Living in a Loud,
Loud World
Preventing hearing loss starts when your young.
by George Alexiades
TWEENS & TEENS News October
2007
Parties, iPods, concerts, movies, TV shows,
video games, traffic. All of these features
of the modern world make life entertaining,
enjoyable and accessible. But our 21st-century
lifestyle is also loud and, if we don’t
take notice, it can affect our hearing.
What Did You Say?
Most teenagers don’t think about hearing
loss. But, if you or your friends experience
any of the following symptoms, you may already
be hearing impaired: you strain to hear normal
conversation, you have to turn up the TV or
radio so high others complain, you watch other
peoples’ expressions to understand what
they are saying, you ask people to repeat
themselves, you misunderstand what people
are saying or you hear ringing in your ears.
Determining the cause of hearing loss is often
difficult. There are three types of hearing
loss: conductive, sensorineural and mixed.
Conductive hearing losses can be due to wax
in the ear canal, a foreign body (bugs, beads,
ends of Q-tips), fluid in the ear, a perforated
ear drum, chronic ear infections or problems
with the bones associated with hearing. A
sensorineural hearing loss, more commonly
referred to as a “nerve hearing loss”
is a problem with the inner ear and can be
due to aging, genetics, noise trauma or an
inner ear abnormality. A mixed hearing loss
is a combination of a conductive and sensorineural
hearing loss, and can be due to a combination
of the factors described above.
Keep reading for a review of the most common
dangers to the ear.
Are iPods a Danger to Hearing?
iPods and other MP3 players are as common
as the clothes you wear, and just as stylish.
But if you crank up an iPod to more than 60
percent of its maximum volume, and listen
to music for more than an hour, you are asking
for trouble. Medically speaking, you are asking
for acoustic trauma. And, it does not matter
if the music you play is classical, rock or
heavy metal.
Some researchers find that young people who
break the so-called 60 percent/60 minute rule
in listening to iPods are at risk of suffering
hearing loss similar that of aging adults.
Other experts warn that people today are losing
their hearing at much younger ages than they
did just a generation ago.
Why is iPod abuse dangerous? With ear buds
placed directly in the ear canal and high-volume
music played over a prolonged period of time,
it’s like working in a loud factory
all day, being a maintenance person under
a jet airplane or using a jackhammer on a
construction site. Employees on all of these
jobs would develop noise-induced hearing loss
if they were not required by health and safety
regulations to wear protective earplugs or
ear muffs.
Similarly, iPod music can cause temporary
and permanent hearing damage. A loud iPod
can cause a ruptured eardrum and, over time,
may cause permanent damage to the tiny hairs
in the inner ear. If these tiny hairs are
damaged, they cannot effectively transmit
sounds to the auditory nerves that connect
to the brain. If this happens, hearing loss
becomes permanent.
Tips About Q-Tips
As a doctor, I treat about four eardrum punctures
a year that are caused by cotton swabs or
Q-tips, which are found in the medicine cabinet
of just about every home in the United States.
People use cotton swabs to clean their ears,
despite warnings on boxes such as “Do
not use swab in ear canal. Entering the ear
canal could cause injury.”
One reason people use Q-tips is to clean wax
out of their ears. But, this often pushes
earwax farther into the ear canal and causes
more blockage. If the cotton swab is pushed
back too far into the canal, it can penetrate
the eardrum.
Earwax is good for you and a sign of a healthy
ear. It helps moisturize the skin in the ear
and prevents the growth of bacteria. If wax
builds up and begins to impair hearing, you
can use an earwax removal kit sold over the
counter in a drug store. It generally contains
a bulb syringe and drops to dissolve the wax.
If that does not work, go to a doctor who
can carefully remove the wax.
The bottom line: Don’t use Q-tips to
clean inside your ears. If you must, you can
use them on the outside of the ear canal,
but never enter the canal.
Treating Swimmer’s Ear
Otitis externa, commonly known as swimmer’s
ear, is an inflammation of the external part
of the ear. It can be caused by many factors,
though it is most commonly caused by water
trapped in the canal. The water forms a cozy
environment for bacteria to grow, thereby
infecting your ear. You can get also swimmer’s
ear from taking a bath or shower. Symptoms
of otitis externa are pain, drainage and clogging.
Treatment of swimmer’s ear can include
use of ear drops with a mild acid solution
or an antibiotic. If it is more serious, oral
antibiotics and even pain medication may be
prescribed.
The Most Common Form of Hearing Impairment
in Kids
Otitis media, ear infections of the middle
ear, are the most common form of hearing impairments
in children. Acute otitis media is caused
by bacteria (or viruses) that enter from the
nose or throat and ascend the eustachian tube
to reach the middle ear. This occurs when
the eustachian tube is not functioning properly,
often because it is inflamed from an allergy
attack, a cold, or a sinus or throat infection.
These infections become less frequent as kids
age and the eustachian tube begins functioning
more like that of an adult’s.
Infection in the middle ear causes an earache,
a red inflamed eardrum and a buildup of pus
and mucus behind the eardrum. Treatment may
include one or more medications— an
antibiotic to fight infection, an antihistamine
to control allergies, a decongestant to abate
a cold’s stuffiness and sometimes analgesic
ear drops to relieve pain.
Fun Fact: Why Your Ears Pop on Airplanes
Do you know what causes your ears to pop when
you fly an airplane? Or why babies fuss and
cry so much during a descent? Blame it on
your eustachian tube.
Normally, each time you swallow, your ears
make a little click or popping sound. This
occurs because a small bubble of air has entered
your middle ear, up from the back of your
nose. It passes through the eustachian tube,
which constantly supplies air to your middle
ear, and keeps air pressure on both sides
of the eardrum about equal. When air pressure
is not equal the ear feels blocked.
This is what happens during a rapid descent
in an airplane: The air inside the plane goes
from low atmospheric pressure caused by high
altitudes to high atmospheric pressure at
ground level. As the plane descends, however,
the pressure in the middle ear stays at a
low atmospheric pressure and causes the sensation
of the ear being blocked. If you swallow and
yawn, it opens up the eustachian tube and
lets the middle ear pressure equalize. The
blocked sensation goes away. As mentioned
earlier, children’s eustachian tubes
do not work as well as adults and have a much
harder time equalizing the pressure on the
plane. So next time you hear a child crying
during a plane descent, understand that he
is having a much worse time than you.
Hearing Aids and Teens
Some teenagers need hearing aids to understand
teachers in school, conversations with friends
or shows on TV. Hearing aids come in several
styles, each with its own advantages and disadvantages.
Behind-the-ear hearing aids wrap around the
top of the external ear. They seem best for
young children, because they allow for the
child’s growth without having to remake
the entire casing as the ear canal enlarges.
The major style drawback is that they are
highly visible.
Teenagers and adults have a broader range
of styles from which to choose. One is an
in-the-ear aid, which is not as visible as
behind-the-ear devices. All the parts of this
aid are contained in a shell that covers the
external ear’s entrance to the ear canal.
Other hearing aid choices are more hidden
and much smaller. One is named an in-the-canal
aid. Only a small portion of this aid is visible.
There is also a completely in-the-canal aid,
which is invisible. The drawbacks of the smaller
devices are that they generally increase feedback
and do not have enough power for people with
severe hearing losses.
How the Ear Helps You Hear
Acoustic sound waves travel through the outer
ear and down the ear canal to vibrate the
tympanic membrane (eardrum), which transmits
vibrations through the bones of the middle
ear to the cochlea (organ of hearing), located
in the inner ear. Hair cells in the cochlea,
in turn, transmit sound vibrations to the
auditory nerve, which are received by neuronal
receptors of the central nervous system in
the form of chemical reactions in the brain.
George Alexiades, M.D., is an otolaryngologist
(an ear-nose-throat specialist) at the New
York Eye and Ear Infirmary in New York City.
