Hearing Loss Association of America

http://www.hearingloss.org/

INTRO PAGE – PAGE ONE

Title: I am Deaf.

I am Deaf. I was diagnosed at 23 months old with sensorineural hearing loss by Dr. Brad Friedrich at Kennedy Krieger Institute in Baltimore. My parents had two options to choose from at the time. The first option was for me to be completely Deaf, which allows me to communicate with American Sign Language (ASL), attend a deaf school and have very little communication in the hearing world. The second option was for me to be oral. This option focuses on verbal communications reducing my potential relationship with the Deaf community. By raising me with the oral method, I learned to communicate with hearing people orally and take advantage of the public school system. This also means I would be with the hearing world and be shunned from the deaf culture. My parents chose option two, for me to become their ‘hearing’ child.

Inclusion in the public school required many years of speech therapy and frequent upgrades to my hearing aids. The upgrades are required as the technology improves granting better access to sounds and to keep up with the normal changes in hearing levels. There were many challenges with going through the public school system. Many of the challenges are learning how to relate to other students, enduring a constant stream of teasing, not understanding the nuances of what people were saying around me and the general attitude of the public school officials. While I was in high school, my parents were warned by guidance counselors. They told my parents that I would not make it through my first year of community college due to my severe hearing loss. Even with that type of challenge, I managed to preserve enough to graduate from a local community college and Towson University . I am now currently in graduate school at University of Baltimore.

Almost thirty years later since birth, I am still deaf. But I have the most amazing technology in my ears. I have been using hearing aids bilaterally most of my life. The hearing aids amplify sounds into my tiny cochlea. Amplifying sounds comes with a price of distortion and clarity, so the louder you go, the worse the quality is. Almost a year ago, again I upgraded my hearing aid with a new technology that is clearly not a hearing aid. I underwent surgery to have a cochlear implant installed in my head with electrodes threaded into my tiny cochlea. A hearing aid amplifies sounds, meanwhile the cochlear implant does no amplification (thus avoiding the loss of quality) and instead directly stimulate the sensation of hearing with in the cochlea.

Six months after getting my cochlear implant surgery; I am getting much better result with the cochlear implant compare to what the hearing aids would give me. The implant has provided me with sounds that are for the first time crisp, clear and concise. Everyday I am so amazed on how technology can give back the hearing that I have lost. I never thought my hearing could be this good. Sounds like an air-conditioner might drive a hearing person crazy but it is pure music to my ears because this is a sound I was never able to understand prior to the cochlear implant. Even the sound of rain is so precious and soothing for me to hear and listen to.

There are four different kinds of hearing loss; conductive, sensorineural, mixed and central hearing loss. I have sensorineural hearing loss. What kind of hearing loss do you have? Is your audiologist giving you these terminologies that you don’t understand? Each one of these are very different and your audiologist will make that determination with the evidence seen from your audiogram and your detailed background and detailed answers from questions asked.

CLASSIFICATION – PAGE TWO

Title: What kind of hearing loss do you have?

Subtitle: Your diagnosis of your hearing loss.

Conductive Hearing Loss

From any condition that interferes with the transmission of sound through the outer and middle ear to the inner ear. This type of hearing loss can be successfully treated in most cases.

In cases of conductive hearing loss, sound waves are not transmitted effectively to the inner ear because of some interference in:

• The external ear canal

• The mobility of the eardrum (problems with the mobility of the eardrum are often caused by accumulation of fluid in the eustachian tube, the tube that connects the middle ear to the back of the throat)

• The three tiny bones inside the middle ear

• The middle-ear cavity

• The openings into the inner ear

• The eustachian tube

Modern techniques make it possible to cure or at least improve the vast majority of cases involving problems with the outer or middle ear. Even if people with conductive hearing loss are not improved medically or surgically, they stand to benefit greatly from a hearing aid, because what they need most is amplification.

Sensorineural Hearing Loss

In sensorineural hearing loss, the damage lies in the inner ear, the acoustic nerve, or both. Most physicians call this condition "nerve deafness."

The cochlea has approximately 30,000 hearing nerve endings (hair cells). The hair cells in the large end of the cochlea respond to very high-pitched sounds, and those in the small end (and throughout much of the rest of the cochlea) respond to low-pitched sounds. These hair cells, and the nerve that connects them to the brain, are susceptible to damage from a variety of causes.

The term "sensory" hearing loss is applied when the damage is in the inner ear. Common synonyms are "cochlear" or "inner-ear" hearing loss.

"Neural" hearing loss is the correct term to use when the damage is in the acoustic nerve, anywhere between its fibers at the base of the hair cells and the relay stations in the brain (the auditory nuclei). Other common names for this type of loss are "nerve deafness" and "retrocochlear" hearing loss.

Sensorineural hearing loss is one of the most challenging problems in medicine. A large variety of hearing impairments fall under this category. Although the chances for restoring a sensorineural hearing loss are slim, a small number of cases can be treated, and some people experience dramatic improvements as a result. However, a great need for further research in this area still exists.

Mixed Hearing Loss

Frequently, a person experiences two or more types of hearing impairment, and this is called mixed hearing loss. This term is used only when both conductive and sensorineural hearing losses are present in the same ear. However, the emphasis is on the conductive hearing loss, because available therapy is so much more effective for this disorder.

Central Hearing Loss

In central hearing loss, the problem lies in the central nervous system, at some point within the brain. Interpreting speech is a complex task. Some people can hear perfectly well but have trouble interpreting or understanding what is being said. Although information about central hearing loss is accumulating, it remains somewhat a mystery in otology (the medical specialty of ear medicine and surgery).

A condition called central auditory processing disorder frequently leads people to think they have hearing loss when their hearing is actually normal. Despite the fact that this problem is extremely common and present in many highly successful people, it is actually classified as a learning disability.

Basically, the problem involves a person's inability to filter out competing auditory signals. People with central auditory processing disorders have difficulties that include:

Problems "hearing" when there are several conversations going on, Inability to read or study with the radio or television on, Problems reading if someone turns on a vacuum cleaner or air conditioner near them, Generally missing the first sentence from people talking to them if they are involved in an auditory attention task (such as watching television), Although such people (and their families and friends) frequently suspect that they have a hearing loss, the function of the ears is usually normal, and routine hearing tests are normal. Naturally, people with this condition may also develop hearing loss from other causes, and this can make it even more difficult for them to function under everyday circumstances.

There is no good treatment for central auditory processing disorders other than educating the person, family, and friends, and trying to control the environment. This is especially important for children, whose grades may go from F to A if they are provided with a silent place in which to do their homework.

The test necessary to diagnose central hearing impairment must be designed to assess a person's ability to handle complex information. Most of the tests now available were not created specifically for this purpose. It requires a very experienced and almost intuitive judgment on the physician's part to make an accurate diagnosis.

PAGE THREE – DEPTH OF OF CLASSIFICATION (NEED TO ADD MORE)

Title: Nerve Deafness

Subtitle: In-Depth explanation of the most common kind of hearing loss.

Sensorineural hearing loss is the most common kind of deafness or hearing loss. Technology is improving day by day to increase chances for a deaf person to be able to hear again for the first time.

SIDEBAR: (Information for each)

Title: Different kinds of hearing devices (Is there a better way to label this??)

Hearing Aids – The hearing aids provide amplification of the sound that is heard thru the microphones. There are several different types of hearing aids; conventional analog, analog programmable, digital programmable hearing aids.

In addition there are several styles. In-the-canal and completely-in-the-canal aids - These aids are contained in a tiny case that fits partly or completely into the ear canal. They are the smallest aids available and offer cosmetic and some listening advantages.

In-the-ear aids - All parts of the aid are contained in a shell that fills in the outer part of the ear. These aids are larger than canal aids, and for some people may be easier to handle than smaller aids.

Behind-the-ear aids - All parts are contained in a small plastic case that rests behind the ear; the case is connected to an ear mold by a piece of clear tubing. This style is often chosen for young children for safety and growth reasons.

Baha (Bone Anchored Hearing Aid) - The Baha is a surgically implantable system for treatment of hearing loss that works through direct bone conduction. It has been used since 1977, and was cleared by the FDA in 1996 as a treatment for conductive and mixed hearing losses in the United States. In 2002, the FDA approved its use for the treatment of unilateral sensorineural hearing loss.

Baha is also used to help people with chronic ear infections, congenital external auditory canal atresia and single sided deafness who cannot benefit from conventional hearing aids. The system is surgically implanted and allows sound to be conducted through the bone rather than via the middle ear - a process known as direct bone conduction.

Cochlear Implants - A cochlear implant is a device that provides direct electrical stimulation to the auditory nerve. In sensorineural hearing loss where there is damage to the tiny hair cells in the cochlea, sound cannot reach the auditory nerve. With a cochlear implant, the damaged hair cells are bypassed and the auditory nerve is stimulated directly. The cochlear implant does not result in "restored" or "cured" hearing. It does, however, allow for the perception of sound "sensation." This is a treatment of sensorineural hearing loss from ranges from severe to profound sensorineural hearing loss (+90dB)

Middle Ear Implant - The middle ear implant is an surgically fully implantable device for treatment of sensorineural hearing loss from ranges from moderate to severe sensorineural hearing loss (40dB – 90 dB). The two transducers, the sensor and the driver that is implanted in the middle ear rather than the inner ear like the cochlear implant.

Just recently been approved by the FDA in February 2010. An middle ear implant has no external devices like the hearing aid, baja or the cochlear implant. This device relies on your natural ear as a microphone.

SIDEBAR 2

Title: Degree of Hearing Loss

Degree of hearing loss	Hearing loss range (dB HL)
Normal	-10 to 15
Slight	16 to 25
Mild	26 to 40
Moderate	41 to 55
Moderately severe	56 to 70
Severe	71 to 90
Profound	91+