Hearing is one of our primary modes of communication. 360 million people worldwide have disabling hearing loss. Hearing loss may result from genetic causes, complications at birth, certain infectious diseases, chronic ear infections, the use of particular drugs, exposure to excessive noise and ageing. Hearing loss may be mild, moderate, severe or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds. it may occur in one or both ear. CONDUCTIVE HEARING LOSS (CHL) SENSORINEURAL HEARING LOSS (SHL) MIXED HEARING LOSS  (MHL)

1. DEAFNESS

2. OVERVEIW
• Hearing is one of our primary modes of
communication. 360 million people worldwide
have disabling hearing loss.
• Hearing loss may result from genetic causes,
complications at birth, certain infectious
diseases, chronic ear infections, the use of
particular drugs, exposure to excessive noise
and ageing.

3. Risk factors
1. Family history of sensorineural
impairment
2. Congenital malformations of the
cranial structure (ear)
3. Low birth weight (<1500 gm.)
4. Use of ototoxic medications
(gentamycin and loop diuretics)

4. Risk factors
5. Recurrent ear infections
6. Bacterial Meningitis
7. Chronic exposure to loud noise
8. Perforation of the tympanic
membrane

5. Definition
• A person who is not able to hear as well
as someone with normal hearing –
hearing thresholds of 25 dB or better in
both ears – is said to have hearing loss.

6. TYPES & ETIOLOGY OF
DEAFNESS
• Many factors influence the type and
amount of hearing loss. hearing loss not
actual disorder but is a clinical
manifestations of many possible problems.
• Hearing loss can be classified into three
main areas.

7. TYPES & ETIOLOGY OF
DEAFNESS
1. CONDUCTIVE HEARING LOSS
(CHL)
2. SENSORINEURAL HEARING LOSS
(SHL)
3. MIXED HEARING LOSS (MHL)

8. CONDUCTIVE HEARING LOSS
 Results from interference of sound
transmission through the external ear and
middle ear.
 it may be caused by Any thing that blocks
the external ear, such as wax, infection or
foreign body.

9. CONDUCTIVE HEARING LOSS
• A conductive hearing loss can be the
result of a blockage in the external ear
canal or can be caused by any disorder
that unfavorably effects the middle ear's
ability to transmit the mechanical energy
to the stapes footplate.

10. CONDUCTIVE HEARING LOSS
• Thickening , retraction, scaring or
perforation of tympanic membrane, or
any pathologic changes in the middle ear.
• Ear obstructions due to foreign bodies
and objects.

11. CONDUCTIVE HEARING LOSS
1. Infection : many infections can lead to
hearing loss ( Otitis media & meningitis)
2. Tympanosclerosis ( is a condition is the
result of repeated infection and trauma to
the tympanic membrane.)
3. Trauma to the tympanic membrane

12. CONDUCTIVE HEARING LOSS
• Increased pressure from hand slap, falling
in water , sports injuries , cleaning of the
ear with a sharp instruments. and
industrial accidents involving welding
sparks can rupture the thin membrane.

13. SENSORINEURAL HEARING
LOSS (SHL)
• Sensorineural hearing loss results
from inner ear or auditory nerve
dysfunction. eighth cranial nerve or
the brain.

14. SENSORINEURAL HEARING
LOSS (SHL)
• The causes for sensorineural hearing loss
sometimes cannot be determined, it does
not typically respond favorably to
medical treatment, and it is typically
described as an irreversible, permanent
condition.

15. causes are mainly including.
• Congenital and hereditary factors
• Noise injury
• Use of ototoxic medications
( gentamicin etc)
• Ageing and degenerative process ,
ototoxicity, Meniere's disease and
systematic disorder such as ( auto
immune diseases, syphilis, and
diabetes mellitus)

17. Severity of Hearing Loss
LOSS IN
DECIBELS
INTERPRETATION
0–15 Normal hearing
>15–25 Slight hearing loss
>25–40 Mild hearing loss
>40–55 Moderate hearing loss
>55–70 Moderate to severe hearing loss
>70–90 Severe hearing loss

18. Severity of Hearing Loss
LOSS IN
DECIBELS
INTERPRETATION
>90 Profound hearing loss

19. PREVENTION
• Mainly it including three levels of
prevention.
1. PRIMARY PREVENTION : Is aimed
at minimizing the risks from trauma,
noise exposure, use of ototoxic drugs and
infections disease such as meningitis,
mumps and measles.

20. • Education to the community and
awareness programme to the general
public regarding causes, use of protective
instruments and way of prevention. e.g.
Helmets when participating sports and
etc.

21. • Occupational or industrial workers
such as who are working in high
noise level should wear ear plugs and
avoid prolonged exposure to noise.

22. • Periodically health check up ( exposure to
noise levels in excess of 80 decibels
( dB) throughout an 8 hours per day is
considered excessive and should avoid .
• In addition , teenagers need to be aware
that listening to extremely loud music in
enclosed spaces. such as cars contribute
to hearing loss.

23. Secondary prevention
• Secondary prevention involves early
detection of hearing impairment
though screening and referral after any
ear problems
• Screaming programme should focus or
performed in clients 65 years and high
risk peoples.

24. Tertiary prevention
• Tertiary prevention focuses on maintains
of optimal function through herring
rehabilitation programmes
• Proper use and care of hearing aids and
implementation of coping and promptly
notify the physician.

25. CLINICAL MANIFESTAIONS
• Most hearing loss gradual and goes
unnoticed by the client. until several
incident of communication problems
have occurred.
• Failure to respond to oral
communications
• In appropriate response to oral
communications.

26. CLINICAL MANIFESTAIONS
• Excessively loud speech
• Abnormal awareness sounds
• Strained facial expression
• Constant need for clarification of
conversation
• Listening to radio or TV at increased
volume.

27. MANAGEMENT
• The goal of management of the client
with hearing loss are
1. To restore hearing
2. To assist hearing
3. To manage tinnitus and implement aural
rehabilitation

28. • Restoring hearing : Hearing loss
that result from blockage or fullness
in the ear associated with an
infections may be restored to normal
with administration of antibiotics for
bacterial infections
• In case of sudden hearing loss (SHL)
promote administration of oral
corticoid steroids.
• Restoring hearing : Hearing loss
that result from blockage or fullness
in the ear associated with an
infections may be restored to normal
with administration of antibiotics for
bacterial infections
• In case of sudden hearing loss (SHL)
promote administration of oral
corticoid steroids.

29. • Assist hearing : Unfortunately most
hearing losses are permanent and
hearing can not restored. the use of
hearing aids and assistive listening
devices can greatly improve the
clients ability to communicate and
interest with others
• Early detection and intervention are
crucial to minimizing the impact of
hearing loss on a child’s development
and educational achievements.
• Assist hearing : Unfortunately most
hearing losses are permanent and
hearing can not restored. the use of
hearing aids and assistive listening
devices can greatly improve the
clients ability to communicate and
interest with others
• Early detection and intervention are
crucial to minimizing the impact of
hearing loss on a child’s development
and educational achievements.

30. • In infants and young children with
hearing loss, early identification and
management through infant hearing
screening programmes can improve the
linguistic and educational outcomes for
the child. Children with deafness should
be given the opportunity to learn sign
language along with their families.
• In infants and young children with
hearing loss, early identification and
management through infant hearing
screening programmes can improve the
linguistic and educational outcomes for
the child. Children with deafness should
be given the opportunity to learn sign
language along with their families.

31. Aural rehabilitation

32. Aural rehabilitation
• Aural rehabilitation is the process of
identifying and diagnosing a hearing loss,
providing different types of therapies to
clients who are hard of hearing, and
implementing different amplification
devices to aid the client's hearing abilities.

33. Goal of Aural rehabilitation
1. Sensory management to optimize
auditory function,
2. Instruction in the use of technology and
control of the listening environment,
3. Perceptual training to improve speech
perception and communication, and
4. Counseling to enhance participation,
and deal both emotionally and
practically with residual limitations.

34. Components of Aural rehabilitation
• Sensory management—to target and
enhance auditory function;
• Instruction—to increase the
probability of positive outcome from
sensory management

35. Components of Aural rehabilitation
• Perceptual training—to target activity,
by supplementing the learning
opportunities provided by everyday
communication;
• Counseling—to target issues of
participation and quality of life that
result from residual deficits of function
and activity.