Members of the media who wish to obtain a copy of the guideline or request an interview should contact: Tina Maggio at , or newsroom entnet. Most hearing loss occurs slowly, over a period of months or years. When hearing loss happens in three days or less, it is called sudden hearing loss. The hearing loss can happen in one or, very rarely, both ears. The hearing loss can be caused by problems with the inner ear or nerve of hearing sensorineural hearing loss [SNHL]. Another kind of hearing loss, conductive hearing loss CHL , is caused by a problem in the ear canal, eardrum, or middle ear.
The overarching objective and purpose of this guideline update is the prompt recognition and management of sudden sensorineural hearing loss SSNHL , which may improve hearing recovery and quality of life.
It gives evidence-based recommendations to healthcare providers about how to identify, assess, and treat patients. KAS7: Patient Education — Strong recommendation Clinicians should educate patients with SSNHL about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy. Some manufacturers produce a hearing aid combined with a sound generator. This, in addition to amplifying sounds, provides extra low level sounds in order to try to help the habituation process getting used to the tinnitus sound.
There has been some research on this with a small number of patients, but further work is required to single out the benefit from that given purely by amplification.
Basics of Sound, the Ear, and Hearing - Hearing Loss - NCBI Bookshelf
There is at present no proven advantage to using these devices rather than simple hearing aids. Currently, digital hearing aids are available free on the NHS. Your GP can refer you to a local audiology service for a hearing test and the fitting of a hearing aid.
Alternatively, some audiology services may accept a self-referral. NHS hearing aids provide a good sound quality to the user. On-going rehabilitation, servicing of the hearing aid, and replacement batteries are free on the NHS. Hearing aids are also prescribed and sold by private hearing aid dispensers.
It can be said that there may be some benefit to buying hearing aids privately as doing so gives access to the latest technology with wireless communication accessories and miniaturisation. The costs of buying a private hearing aid can be high and there may be no guarantee of an improved response in comparison with an NHS aid. There may be on-going costs with servicing, maintenance and batteries.
Whichever approach is taken, it is important that the aid is fitted correctly by verifying the amount of sound being delivered to the ear by the hearing aid, particularly if you have tinnitus. If you do purchase a hearing aid, make sure that it is covered by your insurance for loss or damage, both inside and outside your home. Many hearing aids are susceptible to wax and moisture although some manufacturers coat their aids in an invisible waterproof membrane which provides a good level of protection. Even so, the aids do require regular maintenance to ensure correct function.
If a hearing aid has not been fitted correctly and is either over amplifying or under amplifying, this can cause problems for those with tinnitus. Six of the parents interviewed had children who received their cochlear implant between 7 and 16 years old, an age when their opinions and wishes were taken into consideration. They had all used hearing aids; in some cases, their hearing had degenerated, and in others, their hearing level was such that implantation had not been considered earlier, but a relaxation of eligibility criteria and advances in cochlear implant technology meant that an implant had become an option.
For instance, the parent of a year-old girl, an Auslan user with both deaf and hearing friends who wanted to be able to hear her hearing friends better, explained: It was a joint decision with [our daughter], she initiated the process …. At school they were talking about cochlear implants, and she came home one day and said she'd like to find out a bit more about it.
And that was also with my husband and myself, we felt we were more informed. It was clear from the qualitative data that these decisions were extremely difficult for most parents and, in many cases, for the young people also. Parents worried about the timing when their children were approaching particularly important periods in their schooling, such as moving from primary to high school or into their final years of high school. They were concerned that, although there were potential gains from having an implant, there were possible losses as well.
One young person worried about the possibility of not being able to play contact sport; several others were concerned about the look or the aesthetics of the cochlear implant. Meeting another child with an implant was often the deciding factor for these young people. I think he was only thirteen, so basically we left the decision up to him. And a family came up to visit us … and their daughter, she was eleven at the time I think, and she had an implant. For one family, the decision was particularly difficult because their year-old son still had usable residual hearing and gained benefit from his hearing aids for his severe hearing loss.
Widening candidacy criteria made him eligible for an implant, which he was keen to have.
What do we do? Do we risk losing the low tones and the way he uses the hearing aids to go to a cochlear [implant]? And so even though you arm them with all of the facts, and you are really open with them, and tell them all the difficulties that they could experience, and in fact in some ways I think we really highlighted the difficulties he was going to have, he saw cochlear [implants] through rose-colored glasses. It is not surprising, therefore, that parents were made aware of potential negative medical and health-related outcomes to a far greater extent than they were made aware of other potential negative outcomes that could be involved in cochlear implantation, in the areas of social and psychological outcomes particularly.
This was reflected in the qualitative findings. In the interviews, parents spoke of the cochlear implant center being their major source of information; however, some parents considered the information from this source to be one-sided and circumscribed. Audiologists were also an important source of information; however, the data do not indicate to what extent these audiologists were associated with cochlear implant programs or worked with other audiological services used by deaf infants and children.
The proportion of parents using the Internet as an information source was not especially high, at However, some parents had been seeking information for making decisions some years ago, when Internet use was not so widespread. However, the available information may not be comprehensive.
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In particular, Zaidman-Zait and Jamieson found little or no coverage of education and communication approaches on relevant Web sites. It is of concern if parents are prompted to seek implants for their children by media reports, which are often superficial in their coverage of the issues involved and tend to portray cochlear implants as a miracle restoring hearing to deaf children Komesaroff, ; Power, Parent-to-parent mentoring programs such as those developed by parent associations in Australia can be valuable in providing more informed and balanced, yet personalized, perspectives to parents.
Parents certainly valued information from other parents whose children had cochlear implants and wanted to know about the experiences and outcomes of these children. Slightly over half of the parents surveyed had obtained information from parents of children with implants and more than one third from children with implants themselves, and this was reflected in the qualitative findings. Previous research has shown that parents want as much information as possible when they are making their decision and throughout the different stages of the cochlear implantation process Archbold et al.
In the current study, the majority of parents interviewed emphasized the importance of gaining sufficient information, and many devoted a great deal of time and effort to finding information, meeting other families with children who had cochlear implants and, in some cases, seeking out Deaf community members. However, a few parents expressed a different view. These parents tended to decide quickly, usually because they felt that an implant was the only way their child would gain communication through speech and hearing, and thus, the only option for their child and for them as a family.
These findings are consistent with previous studies reporting that making a decision was easier for parents who believed their children would not develop speech without an implant Burger et al. However, our findings did not reflect the very low proportion of parents who found the decision problematic in the study by Sach and Whynes in England. The interviewees who decided relatively quickly had been keen for their children to have the implant as soon as possible. The quantitative findings indicated that, in considering the option of cochlear implantation for their children, most parents had taken a relatively short amount of time before deciding: In any event, it is important that such a major decision should not be rushed Duncan, This may preclude allowing time for hearing aids to be fully trialed, for the infant to be old enough for behavioral audiology tests to be conducted, or for all possible options to be fully considered.
It appears from both the quantitative and the qualitative findings that most parents had little contact with the Deaf community or organizations of or for deaf people during the time they were making the decision about implantation for their children. The small number of parents interviewed who had made contact with members of the Deaf community said that they found this contact stressful because of the strength of opinion they encountered against implantation, and at the same time felt pressure from hearing people that they would be failing their children if they did not go ahead with the implant.
Hearing loss and tinnitus
For many of the parents in this study, the decision about whether or not to implant their deaf children seemed scarcely to contain more than one initial option or alternative. Thus, they gave little consideration to possible alternatives or were they universally encouraged to consider alternatives. It was apparent from the qualitative findings that parents placed great importance on their children sharing their own social, cultural, and linguistic traditions.
Almost all the parents interviewed spoke of wanting their children to be able to communicate with family and friends, take their place in the hearing world, and have broad opportunities in life, and saw the cochlear implant as providing hearing and subsequent spoken language development and, therefore, a means to those ends. This option held the highest attractiveness for parents. In the context of medical decision making among patients, Pierce and Hicks p.
An alternative that did not appear to be part of the information-giving process for most of the parents was the option of bilingual outcomes, with both Auslan and English being learned and used. The great majority of parents seemed to see these two languages as separate options and not in any complementary manner. There was an embedded assumption that implantation would lead to spoken language outcomes only, with signing seen as a possible backup. From our findings, organizations with expertise in and knowledge of bilingualism for deaf people do not seem to have been widely accessed by parents.
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