Have you ever had your car break down in the middle of the highway? That really stinks! Your car has to be safely pulled off the road. And then, for whatever reason, you probably pop your hood and have a look at your engine.
Humorously, you still do this even though you have no knowledge of engines. Perhaps whatever is wrong will be obvious. Ultimately, a tow truck will need to be called.
And it’s only when the professionals get a look at things that you get an understanding of the problem. That’s because cars are complicated, there are so many moving parts and computerized software that the symptoms (a car that won’t move) aren’t enough to inform you as to what’s wrong.
The same thing can occur sometimes with hearing loss. The cause isn’t always obvious by the symptoms. Sure, noise-related hearing loss is the typical cause. But in some cases, something else like auditory neuropathy is the cause.
Auditory neuropathy, what is it?
Most individuals think of extremely loud noise such as a rock concert or a jet engine when they consider hearing loss. This type of hearing loss is known as sensorineural hearing loss, and it’s somewhat more involved than basic noise damage.
But sometimes, this type of long-term, noise related damage is not the cause of hearing loss. A condition called auditory neuropathy, while less common, can in some cases be the cause. When sound can’t, for whatever reason, be properly carried to your brain even though your ear is receiving that sound perfectly fine.
Symptoms of auditory neuropathy
The symptoms of traditional noise related hearing loss can sometimes look very much like those of auditory neuropathy. You can’t hear well in noisy settings, you keep turning up the volume on your television and other devices, that kind of thing. This can often make auditory neuropathy difficult to diagnose and manage.
Auditory neuropathy, however, has some unique symptoms that make recognizing it easier. These presentations are rather solid indicators that you aren’t dealing with sensorineural hearing loss, but with auditory neuropathy instead. Of course, nothing can replace getting an accurate diagnosis from us about your hearing loss.
The more unique symptoms of auditory neuropathy include:
- An inability to distinguish words: Sometimes, the volume of a word is normal, but you just can’t distinguish what’s being said. The words sound garbled or distorted.
- Sounds seem jumbled or confused: Again, this is not a problem with volume. The volume of what you’re hearing is completely normal, the problem is that the sounds seem jumbled and you can’t understand them. This can go beyond the speech and apply to all types of sounds around you.
- Sound fades in and out: Maybe it feels like somebody is messing with the volume knob inside of your head! This could be an indication that you’re experiencing auditory neuropathy.
What triggers auditory neuropathy?
The root causes of this condition can, in part, be defined by the symptoms. On an individual level, the reasons why you may experience auditory neuropathy may not be entirely clear. Both adults and children can develop this condition. And there are a couple of well described possible causes, broadly speaking:
- The cilia that send signals to the brain can be damaged: If these tiny hairs inside of your inner ear become compromised in a specific way, the sound your ear senses can’t really be sent on to your brain, at least, not in its full form.
- Damage to the nerves: The hearing portion of your brain receives sound from a particular nerve in your ear. The sounds that the brain attempts to “interpret” will sound unclear if there is damage to this nerve. Sounds may seem jumbled or too quiet to hear when this happens.
Auditory neuropathy risk factors
No one is really certain why some individuals will develop auditory neuropathy while others may not. That’s why there’s no exact science to combating it. But you may be at a higher risk of developing auditory neuropathy if you present particular close associations.
It should be noted that these risk factors aren’t guarantees, you could have every single one of these risk factors and still not develop auditory neuropathy. But the more risk factors present, the higher your statistical likelihood of experiencing this condition.
Children’s risk factors
Here are some risk factors that will increase the likelihood of auditory neuropathy in children:
- A low birth weight
- Preterm or premature birth
- A lack of oxygen during birth or before labor begins
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- Liver conditions that result in jaundice (a yellow appearance to the skin)
- Other neurological disorders
Adult risk factors
Here are some auditory neuropathy risk factors for adults:
- Overuse of medications that cause hearing problems
- Specific infectious diseases, like mumps
- Immune disorders of various kinds
- Family history of hearing conditions, including auditory neuropathy
In general, it’s a good idea to limit these risks as much as you can. If risk factors are there, it might be a good idea to schedule regular screenings with us.
How is auditory neuropathy diagnosed?
A typical hearing exam involves listening to tones with a set of headphones and raising a hand depending on which side you hear the tone on. When you have auditory neuropathy, that test will be of extremely minimal use.
Rather, we will generally recommend one of two tests:
- Otoacoustic emissions (OAE) test: This diagnostic is made to determine how well your inner ear and cochlea react to sound stimuli. A tiny microphone is placed just inside your ear canal. Then a battery of tones and clicks will be played. The diagnostic device will then measure how well your inner ear reacts to those tones and clicks. If the inner ear is a problem, this data will expose it.
- Auditory brainstem response (ABR) test: Specialized electrodes will be connected to certain places on your head and scalp with this test. This test isn’t painful or unpleasant in any way so don’t worry. These electrodes place specific focus on measuring how your brainwaves respond to sound stimuli. The quality of your brainwave responses will help us determine whether your hearing problems reside in your outer ear (such as sensorineural hearing loss) or further in (such as auditory neuropathy).
Diagnosing your auditory neuropathy will be much more successful once we do the appropriate tests.
Is there treatment for auditory neuropathy?
So you can bring your ears to us for treatment just like you take your car to the mechanic to have it fixed. In general, there’s no “cure” for auditory neuropathy. But there are several ways to treat this condition.
- Hearing aids: Even with auditory neuropathy, in moderate cases, hearing aids can boost sound enough to enable you to hear better. For some people, hearing aids will work perfectly fine! Having said that, this is not generally the case, because, again, volume is virtually never the issue. Hearing aids are often used in combination with other treatments because of this.
- Cochlear implant: For some people, hearing aids will not be able to solve the problems. In these instances, a cochlear implant might be needed. This implant, essentially, takes the signals from your inner ear and conveys them directly to your brain. The internet has lots of videos of individuals having success with these remarkable devices!
- Frequency modulation: In some cases, it’s possible to hear better by increasing or reducing specific frequencies. That’s what happens with a technology known as frequency modulation. This strategy often uses devices that are, basically, highly customized hearing aids.
- Communication skills training: In some situations, any and all of these treatments might be combined with communication skills training. This will allow you to work with whatever level of hearing you have to communicate better.
The sooner you receive treatment, the better
Getting your disorder treated punctually will, as with any hearing condition, produce better outcomes.
So it’s important to get your hearing loss treated as soon as possible whether it’s the common form or auditory neuropathy. The sooner you make an appointment, the more quickly you’ll be able to hear better, and get back to your daily life! This can be especially critical for children, who experience a lot of cognitive development and linguistic growth during their early years.