Have you ever had your vehicle break down in the middle of the highway? That really stinks! You have to pull your car off the road. And then, for some 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. Perhaps whatever is wrong will be obvious. Inevitably, a tow truck will need to be called.
And a picture of the problem only becomes apparent when experts diagnose it. That’s because cars are intricate, there are so many moving pieces and computerized software that the symptoms (a car that won’t start) aren’t enough to inform you as to what’s wrong.
With hearing loss, this same sort of thing can happen. The symptom itself doesn’t necessarily reveal what the underlying cause is. There’s the usual culprit (noise-associated hearing loss), sure. But sometimes, it’s something else, something such as auditory neuropathy.
Auditory neuropathy, what is it?
When most people think about hearing loss, they think of noisy concerts and jet engines, excessive noise that harms your ability to hear. This form of hearing loss is called sensorineural hearing loss, and it’s a bit more involved than basic noise damage.
But sometimes, this kind of long-term, noise induced damage is not the cause of hearing loss. A condition called auditory neuropathy, while less prevalent, can in some cases be the cause. This is a hearing disorder in which your ear and inner ear receive sounds perfectly 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 a lot like those of auditory neuropathy. Things like cranking the volume up on your devices and not being able to hear well in loud environments. This can frequently make auditory neuropathy hard to diagnose and manage.
Auditory neuropathy, however, has some specific symptoms that make determining it easier. These presentations are rather solid indicators that you aren’t confronting sensorineural hearing loss, but auditory neuropathy instead. Obviously, nothing can replace getting a real-time diagnosis from us about your hearing loss.
Here are a few of the more unique symptoms of auditory neuropathy:
- Sounds sound jumbled or confused: This is, once again, not an issue with volume. The volume of what you’re hearing is just fine, the problem is that the sounds seem jumbled and you can’t understand them. This can pertain to all kinds of sounds, not just speech.
- Sound fades in and out: The volume of sound seems to rise and fall like somebody is messing with the volume knob. If you’re encountering these symptoms it might be a case of auditory neuropathy.
- An inability to distinguish words: Sometimes, the volume of a word is just fine, but you just can’t understand what’s being said. The words sound garbled or distorted.
What triggers auditory neuropathy?
The root causes of this disorder can, in part, be explained by the symptoms. On an individual level, the reasons why you might develop auditory neuropathy may not be totally clear. This condition can develop in both children and adults. And there are a couple of well defined possible causes, broadly speaking:
- The cilia that deliver signals to the brain can be compromised: Sound can’t be sent to your brain in full form once these little delicate hairs have been compromised in a specific way.
- Nerve damage: The hearing center of your brain gets sound from a particular nerve in your ear. The sounds that the brain attempts to “interpret” will seem confused if there is damage to this nerve. When this occurs, you may interpret sounds as garbled, unclear, or too quiet to discern.
Auditory neuropathy risk factors
No one is quite certain why some people will experience auditory neuropathy while others might not. Because of this, there isn’t a definitive way to counter auditory neuropathy. But you may be at a higher risk of experiencing auditory neuropathy if you show particular close associations.
Keep in mind that even if you have all of these risk factors you still might or may not experience auditory neuropathy. But the more risk factors present, the higher your statistical likelihood of developing this condition.
Risk factors for children
Factors that can raise the risk of auditory neuropathy for children include the following:
- Preterm or premature birth
- A low birth weight
- Other neurological disorders
- A lack of oxygen during birth or before labor begins
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- Liver disorders that lead to jaundice (a yellow look to the skin)
Adult risk factors
Here are some auditory neuropathy risk factors for adults:
- Some medications (especially improper use of medications that can cause hearing issues)
- Family history of hearing disorders, including auditory neuropathy
- Various kinds of immune disorders
- Mumps and other specific infectious diseases
Generally, it’s a good plan to limit these risks as much as you can. Scheduling regular screenings with us is a good plan, especially if you do have risk factors.
Diagnosing auditory neuropathy
A typical hearing exam consists of listening to tones with a pair of headphones and raising a hand depending on what side you hear the tone on. That test won’t help much with auditory neuropathy.
Instead, we will typically recommend one of two tests:
- Auditory brainstem response (ABR) test: During this diagnostic test, you’ll have special electrodes attached to specific spots on your head and scalp. This test isn’t painful or unpleasant in any way so don’t worry. These electrodes measure your brainwaves, with particular attention to how those brainwaves react to sound. The quality of your brainwave reactions will help us identify whether your hearing problems reside in your outer ear (as with sensorineural hearing loss) or further in (as with auditory neuropathy).
- Otoacoustic emissions (OAE) test: The response of your inner ear and cochlea to stimuli will be tested with this diagnostic. We will put a small microphone just inside your ear canal. Then, we will play a series of clicks and tones. The diagnostic device will then determine how well your inner ear responds to those tones and clicks. The data will help identify whether the inner ear is the problem.
Once we do the appropriate tests, we will be able to more effectively diagnose and treat your auditory neuropathy.
Is there treatment for auditory neuropathy?
So you can bring your ears to us for treatment just like you bring your car to the mechanic to have it fixed. Auditory neuropathy generally has no cure. But there are several ways to treat this disorder.
- Hearing aids: Even if you have auditory neuropathy, in moderate cases, hearing aids can amplify sound enough to enable you to hear better. For some people, hearing aids will work perfectly fine! But because volume isn’t usually the problem, this isn’t normally the situation. Hearing aids are usually used in conjunction with other treatments because of this.
- Cochlear implant: For some individuals, hearing aids won’t be able to get around the problems. It might be necessary to opt for cochlear implants in these instances. This implant, basically, takes the signals from your inner ear and carries them directly to your brain. They’re pretty amazing! (And you can find all kinds of YouTube videos of them working for patients.)
- Frequency modulation: In some cases, amplification or reduction of certain frequencies can help you hear better. With a technology called frequency modulation, that’s precisely what happens. Essentially, highly customized hearing aids are utilized in this approach.
- Communication skills training: Communication skills training can be combined with any combination of these treatments if necessary. This will help you communicate with 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 produce better outcomes.
So if you think you have auditory neuropathy, or even just normal hearing loss, it’s important to get treatment as soon as possible. The sooner you schedule an appointment, the more quickly you’ll be able to hear better, and get back to your everyday life! Children, who experience a lot of cognitive growth and development, particularly need to have their hearing treated as soon as possible.