Physician: How long have you had your hearing loss?
Patient: Probably all my life, but I didn't find out about it until I was about 30.
Physician: Okay, has it gotten worse over the years?
Patient: It gets gradually worse, yes.
Narrator: Hearing loss is one of the most common conditions affecting older adults. It comes in many forms, as we can see with this patient undergoing a hearing exam by his otolaryngologist.
Physician: Are there any specific situations where you're having difficulty hearing?
Patient: Any place where there's a crowd, lots of people talking.
Physician: How about telephones?
Patient: Telephones are OK.
Physician: Movies? Theater?
Patient: Most of them are too loud, actually.
Physician: OK. Do you have any fullness or pressure in your ears?
Physician: Do you have any ringing or noises in your ear?
Patient: I have ringing.
Physician: Both ears?
Physician: Is it constant or does it come and go?
Patient: Depends on -- it's probably there all the time. I hear it when it's quiet.
Physician: OK. How about dizziness, specifically, a spinning sensation?
Narrator: Hearing performs an important role in our lives. It is essential for our daily existence. How we hear is a complex, yet finely-tuned process. The sound passes through the outer ear and is funneled into the middle ear where it bounces off the eardrum and is amplified by three tiny bones -- the malleus, incus, and stapes. These are the smallest bones in your body. Together, they are smaller than an orange seed. The sound then travels into the part of the inner ear known as the cochlea, which is filled with fluid. Hair cells in the cochlea convert the sound vibration to an electrical impulse, which travels to your brain. As we get older, the chance of developing a hearing loss increases.
A. Julianna Gulya, M.D.: Well, it's very interesting. The ear is affected by the aging process, just as so many other structures are. There is, in fact, a particular hearing loss associated with aging, known as presbycusis, and it is exceedingly common in the senior population. It's not an uncommon condition at all. In general, what happens is that there is loss of the hair cells. They gradually deteriorate, and sometimes even there can be some loss of their associated nerve fibers. In general, the way this presbycusis, or hearing loss with aging, shows up is for poorer hearing or the high-pitched sounds or the high frequencies. The inability to hear those high frequencies means that you have real difficulty hearing when there's background noise, you have major difficulty hearing women and children in particular because their voices are more highly pitched and you also have some difficulty distinguishing different words because consonants -- things like Bs and Ps and Cs, Ks, all those things, those kinds of sounds are, again, more towards the high frequency end, or the higher pitch end of the hearing rainbow.
Narrator: Some people may not want to admit that they have trouble hearing, but not hearing well can keep you from participating fully in every day life.
Stephen Epstein, M.D.: Hearing is essential for our daily existence. If you have a significant hearing loss, you may not hear the doorbell, you may not hear the telephone. If there's a fire alarm, you may not hear it. If you're crossing the street, you may not hear a car horn or a fire engine siren. If you have a severe hearing loss, you may actually have difficulty in one-to-one communication even when you're facing a person, where the point comes to where you may actually have to be reading their lips. It's also interesting to note that a majority of people may not even be aware that they have a hearing loss and they are informed by their friends and relatives that they think that they may have a hearing problem.
Narrator: Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, you can get help.
Stephen Epstein, M.D.: If you are an older person who is experiencing hearing loss, my advice to you is don't neglect it. Don't be shy, don't be bashful. You should have your ears examined and you should have a hearing test performed because hearing loss can be treated today. And don't forget, with a hearing loss that can be corrected, you can improve on the quality of your life.