventions to help control hypertension and diabetes mellitus. The increased risk of hearing loss and the associated negative impact on quality of life offer even stronger data to support the argument for smoking cessation.
Noise reduction is also a risk factor that can be controlled to a great degree. Dr. Kramer speculated that current OSHA regulations designed to protect individuals from occupational noise exposure should have a significant impact on prevention of hearing loss, although he expects that data won’t show up in the statistics for several years. He also suggested that physicians should educate themselves on the types of hearing protection that are available. For example, he noted that today there are Musicians’ Earplugs TM available, which lower sounds by 15 to 25 decibels without distortion, so even professional musicians can reduce noise effect and protect their hearing without affecting the quality of sound.
Despite our best efforts, some patients will continue to experience hearing impairment. Earlier screening and diagnosis can identify the need for practical intervention with amplification. There remains a certain stigma connected to the use of amplification devices. Physicians can help their patients overcome reluctance to use such devices by educating themselves on the latest technologies available and by providing patients with statistics and counseling regarding the impact their hearing loss can have on quality of life.
Said Dr. Kramer, The good news is that for people with hearing loss who perceive it and acknowledge it, there has been a tremendous amount going on with hearing aid design, particularly in the last five years. Growth in amplification is truly amazing. Physicians should advise their patients that hearing aids are there, they’re good, and they’re getting better and better. Technology in this area is improving faster than computer technology.