Falls have important health implications, especially for an aging population where they can lead to significant morbidity and mortality. Elderly people are particularly vulnerable to the consequences of injuries caused by falls, since older individuals typically have greater bone fragility and poorer protective reflexes.[35] Fall-related injury can also lead to burdens on the financial and health care systems.[35] In literature, age-related hearing loss is found to be significantly associated with incident falls.[36] There is also a potential dose-response relationship between hearing loss and falls---greater severity of hearing loss is associated with increased difficulties in postural control and increased prevalence of falls.[37] The underlying causal link between the association of hearing loss and falls is yet to be elucidated. There are several hypotheses that indicate that there may be a common process between decline in auditory system and increase in incident falls, driven by physiological, cognitive, and behavioral factors.[37] This evidence suggests that treating hearing loss has potential to increase health-related quality of life in older adults.[37]
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Frequent, prolonged exposure to loud noise increases the risk of getting tinnitus, or of making it worse, so take care to avoid very loud sounds, or protect your ears against them. Wear proper ear protectors (not cotton wool) when hammering metal, using power tools or when you are near any noisy motors. Ear protection is also important if you watch live music or play in a band or orchestra. Ear protection should not be used if ordinary, everyday sounds are uncomfortable (this may be hyperacusis or oversensitivity to sound). If earplugs are worn for blocking out such sounds, it can actually make hyperacusis worse.
Sound waves reach the outer ear and are conducted down the ear canal to the eardrum, causing it to vibrate. The vibrations are transferred by the 3 tiny ear bones of the middle ear to the fluid in the inner ear. The fluid moves hair cells (stereocilia), and their movement generates nerve impulses which are then taken to the brain by the cochlear nerve.[75][76] The auditory nerve takes the impulses to the brainstem, which sends the impulses to the midbrain. Finally, the signal goes to the auditory cortex of the temporal lobe to be interpreted as sound.[77]

Vivien Williams: …become fewer or don't function well. Hearing aids help to increase volume. For people with profound hearing loss, cochlear implants work by bypassing the hair cells and sending signals directly to the hearing nerve and brain. Once health care professionals figure out your type of hearing loss, they can tailor treatment that's best for you. For the Mayo Clinic News Network, I'm Vivien Williams.
Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
The first person to talk to is your GP. You may need to be referred to an Ear, Nose and Throat (ENT) Surgeon or an Audiovestibular Physician, who will rule out any medical factors, assess your hearing and probably give you some information about what tinnitus is and how best to manage it. Some hospitals have hearing therapists or specially trained audiologists who are available to offer more support if you need it.
^ Fuente A, Qiu W, Zhang M, Xie H, Kardous CA, Campo P, Morata TC (March 2018). "Use of the kurtosis statistic in an evaluation of the effects of noise and solvent exposures on the hearing thresholds of workers: An exploratory study" (PDF). The Journal of the Acoustical Society of America. 143 (3): 1704–1710. Bibcode:2018ASAJ..143.1704F. doi:10.1121/1.5028368. PMID 29604694.
Itching (pruritis) of the ear due to otitis externa is caused primarily by irritation with foreign objects like a cotton ear swabs, hair pins, pens/pencils and matchsticks. The accumulation of water, dust or dirt, sand and other foreign particles that can enter the ear may also be responsible. An allergic reaction may occur or an infection may arise. Certain itchy skin conditions like psoriasis and eczema may also be responsible for itching of the ear canal.
Conductive hearing loss results when there is any problem in delivering sound energy to your cochlea, the hearing part in the inner ear. Common reasons for conductive hearing loss include blockage of your ear canal, a hole in your ear drum, problems with three small bones in your ear, or fluid in the space between your ear drum and cochlea. Fortunately, most cases of conductive hearing loss can be improved.
A common cause of tinnitus is inner ear hair cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves. This triggers cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can "leak" random electrical impulses to your brain, causing tinnitus.
Fetal alcohol spectrum disorders are reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake. Premature birth can be associated with sensorineural hearing loss because of an increased risk of hypoxia, hyperbilirubinaemia, ototoxic medication and infection as well as noise exposure in the neonatal units. Also, hearing loss in premature babies is often discovered far later than a similar hearing loss would be in a full-term baby because normally babies are given a hearing test within 48 hours of birth, but doctors must wait until the premature baby is medically stable before testing hearing, which can be months after birth. [56]The risk of hearing loss is greatest for those weighing less than 1500 g at birth.
▶ For most inner ear problems, a sodium-restricted, caffeine-free diet is recommended. Caffeine is a central nervous system stimulant and its intake makes the symptoms of inner ear disorder (especially headache and dizziness) appear more pronounced. Hence, it is advisable to reduce the intake of caffeine as much as possible till the condition is completely treated. Excess sugar in the diet also triggers dizziness.
An outer ear infection is sometimes called swimmer’s ear. That’s because it often starts as a result of water that remains in your ear after swimming or bathing. The moisture becomes a breeding ground for bacteria. If your outer ear is scratched or if you irritate the outer lining of your ear by putting your fingers or other objects in your ear, a bacterial infection can occur.
These symptoms often happen all at the same time and last anything from minutes to hours. It is a very distressing condition because it is so unpredictable. Furthermore, it can take a day or two for the symptoms to completely disappear and sufferers often feel drained after an attack. Additionally, although the condition usually starts in one ear, it can spread to both over time.
In the United States hearing is one of the health outcomes measure by the National Health and Nutrition Examination Survey (NHANES), a survey research program conducted by the National Center for Health Statistics. It examines health and nutritional status of adults and children in the United States. Data from the United States in 2011-2012 found that rates of hearing loss has declined among adults aged 20 to 69 years, when compared with the results from an earlier time period (1999-2004). It also found that adult hearing loss is associated with increasing age, sex, race/ethnicity, educational level, and noise exposure.[111] Nearly one in four adults had audiometric results suggesting noise-induced hearing loss. Almost one in four adults who reported excellent or good hearing had a similar pattern (5.5% on both sides and 18% on one side). Among people who reported exposure to loud noise at work, almost one third had such changes.[112]
Muscle spasms: Tinnitus that is described as clicking may be due to abnormalities that cause the muscle in the roof of the mouth (palate) to go into spasm. This causes the Eustachian tube, which helps equalize pressure in the ears, to repeatedly open and close. Multiple sclerosis and other neurologic diseases that are associated with muscle spasms may also be a cause of tinnitus, as they may lead to spasms of certain muscles in the middle ear that can cause the repetitive clicking.
Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It might be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults. Tinnitus can accompany any type of hearing loss and can be a sign of other health problems, such as high blood pressure, allergies, or as a side effect of medications.

Conductive hearing loss is sometimes temporary and can be treated with medication or minor surgery, if necessary. However, more major surgery may be required to fix the ear drum or hearing bones. If conventional hearing aids don't work, there are also some implantable devices for this type of hearing loss, such as a Bone Anchored Hearing Aids (BAHAs).
Conductive hearing loss makes all sounds seem faint or muffled. The hearing loss is usually worse in lower frequencies. Congenital conductive hearing loss is identified through newborn hearing screening or may be identified because the baby has microtia or other facial abnormalities. Conductive hearing loss developing during childhood is usually due to otitis media with effusion and may present with speech and language delay or difficulty hearing. Later onset of conductive hearing loss may have an obvious cause such as an ear infection, trauma or upper respiratory tract infection or may have an insidious onset related to chronic middle ear disease, otosclerosis or a tumour of the naso-pharynx. Earwax is a very common cause of a conductive hearing loss which may present suddenly when the wax blocks sound from getting through the external ear canal to the middle and inner ear.
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. No single approach works for everyone, and you may need to try various combinations of techniques before you find what works for you. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds.
Besides being an annoying condition to which most people adapt, persistent tinnitus may cause anxiety and depression in some people.[12][13] Tinnitus annoyance is more strongly associated with the psychological condition of the person than the loudness or frequency range.[14][15] Psychological problems such as depression, anxiety, sleep disturbances, and concentration difficulties are common in those with strongly annoying tinnitus.[16][17] 45% of people with tinnitus have an anxiety disorder at some time in their life.[18]
There can be damage either to the ear, whether the external or middle ear, to the cochlea, or to the brain centers that process the aural information conveyed by the ears. Damage to the middle ear may include fracture and discontinuity of the ossicular chain. Damage to the inner ear (cochlea) may be caused by temporal bone fracture. People who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent.[73][74]
Conductive hearing loss (CHL) occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles). If a conductive hearing loss occurs in conjunction with a sensorineural hearing loss, it is referred to as a mixed hearing loss. Depending upon the severity and nature of the conductive loss, this type of hearing impairment can often be treated with surgical intervention or pharmaceuticals to partially or, in some cases, fully restore hearing acuity to within normal range. However, cases of permanent or chronic conductive hearing loss may require other treatment modalities such as hearing aid devices to improve detection of sound and speech perception.
When you first experience tinnitus, you may naturally be worried and very aware of this new sound. We constantly monitor our bodies and if anything changes, we become aware of the changes. Hearing tinnitus for the first time can be quite frightening if you think it means that something is wrong with you, or that it might change your life. It’s a new sensation and you need to give yourself time to adapt.
Hearing loss is associated with Alzheimer's disease and dementia. The risk increases with the hearing loss degree. There are several hypotheses including cognitive resources being redistributed to hearing and social isolation from hearing loss having a negative effect.[27] According to preliminary data, hearing aid usage can slow down the decline in cognitive functions.[28]
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Is conductive hearing loss curable? Yes, often. Most cases of conductive hearing loss are temporary and are cured by means of appropriate medical treatment, so it is important to seek immediate medical assistance. Other types of conductive hearing losses can be treated with hearing aids or types of hearing implants. Finally, some types of conductive hearing loss can be treated through surgery.

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Your ear consists of three major areas: outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped structure in the inner ear (cochlea).
Fluid accumulation is the most common cause of conductive hearing loss in the middle ear, especially in children.[2] Major causes are ear infections or conditions that block the eustachian tube, such as allergies or tumors.[2] Blocking of the eustachian tube leads to decreased pressure in the middle ear relative to the external ear, and this causes decreased motion of both the ossicles and the tympanic membrane.[3]
Vivien Williams: …become fewer or don't function well. Hearing aids help to increase volume. For people with profound hearing loss, cochlear implants work by bypassing the hair cells and sending signals directly to the hearing nerve and brain. Once health care professionals figure out your type of hearing loss, they can tailor treatment that's best for you. For the Mayo Clinic News Network, I'm Vivien Williams.
Even with all of these associated conditions and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish.

With ASD, TTTS is associated with hyperacusis: the symptoms are triggered or exacerbated by exposure to sound perceived as intolerable, and the primary cause is related to an anxiety/trauma response to sound. Clinically, TTTS appears to be triggered by the anticipation as well as the perception of sounds considered to be highly threatening and/or intolerable. There is little known and much to research in understanding this aetiologic pathway.


This is one psychological approach that can be useful in managing tinnitus. The idea is that when you became aware of your tinnitus, you responded to it negatively. For example, you may have thought there was something seriously wrong with your hearing (a belief) and this led to you being anxious (an emotion), and you then tried to feel better, for example by avoiding silence (a behaviour). Some beliefs and behaviours are helpful and that’s great – keep doing them! But some beliefs and/or behaviours are unhelpful and CBT helps you to recognise them, and then you work together with the clinician (usually a psychologist, audiologist or hearing therapist) to find different ways of responding to the tinnitus so it becomes less bothersome.
The sound perceived may range from a quiet background noise to one that even is heard over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one's own pulse or muscle contractions, which is typically a result of sounds that have been created by the movement of muscles near to one's ear, or the sounds are related to blood flow in the neck or face.[8]
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