There are three main types of hearing loss: conductive, mixed, and sensorineural. This article explores the different treatment options available for each type.
Conductive hearing loss
A conductive hearing loss occurs when there is a problem in the outer and/or middle ear. Common issues that may cause a conductive hearing loss are wax occlusion, outer ear infections, middle ear infections, otosclerosis, microtia and atresia, just to name a few. Treatment options available:
- Medical/Surgical: Medical treatment options depend on the cause of the conductive hearing loss. They can be as simple as wax removal, or medications for otitis externa or media. Surgical options may include myringotomy tubes for otitis media, tympanoplasty for tympanic membrane perforations, stapedectomy for otosclerosis, and laser treatments, amongst others.
- Hearing aids: After being clear by an otolaryngologist, many types of conductive hearing loss are treated with a traditional hearing aid. Hearing aids are often highly effective since the main issue for a conductive hearing loss is the ability to provide an ample amount of sound.
- Bone conduction hearing aids: These are attached to the head by a band, and the hearing processor is placed on the forehead or on the bone behind the ear to transfer sound via bone conduction.
- Osseointegrated auditory devices: This is a hearing device that has an external sound processor attached to a prosthesis that is drilled into the bone behind the ear. Like the bone conduction hearing aids, these devices use bone conduction to send sounds directly to the cochlea.
Sensorineural hearing loss
A sensorineural hearing loss occurs when there is damage anywhere along the pathway, from the inner ear to the brain. It is a permanent hearing loss. Treatment options available:
- Hearing aids: The most common treatment option for sensorineural hearing loss is a hearing aid.
- Cochlear Implants: These are recommended if a traditional hearing aid won’t provide enough amplification. A cochlear implant is a hearing device that has an external processor. It has a transmitter attached to the head by a magnet and an electrical device that is inserted into the cochlea to transfer sound to the brain. If a patient is struggling to hear in their everyday life even with their hearing aids, it could be time to consider a cochlear implant. According to cochlear.com1, the cochlear implant eligibility in the US is:
In adults
- Moderate to profound sensorineural hearing loss in both ears
- An unaided word recognition score of 60% or lower in the better ear
In children (2-17 years)
- Severe to profound sensorineural hearing loss in both ears
- Unaided Multisyllabic Lexical Neighbourhood Test or Lexical Neighbourhood Test score of 30% or lower
In infants (9-24 months)
- Profound sensorineural hearing loss in both ears
Single Sided Deafness
Single Sided Deafness (SSD) is when an individual has sensorineural hearing loss that is profound but is only present in one ear. For SSD, the affected ear is considered non-functioning, so would not be helped with a traditional hearing aid. The other ear generally has normal hearing or a mild hearing loss. Treatment options available:
- CROS/BICROS hearing aids: CROS stands for Contralateral Routing System. The patient wears something that resembles a hearing aid on both ears. The hearing aid on the “bad” ear, picks up the sound and transfers it to the hearing aid of the better ear. If hearing loss is present in the “good” ear, a BICROS system is used and will provide the information for the bad ear, but also amplify the sounds on the better ear as well.
- Bone conduction hearing aids: These are attached to the head by a band. The hearing processor is placed on the bone behind the bad ear to transfer sound via bone conduction. This is only used if the good ear has normal, or close to normal hearing.
- Osseointegrated auditory devices: This is a hearing device with an external sound processor that is attached to a prosthesis. It is drilled into the bone behind the poorer ear. Similarly, to the bone conduction hearing aids, these devices use bone conduction to send sounds to the cochlea. They are only used if the better ear has normal, or close to normal hearing.
- Cochlear Implant: The FDA has approved cochlear implantation for those who are five years old or more.2 This is only if they have a monosyllabic word score of 5% or lower and experience with a CROS aid or similar device. Candidates must also have a functional auditory nerve and have had profound hearing loss for 10 years or less.
Mixed hearing loss
A mixed hearing loss is a combination of conductive and sensorineural. Treatment options available:
- Medical/Surgical: For the conductive component, medical treatment options vary depending on the issue that is causing the conductive hearing loss. For the sensorineural component, other treatment options are still needed to provide sufficient sound.
- Hearing aids: This is often the most prescribed option for mixed hearing loss.
- Bone conduction hearing aids: These can be used if the sensorineural component is a moderate or better hearing loss. They work best if the hearing loss is mostly conductive.
- Osseointegrated auditory devices: As with the bone conduction hearing aids, the devices work best when the hearing loss is mostly conductive.
- Cochlear Implants: The eligibility for cochlear implantation for mixed hearing loss would be the same as for sensorineural hearing loss mentioned above.
Diagnostic audiometers
It is essential to have a thorough diagnosis of the cause and type of hearing loss before being able to select the right treatment.
Amplivox has developed a suite of innovative and user-friendly diagnostic audiometers to perform a wide range of hearing loss tests, that will help to inform your choices.
For more information on our range of diagnostic audiometers, please visit our audiometers webpage, contact our customer support team on +44 (0)1865 880 846 or email.
References
1Cochlear. Cochlear implant candidacy (2022). Accessible at:
https://www.cochlear.com/us/en/professionals/products-and-candidacy/candidacy/cochlear-implant.
2A. Racey, AuD. Recent FDA-Approval of Cochlear Implants For Single-Sided Deafness and Asymmetric Hearing Loss (2019). AudiologyOnline. Accessible at: https://www.audiologyonline.com/interviews/recent-fda-approval-of-cis-for-ssd-26040#:~:text=All%20candidates%20must%20have%20limited,of%2010%20years%20or%20less.