Have you ever been in the middle of the road and your car breaks down? It’s not a fun situation. You have to pull your car off the road. And then, for whatever reason, you probably open your hood and take a look at your engine.
Humorously, you still do this despite the fact that you have no knowledge of engines. Maybe whatever is wrong will be obvious. Ultimately, a tow truck will need to be called.
And it’s only when the professionals check out things that you get an understanding of the problem. That’s because cars are complex, there are so many moving parts and computerized software that the symptoms (a car that won’t move) are not enough to tell you what’s wrong.
With hearing loss, this same sort of thing can happen. The symptom itself doesn’t automatically indicate what the underlying cause is. There’s the common cause (noise-related hearing loss), sure. But in some cases, it’s something else, something like auditory neuropathy.
What is auditory neuropathy?
When most people consider hearing loss, they think of noisy concerts and jet engines, excessive noise that harms your ability to hear. This kind of hearing loss, called sensorineural hearing loss is a bit more complicated than that, but you get the idea.
But in some cases, this kind of long-term, noise related damage isn’t the cause of hearing loss. A condition known as auditory neuropathy, while less common, can in some cases be the cause. This is a hearing disorder where your ear and inner ear collect sounds just fine, but for some reason, can’t fully convey those sounds to your brain.
Auditory neuropathy symptoms
The symptoms of traditional noise related hearing loss can often look very much like those of auditory neuropathy. Things like turning the volume up on your devices and not being capable of hearing very well in loud environments. That’s why diagnosing auditory neuropathy can be so challenging.
Auditory neuropathy, however, has some specific symptoms that make discovering it easier. These presentations are pretty solid indicators that you aren’t dealing with sensorineural hearing loss, but with auditory neuropathy instead. Obviously, nothing can replace getting an accurate diagnosis from us about your hearing loss.
Here are some of the more unique symptoms of auditory neuropathy:
- An inability to make out words: Sometimes, you can’t make out what somebody is saying even though the volume is normal. Words are unclear and muddled sounding.
- Sound fades in and out: The volume of sound seems to go up and down like somebody is messing with the volume knob. If you’re dealing with these symptoms it might be a case of auditory neuropathy.
- Sounds sound jumbled or confused: Again, this is not an issue with volume. The volume of what you’re hearing is completely normal, the issue is that the sounds seem jumbled and you can’t make sense of them. This can go beyond the spoken word and apply to all kinds of sounds around you.
Some triggers of auditory neuropathy
These symptoms can be articulated, in part, by the underlying causes behind this specific condition. It may not be very clear why you have developed auditory neuropathy on an individual level. This disorder can develop in both adults and children. And, broadly speaking, there are a couple of well described possible causes:
- Damage to the nerves: The hearing portion of your brain gets sound from a specific nerve in your ear. If this nerve gets damaged, your brain can’t get the complete signal, and as a result, the sounds it “interprets” will seem wrong. Sounds may seem jumbled or too quiet to hear when this happens.
- Damage to the cilia that send signals to the brain: Sound can’t be sent to your brain in complete form once these little delicate hairs have been compromised in a particular way.
Risk factors of auditory neuropathy
No one is quite sure why some individuals will experience auditory neuropathy while others may not. That’s why there’s no exact science to preventing it. Nevertheless, there are close associations which may show that you’re at a higher risk of experiencing this condition.
Keep in mind that even if you have all of these risk factors you still might or may not develop auditory neuropathy. But the more risk factors shown, the higher your statistical probability of experiencing this disorder.
Risk factors for children
Factors that can increase the risk of auditory neuropathy for children include the following:
- Other neurological conditions
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- Preterm or premature birth
- A low birth weight
- Liver disorders that cause jaundice (a yellow look to the skin)
- A lack of oxygen before labor begins or during birth
Adult risk factors
Here are a few auditory neuropathy risk factors for adults:
- auditory neuropathy and other hearing disorders that are passed on genetically
- Overuse of medications that cause hearing problems
- Mumps and other distinct infectious diseases
- Various types of immune diseases
In general, it’s a good plan to minimize these risks as much as you can. If risk factors are there, it might be a good idea to schedule regular screenings with us.
Diagnosing auditory neuropathy
A typical hearing test consists of listening to tones with a pair of headphones and raising a hand depending on what side you hear the tone on. When you’re dealing with auditory neuropathy, that test will be of extremely minimal use.
One of the following two tests will usually be done instead:
- Otoacoustic emissions (OAE) test: This diagnostic is made to measure how well your inner ear and cochlea react to sound stimuli. A tiny microphone is put just inside your ear canal. Then, we will play an array of clicks and tones. Then your inner ear will be assessed to see how it responds. The data will help determine whether the inner ear is the issue.
- Auditory brainstem response (ABR) test: Specialized electrodes will be fastened to specific places on your head and scalp with this test. This test isn’t painful or unpleasant in any way so don’t be concerned. These electrodes measure your brainwaves, with specific attention to how those brainwaves react to sound. The quality of your brainwave reactions will help us determine whether your hearing issues reside in your outer ear (as with sensorineural hearing loss) or further in (as with auditory neuropathy).
Diagnosing your auditory neuropathy will be much more effective once we do the appropriate tests.
Is there treatment for auditory neuropathy?
So, in the same way as you bring your car to the mechanic to get it fixed, you can bring your ears to us for treatment! In general, there’s no “cure” for auditory neuropathy. But this disorder can be managed in a few possible ways.
- Hearing aids: Even with auditory neuropathy, in moderate cases, hearing aids can boost sound enough to enable you to hear better. For some people, hearing aids will work just fine! Having said that, this is not generally the case, because, again, volume is almost never the problem. Due to this, hearing aids are frequently combined with other therapy and treatment options.
- Cochlear implant: For some individuals, hearing aids won’t be able to get around the issues. It may be necessary to opt for cochlear implants in these situations. Signals from your inner ear are sent directly to your brain with this implant. They’re pretty amazing! (And you can find many YouTube videos of them working for patients.)
- Frequency modulation: In some cases, it’s possible to hear better by boosting or reducing certain frequencies. With a technology known as frequency modulation, that’s precisely what occurs. This approach often utilizes devices that are, basically, highly customized hearing aids.
- Communication skills training: Communication skills training can be put together with any combination of these treatments if needed. This will help you communicate using the hearing you have and work around your symptoms instead of treating them.
It’s best to get treatment as soon as possible
As with any hearing disorder, timely treatment can result in better results.
So it’s important to get your hearing loss treated right away whether it’s the common form or auditory neuropathy. You’ll be able to get back to hearing better and enjoying your life once you make an appointment and get treated. Children, who experience a great deal of cognitive growth and development, particularly need to have their hearing treated as soon as possible.