Hearing Loss: How Can I Hear Better?

Have you noticed that you haven’t been able to hear as well as before? Hearing loss is pretty common in Singapore and can affect both young and old alike. But why do you actually have hearing problems? We see many patients at our ENT specialist clinics in Singapore with all types of hearing loss, which may be caused by ear infection, ear trauma, eardrum rupture, noise damage, age related hearing loss and many other ear conditions.

The simplest cause to treat for hearing loss is when it is caused by impacted earwax. In some people, especially those who like to dig their ears frequently, earwax may accidentally be pushed deeper into their ear canals, blocking them off and causing a temporary conductive hearing loss. We gently remove the impacted earwax by micro-suctioning, where special tiny suckers are used to painlessly remove the stuck earwax under the microscope. This is a really rewarding experience for both ENT doctor and patient as it gives immediate welcome relief to allow you to hear clearly again. ENT specialists in Singapore don’t like to irrigate the ear with water, which is what many family GPs would do, because we worry about underlying infection, sometimes fungal, or eardrum perforations which will worsen upon water exposure.

So what happens if you have an ear infection? You may suffer ear pain, blocked ear or ear discharge. Ear infections can be bacterial or fungal, or due to underlying eczema, an inflammatory allergic condition of the skin inside the ear canal. The mainstay of treatment for ear infections affecting the outer ear or ear canal is to have your ear thoroughly cleaned out gently by your friendly ENT specialist in Singapore, who can then apply soothing antibiotic steroid ointment inside your inflamed itchy ear canals and prescribe a course of eardrops. It is very important not to dig your ears and to keep them dry during the recovery period to allow your poor ears to recover fully. Chronic “ear diggers” (yes, you know who you are!) inevitably return to our clinic for further sessions due to recurrent flareups of their ear condition.

Hearing loss in Singapore may be due to a perforated eardrum which in turn may have been caused by sinus or nose infections tracking up the Eustachian pressure tube to infect the eardrum. Sometimes, direct trauma either with a foreign body or sudden extreme pressure waves can rupture the eardrum e.g. during a loud blast or explosion nearby. Direct impact falling with ear hitting the water surface eg when swimming or diving, can also puncture the eardrum or bruise the eardrum severely, enough to result in a conductive hearing loss. The eardrum has an important role in preventing your middle ear from getting infected and needs to be intact to do so. If your perforated eardrum hasn’t healed in 6-8 weeks, it is far less likely to do so on its own further down the line and you should consider having it repaired through surgery. The surgical procedure is called a Myringoplasty or Tympanoplasty, and may be done as day surgery, where a healthy piece of tissue called a “graft” is used to patch up the eardrum perforation.

Many young people may already have underlying hearing loss due to repeat exposure to prolonged or loud noise from their earphones, e.g. when listening to music. In this current Covid situation, many people are working from home through online meetings, where they use earphones for long hours daily. We have been seeing a sudden increase in the number of patients coming to see us for tinnitus (irritating ear noise) and hearing loss, which make me suspect that it is the frequent usage of earphones inserted into the ear canals blasting sound away nonstop for a few hours everyday, that is irritating the inner ear nerve endings to lead to tinnitus and hearing loss i.e. Noise induced ear damage or noise induced hearing loss. Noise damage to your inner ears is often permanent and irreversible so prevention is always better.

As we age, many of us begin to experience tinnitus or mild hearing loss, beginning usually from our forties onwards. Age-related hearing loss is due degenerative causes like poorer bloodflow to the inner ear and atrophy or weakening of the inner ear nerve endings. Age-related hearing loss tends to affect the higher frequencies of our hearing range so this means you will notice difficulty listening in a noise background or when you listen to music or watch TV. You may also start to miss out on certain parts of conversation, especially when consonants are used (the “p”, “sssss”, “th”, “t” sounds for example).That can be rather socially awkward which then makes the hearing-impaired person more reluctant to participate in social activities, becoming more withdrawn, and leading to a higher risk of depression and early onset dementia.

Sometimes, hearing loss in Singapore may be caused by a rare benign inner ear nerve tumour called an acoustic neuroma or vestibular schwannoma. The early presenting symptoms are usually hearing loss or tinnitus, sometimes vertigo may also occur. It tends to affect the hearing in one ear so such patients need to have an MRI scan of their inner ear to screen specifically for an acoustic neuroma. Subsequent treatment will depend on the neuroma’s size, growth rate, age of the patient and severity of the hearing loss. Many cases may be conservatively monitored with the use of yearly MRI scans, although the neuromas which continue to grow will have to be treated either by “gamma knife” radiation or surgical removal.

In conclusion, hearing loss should not be ignored and you should see your top ENT specialist in Singapore to get it properly checked out and treated early!

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