Why is hearing getting worse?

Our hearing fails many of us sooner than one would like. Hearing loss begins right after birth. Initially, only very high tones (20,000 Hz or 20 kHz) are affected. Up to young adults, no hearing loss can be detected in the frequency range from 125 Hz to 8 kHz that is normally examined. Already at the age of 40 there is an average hearing loss for 8 kHz and 6 kHz. Hearing at high frequencies gradually deteriorates and is therefore imperceptible to those affected. This hearing loss can affect communication with other people as early as the age of 55. The cause is an increasing loss of the cells in the cochlea, which amplify what is heard at low and medium volumes and have a dampening effect at high volumes. This also explains the apparently paradoxical phenomenon that people who are hard of hearing are often very sensitive to noise. The dampening effect of the so-called outer hair cells is missing.

Why do hard of hearing people often not notice their hearing loss themselves?

Human communication is the result of hearing, seeing and interpreting. Unconsciously, people who are hard of hearing read the lips of their interlocutors and rhyme words that they do not understand. There is a tendency for the interlocutors to assume that they are not speaking clearly enough and far too quickly. However, it is very unlikely that everyone else will not speak well or purposely not turn the TV up as loud as you would like it to be. The danger of problems in the family of the hard of hearing should not be underestimated. Constant questioning or repetition are detrimental to good communication. Then there is more silence and the behavior of the other person is perceived as directed against oneself.

Why are hearing aids so unpopular?

Hearing aids have a negative image. A hearing aid is obvious proof that you are old. Experiences from the time of analogue hearing aids, such as loud whistling due to feedback and a blocked feeling in the auditory canal, make life difficult for us and the hearing aid acoustician. Today all hearing aids are digital! The industry has made the same advances in hearing aids as it has in all the other digital devices we use every day. Directional microphones, intelligent noise suppression and various programs for different listening situations are already part of the standard equipment. Other features such as an integrated hands-free system for the phone or an app for the smartphone are subject to a surcharge, but they are possible. Speakers that are in the ear canal deliver excellent sound and are worth every extra euro you have to pay for them. As a patient you can get a high-tech device for 10 euros per device, which is unparalleled in medicine. There are far fewer reasons to refuse a hearing aid today than there were ten years ago. It's all about trying.

Are hearing and understanding the same?

In our conversations with our patients, we differentiate between hearing in the narrower sense and understanding. We hear with our ears and understand what we hear in our brain. The processing of sounds takes place in a specialized center of our cerebral cortex. Not only words are recognized there. The acoustic signals are also evaluated and filtered. Unimportant things do not reach our consciousness, whereas important things or noises that can mean danger are consciously perceived. Here is an example from everyday life: If you live in a big city, you are not aware of an emergency vehicle with a siren driving past in front of your house. However, if you have dialed the emergency number a few minutes beforehand, you will hear the siren from a great distance.

Why does the hard of hearing understand better in a quiet environment?

Age-related hearing loss affects the high frequencies first. We need these to filter out important signals from disturbing noises. If the high tones are no longer perceived well, we lose the ability to hear the useful sound from the background noise. At the same time, we miss the sharp consonants such as "s", "f" or "t". Without these, we are left with the vowels and soft consonants such as "w", "b" or "m". Without further information such as the speaker's lips, the hard of hearing has no chance of understanding the speaker. If the speaker is in the next room or turns his back on the person who is hard of hearing, their words can be heard but not understood.

Are there medical risks from hearing loss?

A hearing loss leads to loneliness. Many people who are hard of hearing avoid situations in which they no longer understand anything. The zest for life decreases and the risk of depression in old age increases. The decrease in acoustic sensory impressions favors the development of dementia, because hearing impaired people tend to isolate themselves and thus receive fewer sensory impressions overall. We can train our brain like a muscle and, like a muscle, it can lose its abilities if not used. Dementia is nothing else than the loss of abilities as a result of a reduction in brain mass.

Can a hearing aid damage my ear?

Hearing aids definitely do not cause hearing loss or any other harm. Our inner ear doesn't lose any abilities either because we wear a hearing aid. Hearing aids give us the ability to communicate even in difficult and noisy listening situations. Anyone who uses a hearing aid for the first time has to learn how to understand and evaluate it again. However, the learning speed of our brain and thus also of the auditory center decreases with age. As a person affected, you can therefore not use a hearing aid too early. Unfortunately, many arrive too late and then have to struggle for a long time in order to cope again in difficult situations.

How to wear hearing aids

People who are hard of hearing have to wear their hearing aids regularly, ie from morning to night. It doesn't matter if someone else is with the deaf person or not. The brain has to relearn how to suppress unimportant noises. This is the only way it can filter out the speech from the ambient noise in the conversation. Anyone who starts wearing their hearing aids at the age of 55 or 65 will still be able to understand well in old age. Only very few people manage to get used to hearing aids at the age of 80.

We could write a lot more about this topic. But that would go beyond the scope here. Therefore, we can only encourage you to have your hearing tested too soon rather than too late. The good news is that today we can compensate for practically any hearing loss to the extent that communication with other people is possible again. The bad news is that unfortunately many people only come to us when they no longer understand anything and it would then take years to be able to participate in everyday life again.

Can I prevent hearing loss? Is there an early detection test?

There is still no statutory early detection examination for hearing damage, but it would make sense.

As ear, nose and throat doctors, we are your contacts for hearing problems such as hearing loss, sensitivity to noise and ringing in the ears.