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There are a number of reasons I refer a hearing test patient out to an ear, nose and throat doctor. During our initial office interview if a patient tells me they have pain in their ears, I am to refer. If a patient has struggles with vertigo I am to refer. If a patient tells me their hearing loss is early onset, meaning it just recently started, I am to refer. With my video-otoscope if I see tumors, polyps or other blockage growths, I am to refer.
Also, I do not diagnose. The patient sees the pictures on my screen, but I explain it is necessary for them to see an ENT to get answers before we continue with the hearing test. If it is a wax blockage, it must be removed before I do the test. If a patient has a history of using ototoxic medicine, medicine that damages hearing, they should see an ENT. Along with that, if they are battling cancer and taking chemotherapy or receiving radiation they should see an ENT before a hearing test and any conversation about hearing aids. Routinely, a patient under 18 years of age should see an ENT to begin the investigation into their hearing loss. In most cases, a younger patient with hearing loss has been guided by their parents to an ENT long before they turn 18.
After the test if I find asymmetrical hearing loss, where one ear is significantly worse that the other, I am to refer. Both ears have been exposed to the same life and the same sounds, so if one ear is significantly worse an ENT should discover why, if possible. Another test referral issue is called air to bone score gap. Air is found by playing sounds, bone is found by vibrating sounds. If the gap between these scores is significant. I am to refer.
Lastly, guidelines suggest referrals if a patient has hearing loss beyond the moderate level. In reality, patients with severe hearing loss have had it a long time and most went to an ENT long ago. But what about determining if a patient's hearing loss is temporary or permanent? Have you noticed you're not hearing as well as you normally do? There are many causes of hearing loss, from age-related hearing loss to viral infections like mumps. Depending on the cause, your hearing loss may be temporary or permanent.
If you've developed rapid and sudden hearing loss in one or both ears get medical help right away. You may have harmful inflammation that can be treated. Without treatment, this hearing loss can become permanent. Most temporary hearing loss doesn't start abruptly, but rather gradually over a few days or weeks before it becomes noticeable. Temporary hearing loss may be the result of an obstruction in your ear canal or a similar health-related condition. Sometimes a bad cold can develop into an ear infection which can muffle hearing. Although this condition is
most common in children, it can occur at any age. And while ear infections typically clear up by themselves, it's always a good idea to see your doctor just in case yours needs to be treated with an antibiotic.
The hair follicles and glands in your inner ear produce cerumen, a substance also known as earwax. Although this wax usually falls out of your ears naturally or with a gentle washing, it sometimes builds up and blocks the ear canal. When this happens, you may feel a sensation that the ear is plugged, hear "ringing" in your ear (also known as tinnitus) or experience some hearing loss. If the wax can't be removed by gently cleaning with a warm washcloth, consult your physician or a walk-in clinic. Trying to remove the wax with sharp objects, such as hair pins, or cotton swabs may push it deeper into your ear canal and, in rare cases, perforate the eardrum. Candling is used extensively in Amish communities, but I do not recommend that method.
When you exercise beyond your fitness level, you may experience temporary hearing loss. While hearing typically returns to normal in a few hours, see your doctor if the symptoms persist. Extreme stress can also trigger hearing problems or tinnitus. It's also common to temporarily lose your hearing or experience tinnitus after you've been exposed to loud noise, such as at a loud concert or while operating noisy lawn equipment. While your hearing will most likely return to normal afterward, protect yourself by wearing foam ear plugs or ear muffs the next time you're in a similar situation. While a single loud blast may temporarily worsen your hearing, repeated exposures to blasts or other loud noises can lead to permanent hearing loss. In fact, this is the most common form of sensorineural hearing loss, which is permanent. Sensorineural refers to the ears' nerves and tiny sensory cells that are easily damaged.
The other very common type of sensorineural hearing loss is presbycusis, or age related hearing loss. By age 75, many people will notice they're not hearing as well as they used to. However, the onset is gradual, not sudden. Regardless, treating age-related hearing loss is important, as hearing aids are associated not just with hearing better, but also reducing your risk of health conditions. Quite a few health conditions can cause permanent hearing loss. Space in this article limits the development of those topics. Regardless, if you suspect your hearing has changed, see your family doctor or a hearing healthcare provider. They can determine whether your hearing loss is temporary or permanent and recommend the best course of treatment.
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Jeff Bayliff is owner of the Hear the Birds Hearing Aid Centers in Lock Haven and State College.