Deafness – forms, symptoms – treatment

Deafness – forms, symptoms & treatment

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Overview of deafness and hearing impairment

Definition: Hearing impairment, impairment of hearing


  • Congenital hearing loss
  • Lack of oxygen at birth
  • meningitis
  • Sudden Hearing Loss
  • Malfunction of the ear
  • injury
  • presbycusis

symptoms: Certain frequencies and volumes can no longer be heard

Diagnosis: Anamnesis at ENT doctor, various hearing tests

Treatment: Drug / surgical treatment, hearing aids, implants

Communication: Sign language, “lip reading”

Deafness Definition: What is a hearing impairment?

A Hearing is a impairment of hearing. This can of hearing loss about hardness of hearing up to deafness rich. This can innate or in the course of lifeacquired his.

Deafness means concretely that noises and sounds are no longer perceptible due to bilateral deafness of the ears. The medical Definition of deafness, however, refers only to the hearing.

Anatomy of the Ear: How Does the Ear??

The ear is anatomically divided into three parts:

The outer ear consists of the auricle and the outside ear canal, through the sound waves in the middle ear reach.

The transition to middle ear make that eardrum, which directly with the hammer (Malleus) is connected. This makes up together with two little bones anvil and stirrup the ossicles. she conduct sound from the eardrum to the middle ear in the inner ear, where the auditory perception seated.

The inner ear and the middle ear are located in the temporal bone, part of the skull. From the auditory ossicles, the sound is transmitted through the oval windows in the liquid-filled cochlea transfer.

In the cochlea the sound is registered and over the auditory in the brain first processed in the lateral brain and then sent to higher processing centers. The sound can bypass the eardrum and also enter the cochlea via the cranial bone (bone conduction).

Everyone step of the auditory perception and the subsequent one processing can be disturbed and therefore too Lead deafness.

These dysfunctions of the ear can lead to deafness:

  • Congenital sound conduction disorders
  • Increased bone growth in the auditory canal (exostosis)
  • Narrowing (stenosis) from scars and inflammation
  • Chronic otitis media
  • Chronic ventilation disorder of the Eustachian tube
  • otosclerosis

Forms of deafness

One differentiates between the two forms Conductive hearing loss and Sensorineural hearing loss. The course can either acute or chronic his.

Distinction can also be made between absolute and practical deafness:

  • Absolute deafness: Means a hearing loss of more than 60 decibels in the range 125 – 250 hertz and more than 100 decibels in the rest of the frequency range.
  • Practical deafness: Means that hearing loss is between 85 – 100 decibels. This residual hearing still allows a perception of individual sounds or noises.

In addition, deafness is also defined through linguistic and cultural identity. Accordingly, people with impaired hearing are hearing impaired, who communicate mostly in sign language. Often they see themselves as part of this language community and their culture.

Classification after the occurrence of deafness

A deafness can be innate and therefore already exist at birth (innate deafness). Or it forms in the course of life (acquired deafness). Depending on when the acquired hearing impairment occurs, a distinction is made between different forms.

These forms of deafness are distinguished:

  • Prelingual Deafness: Those affected are already deaf before they can develop a language.
  • Postlingual Deafness: The bilateral deafness occurs only after completed language development.

This subdivision is important in terms of the consequences that deafness or bilateral deafness can have.

Is that possible hearing both ears in front the 7th year of age lost, this is often with complete loss of the already acquired Language vocabulary connected. The result is speechlessness. Begins the absolute or practical deafness on the other hand after the 7th year of age, stay that Vocabulary received.

Conductive hearing loss

In the case of conductive hearing loss, the sound not right anymore to the inner ear passed become. It is created by a shutter of meatus or by damage to the sound-conducting structures, usually by changes in the area of ​​the ear on the outer side or the middle ear.

Acute conductive hearing loss can be caused by the following circumstances:

  • Increased formation of earwax or “pushing backwards” when cleaning
  • Water that has entered the ear while bathing or swimming
  • Injuries of the eardrum (explosions, slaps, objects such as cotton swabs)
  • Closure of the Eustachian tube, the tube that connects the middle ear to the nasopharynx
  • Fluids in the middle ear, such as colds or changes in air pressure (flying, diving)
  • Otitis

Chronic conductive deafness can be caused by the following circumstances:

  • Chronic otitis media
  • Tubal ventilation disorder
  • Increased bone growth in the middle ear (otosclerosis)
  • Narrowing by scars, inflammation, tumors
  • Congenital malformations of the ear

Sensorineural hearing loss

The sound sensory disorder is one damage or one insufficient function of the cochlea as well as the auditory nerve or of brain basis.

An acute sensory disturbance can be triggered by the following causes:

  • Sudden Hearing Loss
  • Heavy noise (New Year‘s Eve party, shots, explosions, music concerts)
  • Infections (mumps, measles, scarlet fever, typhoid, AIDS, shingles)
  • head injuries
  • Diseases such as Meniere’s Disease, Renal Impairment, Vascular Alterations, Cervical Diseases, Multiple Sclerosis
  • Extreme stress situations

A chronic sensory disturbance can be triggered by the following causes:

  • Aging processes (“age-related hearing loss”)
  • Years of noise exposure (industry, construction, discos)
  • Congenital malformations of the ear
  • Diseases such as kidney and thyroid dysfunction, diabetes, vascular changes, immune and autoimmune diseases
  • Acoustic neuroma (benign tumor)
  • Meniere’s Disease (Disease of the Inner Ear)

Degrees of deafness and deafness

From a medical point of view, there are several gradations from hardness of hearing and deafness. The hearing loss is determined by means of an audiogram in different sound frequencies determined.

The grades of hearing impairment are subdivided as follows:

  • hearing: Is a mean hearing loss at about 50 decibels. Slight deafness is 20-40 decibels Hearing loss, severe hearing loss 60-80 decibels Hearing loss.
  • Residual hearing: Defined by a hearing loss from about 90 decibels. This is also understood to mean “deafness-related deafness”.
  • Deaf: Deaf is when the hearing loss is more than 120 decibels.
The ticking of a wristwatch is about 20 decibels. A normally strong conversation is 55 decibels, traffic noise about 75 decibels.

hardness of hearing can acute or chronic occur. In most cases, one is acute Deafness only from short duration and heals in other cases, this must be like in chronic hearing damage one treatment be subjected. Whether and how well a hearing loss treat lets, is differently.

Depending on the volume and pitch of an affected person no longer hearing, doctors distinguish different degrees of hearing impairment or deafness.

These degrees are distinguished in deafness and deafness:

  • Low grade deafness: For example, the person no longer hears the ticking of a wristwatch (hearing loss of 20 – 40 decibels).
  • Moderate deafness: The patient no longer perceives any ambient noise, for example birdsong (hearing loss of 41 – 60 decibels).
  • High grade deafness: Affected no longer hears conversations (hearing loss of 61 – 80 decibels).
  • Residual hearing or deafness: The patient does not hear very loud noises, such as loud dance music (hearing loss over 81 decibels).

If the hearing differs by a maximum of 20 decibels, there is no hearing loss.

What is the difference between deafness and deafness??

who deaf is, takes language and Sounds just limited true. Should the hearing hardly or no longer available to be, one speaks of “Deafness”. The victims then hear single sounds, but no longer perceive any connections of the language.

  • Under hardness of hearing one understands an impaired oneauditory perception.
  • Under deafness one understands the complete one loss of the auditory perception.

The difference can be determined objectively with a hearing test (tone threshold audiometry). The hearing loss is detected in the so-called main speech area. The main language area is that frequency area in which primarily the human language takes place.

What are the causes and risk factors of deafness??

Estimated to have around 15% of the Deaf your Deafness inherited. In the most cases is the deafness but acquired.

Before the birth can he fetus because of a viral disease of the mother (Rubella, toxoplasmosis) or by medication damaged have been. During the birth can lack of oxygen or mechanical birth trauma a Hearing cause.

Causes of hearing loss in childhood are mostly:

  • Meningitis
  • Skull fractures
  • Viral infections such as mumps or measles
  • Chronic middle ear infections
  • Certain medications

In many cases, however, the cause remains unknown despite medical progress.

Causes of hearing impairment can be:

  • noise-induced hearing
  • presbycusis
  • Congenital hearing loss
  • Lack of oxygen at birth
  • meningitis
  • Sudden Hearing Loss
  • otosclerosis
  • injury

Is a hearing impairment heritable?

The innate deafness is inheritable or may have their causes in damaging influences during pregnancy. Consumption of alcohol or nicotine during the pregnancy can a deafness or deafness in the unborn baby.

Congenital deafness

Hearing disorders or deafness can occur frequently within a family. The causes of genetic deafness are malformations of the inner ear or the brain.

Besides, too infections of the mother during the pregnancy, such as rubella, disturb the development of hearing in the unborn child. Thus, the hearing is impaired or even leads to deafness.

In addition, certain increase drugs, but also drugs during pregnancy, the risk of hearing loss in the child.

Well-known examples of hearing-damaging drugs are:

  • thalidomide
  • Antibiotics from the group of aminoglycosides
  • macrolides
  • glycopeptides.

lack of oxygen and Cerebral hemorrhage during the birth can also for deafness to lead. So have premature babies children, due to a inadequate lung maturity shortly after the birth on lack of oxygen suffer, one higher risk for a hearing disorder. This also applies to newborns who have been in the incubator for more than two days.

Acquired deafness

The most frequentreason for one acquired deafness is a serious or longer infection ofear. This can severely damage both the middle ear (sound conduction) and the inner ear (sound sensation).

Also Infections of the meninges or the brain can cause damage to the hearing. Meningitis-related injury to the ear can lead to ossification of the cochlea.

At a encephalitis Nerve pathways in the brain, which are responsible for the transmission of the acoustic information from the inner ear, are damaged. Likewise, the receiving site for this information in the brain (auditory cortex) can be affected by encephalitis and thus a deafness cause.

Symptoms and first signs of deafness

at hardness of hearing are different symptoms depending on reason strong in extent and kind. Deafness is always expressed in the fact that Affected sounds and Sounds only in attenuated form perceive.

First signs of hearing problems are:

  • Overhearing of nature sounds
  • Overhearing household noise
  • Overhearing of telephone or bell
  • Increased feeling that the conversation partner is mumbling
  • Bad speech understanding in background noise
  • People around the person complain about too loud audio equipment

Depending on the degree of deafness, conversations are becoming increasingly difficult. Most people turn up the volume of audio devices without being aware of their problem. By a strong, unbalanced hearing loss that can impaired social life his. Depressed moods are then possible as further symptoms and consequence of hearing problems.

In addition to a hearing loss, additional, different symptoms may occur. In some cases sufferers notice tinnitus with increasing hearing loss or hearing loss. Since that inner ear that too Vestibular system It may be due to changes in the inner ear Dizziness come.

hardness of hearing characterized by the fact that certain frequencies and volumes less or at all no longer heard become. Accompanying symptoms depend very much on the actual cause and extent of the disease.

For example, lead pathological changes In the inner ear often at the same time to tinnitus, dizzy spells and balance disorders, since the organ of equilibrium is also in the inner ear.

Hard of hearing people are exhausted faster, because the listening process with higher effort and more concentration connected is.

the time being, however questioned of the doctor the patients after symptoms and previous illnesses (anamnesis). The doctor wants to know since when the hearing loss first noticed and if even more complaints consist.

Before the ENT doctor the hearing with a hearing test more precisely, he takes one physical examination in front. These include various tests, such as the tuning fork test. This test can give information about the type of hearing loss after a detected hearing loss. Using a ear mirroring (Otoscopy) the doctor may be possible changes in the ear recognize.

With a hearing loss, the doctor leads to the exact diagnosis different listening tests by. You help him, the hearing for the individual pitches (Frequencies). The doctor determines the sounds that the patient can still hear.

With a hearing loss diagnosis usually still comes more tests in question, about the tympanometry and the Stapedius reflex measurement. Here, the doctor measures the function of eardrum. The measurement of so-called otoacoustic emissions is instructive to get to the bottom of the cause of a hearing loss.

Diagnosis of deafness:

  • Anamnesis by ENT doctor
  • Physical examination
  • hearing tests: Otoscopy (ear reflexology), tuning fork test, tympanometry, Stapedius reflex measurement

How is deafness treated??

In a hearing loss depends the therapy of the causes from. Depending on the cause is one special treatment necessary. This may be due to deafness drug or operational Measures to the adaptation of a hearing aid walk.

Hearing Aids can be worn behind the ear or directly in the ear. On Hearing Care advises about the individual options and fits the hearing aid.

Psychotherapeutic treatment is useful in cases of deafness if the hearing loss is caused by stress or if the person suffering from the condition suffers from depressive mood.

Hearing aids for hearing loss

Some deaf people wear it Hearing Aids, to continue to use the low residual hearing. Almost always then can strong sounds, such as car horns or shouts, perceived become.

A speech understanding or closer hearing is hardly given. By means of a hearing aid no familiar hearing or even speech comprehension can be expected. An adaptation of the hearing aid is carried out by hearing aid acoustician.

Cochlear implants in deafness

So-called cochlear implants are electrodes implanted on one or both sides, which are connected to the transmitter and receiver on the outside of the head. These transmit some of the sounds. These can be from the wearer in implemented to varying degrees and Roger that especially at Late Deaf are mostly good results to achieve.

Early hearing impaired can usually only one part of the Sounds and language recognize and understand. Most remain the carriers Nevertheless strongly deaf or deaf.

In that sense, it can no comprehensive hearing and comprehension, as healthy listeners know it, achieved become. Consequently, the communicative orientation of the implanted often remains uncertain.

Deafness in everyday life

When hearing people do not speak sign language, communication requires deaf people to refrain from speaking from the communication partner’s mouth.

The lipreading is for the person concerned exhausting and often leads to misunderstandings in communication. Because around 30% of the spoken word can be perceived and understood correctly under optimal conditions. The remaining 70% must be more or less guessed. To counter misunderstandings, some things can be considered in advance.

Dealing with the deaf in everyday life

Listeners can follow the following rules:

  • Deaf people should go look at the speech and keep eye contact.
  • You should be careful enough Light falls on the face and the mouth is not covered is.
  • Speak slowly and clearly, but not louder than usual. Too loud speech distorts facial features and makes reticles difficult.
  • Clear facial expressions and gestures use, as well as natural gestures.
  • Short, clear sentences use.
  • preferably high German speak, because the rejection of dialects is even more difficult.
  • If you want to appeal to the deaf, you can do his Attention by winking to draw a hand. One should not be afraid to touch the deaf lightly on the shoulder or on the arm, or switch the light on and off. The deaf will respond in this way and will not find it strange.
  • Learning the sign language can help to communicate with the affected person even better and more effectively.

Dealing with hearing impaired people throughout history

For centuries deaf people had a very difficult position in society. Since they could barely communicate with other people, they were considered mentally impaired. That changed when the Parisian priest Abbé Charles Michel de L’Epée became the first deaf school in the second half of the 18th century called into life. He is still considered spiritual today Father of Sign Language.

In Germany founded Samuel Heinicke at about the same time in Leipzig, the “Chursächsische Institute for mute and other afflicted with language problems”. ThereDeaf people learned to speak and to read the lips, but no sign language.

Did you know?
To date, the sign language approach is also referred to as the “French method” and the spoken language as “German method”. Supporters of the two languages ​​still disagree on which method is best for making life easier for the deaf.

While the sign language in Germany was frowned upon in many hearing-impaired schools around 1980, it is now widely recognized. Many parents of deaf children choose to educate their children “bilingually”. So they make sure that the children learn how to sign as well as to speak or to read the lips.

The conversation between hearing deaf is not a problem. However, communication with the hearing is usually very stressful for both sides. Although some deaf people can speak comprehensibly, it is difficult for most to understand hearing in any situation.

Even if the deaf can read well from the lips, they have to “put together” most of the words. People with limited sensory perception can practice many, even more highly qualified occupations and participate in social life.

Sign language

If hearing impairment occurs during adulthood, the ability to express aloud speech is often preserved. in the optimally, become deaf and Deaf children bilingual trained. However, this is not possible at every school. There are already own schools and facilities for deaf and hard of hearing children and adolescents.

There are two main groups of people with hearing impairment:

  • Sign language-oriented hearing-impaired people: Communication via sign language, mostly for people with severe hearing loss and deaf people.
  • Speech-language hearing-impaired people: Communication via spoken language, mostly in the hard of hearing or late hearing impaired.

Visual aids like lip reading, writing or gestures can the communication facilitate, However, they transmit only a small part of the message.

TheSign language is a visual-gestural language with own structure and grammar.

Deafness: Promotion in Germany

The early support by deaf or hard of hearing adults is one new development in Germany. One model that already practices this is the Initiative “GIB ZEIT”.

“GIB ZEIT” offers Familys with a deaf or deaf child the possibility an encounter with deaf or hard of hearing adults. At the request of the family, a deaf member of “GIB ZEIT” regularly comes home to join a group understanding with the help of Sign language to work.

That way you can Deaf children from listening families together with her family Learn sign language. Together, he is growing vocabulary and the ability to understanding.

These situations can improve thanks to the sign language:

  • When hearing parents of deaf children learn sign language, they give their deaf child the opportunity to learn a native language and have a carefree childhood.
  • When a child is not understood and unable to understand, it causes aggression. Effective communication reduces aggression.
  • The deaf child can get in direct contact with deaf adults. The deaf children see that deaf adults have a job and can lead a normal, carefree life.
  • General knowledge is made better by communicating with deaf adults.
  • Sign language is needed for carefree communication within the family.


at hardness of hearing the course can be very differently his. He is the trigger reason dependent. at sign from deafness or others hearing It is important to one ENT doctor visit.

Especially at children It is of great importance, innate as well as acquired misheard so early as possible to remedy, because through the hardness of hearing otherwise language difficulties can develop.

So that a hearing loss does not persist permanently, one should consult with a change in the hearing always the doctor. A sudden hearing loss is always considered an emergency and must be promptly medically clarified.

In addition, it is important for the prevention of deafness, the ears not permanently exposing to excessive noise. This applies both in the work area as well as in the free time. At the workplace, legal regulations ensure adequate hearing protection.

But also Leisure noise can the Damage your hearing and to hardness of hearing to lead. Often, music in discotheques or at concerts reaches harmful levels. Therefore, it makes sense in the leisure sector, with noise on one ear protection to pay attention. ear plug can be put into the ear when there is noise. This can prevent damage to the hearing.

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Christina Cherry
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