Have you ever had your car break down in the middle of the road? That really stinks! You have to pull your car off the road. Then you probably open your hood and have a look at the engine. Who knows why?
What’s funny is that you do this even if you have no idea how engines work. Maybe whatever is wrong will be obvious. Eventually, you have to call someone to tow your car to a garage.
And a picture of the problem only becomes obvious when mechanics get a look at it. That’s because cars are complicated, there are so many moving pieces and computerized software that the symptoms (a car that won’t start) are not enough to inform you as to what’s wrong.
With hearing loss, this same kind of thing can occur. The symptom itself doesn’t necessarily indicate what the underlying cause is. There’s the usual cause (noise-associated hearing loss), sure. But sometimes, it’s something else, something like auditory neuropathy.
What is auditory neuropathy?
When most individuals think about hearing loss, they think of loud concerts and jet engines, excessive noise that damages your ability to hear. This type of hearing loss, known as sensorineural hearing loss is somewhat more complex than that, but you get the point.
But in some cases, this sort of long-term, noise related damage isn’t the cause of hearing loss. A condition known as auditory neuropathy, while less prevalent, can in some cases be the cause. When sound can’t, for some reason, be properly transmitted to your brain even though your ear is collecting that sound perfectly fine.
Symptoms of auditory neuropathy
The symptoms of traditional noise related hearing loss can sometimes look a lot like those of auditory neuropathy. You can’t hear very well in loud situations, you keep cranking the volume up on your television and other devices, that sort of thing. That’s why diagnosing auditory neuropathy can be so difficult.
Still, auditory neuropathy does have some unique features that make it possible to diagnose. These presentations are rather solid indicators that you aren’t confronting sensorineural hearing loss, but with auditory neuropathy instead. Though, naturally, you’ll be better informed by an official diagnosis from us.
Here are some of the more unique symptoms of auditory neuropathy:
- Sound fades in and out: The volume of sound seems to rise and fall like someone is messing with the volume knob. If you’re dealing with these symptoms it might be a case of auditory neuropathy.
- An inability to make out words: In some cases, the volume of a word is just fine, but you just can’t understand what’s being said. Words are unclear and muddled sounding.
- Sounds seem jumbled or confused: Once again, this is not a problem with volume. You can hear sounds but you simply can’t understand them. This can go beyond the spoken word and apply to all types of sounds around you.
What triggers auditory neuropathy?
These symptoms can be explained, in part, by the underlying causes behind this particular condition. On an individual level, the reasons why you might develop auditory neuropathy may not be entirely clear. Both children and adults can develop this disorder. And there are a couple of well defined possible causes, broadly speaking:
- Nerve damage: There’s a nerve that transmits sound signals from your inner ear to the hearing center of your brain. If this nerve gets damaged, your brain doesn’t get the full signal, and as a result, the sounds it “interprets” will sound off. When this occurs, you might interpret sounds as jumbled, unclear, or too quiet to differentiate.
- The cilia that transmit signals to the brain can be damaged: If these little hairs in your inner ear become compromised in a particular way, the sound your ear detects can’t really be passed on to your brain, at least, not in its full form.
Risk factors of auditory neuropathy
No one is really sure why some individuals will develop auditory neuropathy while others may not. Because of this, there isn’t a definitive way to counter auditory neuropathy. Still, there are close connections which may reveal that you’re at a higher risk of developing 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 you’re more statistically likely to develop auditory neuropathy the more risk factors you have.
Risk factors for children
Factors that can increase the risk of auditory neuropathy for children include the following:
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- A low birth weight
- A lack of oxygen during birth or before labor begins
- Liver conditions that lead to jaundice (a yellow appearance to the skin)
- Preterm or premature birth
- Other neurological disorders
Risk factors for adults
For adults, risk factors that increase your likelihood of experiencing auditory neuropathy include:
- Some medications (specifically improper use of medications that can cause hearing issues)
- Various types of immune diseases
- Certain infectious diseases, such as mumps
- auditory neuropathy and other hearing conditions that run in the family
Minimizing the risks as much as possible is generally a good idea. If risk factors are present, it might be a good idea to schedule regular screenings with us.
Diagnosing auditory neuropathy
During a standard hearing assessment, you’ll likely be given a pair of headphones and be asked to raise your hand when you hear a tone. When you’re dealing with auditory neuropathy, that test will be of extremely limited use.
One of the following two tests will normally be used instead:
- Otoacoustic emissions (OAE) test: The response of your inner ear and cochlea to stimuli will be checked with this diagnostic. We will put a small microphone just inside your ear canal. Then, we will play a series of clicks and tones. Then your inner ear will be measured to see how it responds. The data will help identify whether the inner ear is the issue.
- Auditory brainstem response (ABR) test: During the course of this diagnostic test, you’ll have special electrodes attached to certain spots on your scalp and head. Again, don’t be concerned, there’s nothing painful or unpleasant about this test. These electrodes put particular emphasis on measuring how your brainwaves respond to sound stimuli. Whether you’re experiencing sensorineural hearing loss (outer ear) or auditory neuropathy (inner ear) will be established by the quality of your brainwaves.
Diagnosing your auditory neuropathy will be much more effective once we do the appropriate tests.
Does auditory neuropathy have any treatments?
So, just like you bring your car to the mechanic to have it fixed, you can bring your ears to us for treatment! auditory neuropathy generally has no cure. But this disorder can be treated in several possible ways.
- Hearing aids: In some less severe cases, hearing aids will be able to provide the necessary sound amplification to help you hear better, even with auditory neuropathy. For some people, hearing aids will work just fine! That said, this isn’t generally the case, because, again, volume is almost never the problem. As a result, hearing aids are usually coupled with other therapy and treatment options.
- Cochlear implant: Hearing aids won’t be able to solve the problem for most individuals. In these situations, a cochlear implant could be necessary. Signals from your inner ear are conveyed directly to your brain with this implant. They’re rather amazing! (And you can watch all kinds of YouTube videos of them working for patients.)
- Frequency modulation: Sometimes, amplification or diminution of specific frequencies can help you hear better. With a technology called frequency modulation, that’s precisely what happens. This strategy often utilizes devices that are, basically, highly customized hearing aids.
- Communication skills training: In some situations, any and all of these treatments may be combined with communication skills training. This will let you work with whatever level of hearing you have to communicate better.
It’s best to get treatment as soon as you can
As with any hearing condition, timely treatment can lead to better outcomes.
So if you suspect you have auditory neuropathy, or even just ordinary hearing loss, it’s important to get treatment as soon as you can. The sooner you schedule an appointment, the more quickly you’ll be able to hear better, and get back to your daily life! Children, who experience a lot of cognitive growth and development, particularly need to have their hearing treated as soon as possible.