Deafness
Deafness or hearing loss is a reduction in the ability to perceive sounds.
Hearing plays a role in alerting and communicating. Any impairment of hearing, whatever its origin, has repercussions on our social life and cognitive functions. Deafness may be associated with tinnitus, hyperacusis, vertigo or balance problems.
When faced with a gradual or sudden decline in hearing, whether unilateral or bilateral, a complete assessment is necessary.
Deafness assessment
This involves a thorough medical history, an assessment of the impact of deafness on the patient’s life and a microscopic examination of the ears, supplemented if necessary by hearing tests:
- Pure tone and speech audiometry (speech in silence, speech in noise)
- Multi-frequency tympanometry, stapedial reflex testing
- Search of Auditory
- Brainstem Response (ABR)
- Search for Otoacoustic Emission (OEP, OEAS, OEAP, PDA)
- Electrocochleography
Sometimes, this assessment is supplemented by imaging of the ears and/or central auditory pathways and areas (MRI, CT scan, cone-beam).
At the end of this assessment, the patient’s hearing loss is classified according to its origin (conductive, sensorineural or mixed, auditory neuropathy, of central origin) and its degree (mild, moderate, severe, profound).
Appropriate treatment is then offered, which may include simple surveillance, advice on prevention or hearing protection, medication or a hearing aid. Sometimes surgery is necessary (middle ear surgery, acoustic nerve neuroma surgery, skull base surgery, bone implants).
OTONEURO MONACO : the reference for deafness
Otoneuro Monaco is a reference center for the specialized evaluation of hearing loss. Our care pathway is based on a collaborative network bringing together otologic surgeons, cochlear implant centers, experienced hearing-aid specialists, and other specialized professionals, including speech therapists and neuropsychologists, in order to provide each patient with a coordinated diagnostic and therapeutic pathway.
Main pathologies treated :
- Presbycusis (age-related hearing loss)
- Sudden deafness caused by vascular, microvascular, viral, cranial or sound trauma
- Occupational deafness
- Toxic deafness (chemotherapy, other ototoxic drugs)
- Genetic deafness
- Auditory Neuropathy
- Spectrum Disorders or « hidden hearing loss ».
- Meniere’s disease
- Chronic simple otitis, cholesteatoma
- Otosclerosis
- Perilymphatic fistulas
- Dehiscence of the anterior semicircular canal (Minor’s syndrome), other “third windows ».
- Neuroma or schwannoma of the acoustic nerve
We also perform comprehensive hearing evaluations for children with speech or learning difficulties.
Your questions about hearing loss in adults:
What are the first signs of hearing impairment in someone exposed to noise over a long period?
The first signs of overexposure to noise are often a loss in the high frequencies, difficulty understanding speech in noisy surroundings, needing people to repeat themselves and hearing tinnitus or ringing after exposure. The person may still hear low-pitched sounds, which masks the problem and can delay diagnosis.
How does noise damage hearing?
Noise damages the sensory cells of the inner ear, but also the auditory pathways (synapses, auditory nerve). Prolonged or intense exposure leads to their irreversible destruction.
How can noise-induced hearing loss be prevented?
Avoid or reduce prolonged exposure to noise and wear suitable hearing protection (earplugs, ear defenders). Take regular breaks when you are exposed to noise.
What are the main conditions that cause conductive hearing loss?
Conductive hearing loss may be caused by:
earwax build-up, acute or chronic otitis media, a perforated eardrum, otosclerosis or, in rare cases, a benign tumour.
What is simple chronic otitis media?
Simple chronic otitis media is a persistent perforation of the eardrum, often following repeated ear infections. It causes variable hearing loss and sometimes discharge from the ear.
What is a cholesteatoma?
A cholesteatoma is an abnormal growth of skin in the middle ear, which gradually destroys the ossicles and bony structures and can spread to neighbouring areas (cochlea, facial nerve, meninges, brain, etc.).
What are the main conditions that cause sensorineural hearing loss?
The main conditions that cause sensorineural hearing loss are:
- Presbycusis (natural ageing).
- Acoustic trauma.
- Inner-ear disorders (Ménière’s disease, labyrinthitis).
- Auditory neuropathies (genetic, chronic noise exposure, toxic substances, etc.).
- Genetic disorders.
- Tumours of the auditory nerve (acoustic neuroma).
- Central causes (stroke, multiple sclerosis).
Which medicines can cause hearing loss?
Hearing loss can be caused by medicines such as certain antibiotics (aminoglycosides), anti-cancer drugs (cisplatin), high doses of diuretics or antimalarial drugs.
Your questions about hearing loss in children:
When should my child's hearing be checked?
Children’s hearing should first be screened at birth, then at the age of 6 as part of the compulsory health check carried out at school or by a doctor. You should also have your child’s hearing checked in the event of delayed speech, recurrent ear infections, a family history of hearing loss, suspected difficulty hearing in noisy surroundings, etc.
What signs should alert me to possible hearing loss in my child?
- They do not react to sounds or to their name being called.
- They speak very little or poorly, or their language skills regress.
- They have difficulty understanding at school.
- They turn up the volume on the television.
- They seem distracted or restless in a group.
How is a newborn's hearing tested?
The newborn hearing test is quick and painless. It relies on otoacoustic emissions (a tiny probe in the ear) or auditory evoked potentials (measuring brain activity in response to sounds).
From what age can a child be tested in the same way as an adult?
From the age of 5 to 6, most children can complete a standard pure-tone audiogram, although some can do so earlier, depending on their maturity.
What are the main causes of hearing loss in children?
Hearing loss in children is generally caused by infections during pregnancy or birth, chronic glue ear (otitis media with effusion) or acoustic trauma (rare in children).
When does a child with hearing loss need hearing aids?
As soon as hearing loss interferes with the development of speech, language and communication, hearing aids should be offered as quickly as possible.
When should a cochlear implant be considered for a child?
In children, a cochlear implant should be considered in cases of severe or profound bilateral hearing loss, when hearing aids are not enough. Early implantation leads to better language development.
Hidden hearing loss is when a child has hearing difficulties despite a normal audiogram, often revealed by difficulty understanding speech in noise. Specialist tests, carried out at Otoneuro Monaco, are needed to detect it.
