Have you ever had your vehicle break down in the middle of the road? That really stinks! Your car has to be safely pulled off the road. And then, for some reason, you probably pop your hood and have a look at your engine.
What’s funny is that you do this even though you have no idea how engines work. Perhaps you think there’ll be a convenient handle you can turn or something. Sooner or later, you have to call someone to tow your car to a garage.
And it’s only when the experts get a look at things that you get an understanding of the issue. That’s because cars are complex, there are so many moving pieces and computerized software that the symptoms (a car that won’t move) are not enough to tell you what’s wrong.
With hearing loss, this same sort of thing can happen. The symptom itself doesn’t automatically identify what the cause is. There’s the normal culprit (noise-associated hearing loss), sure. But sometimes, something else like auditory neuropathy is the cause.
What is auditory neuropathy?
When most people consider hearing loss, they think of loud concerts and jet engines, excessive noise that harms your hearing. This form of hearing loss is called sensorineural hearing loss, and it’s a bit more involved than basic noise damage.
But sometimes, this type of long-term, noise induced damage is not the cause of hearing loss. While it’s less common, hearing loss can in some cases be caused by a condition called auditory neuropathy. When sound can’t, for some reason, be effectively sent to your brain even though your ear is receiving that sound just fine.
Symptoms of auditory neuropathy
The symptoms related to auditory neuropathy are, at first glimpse, not all that distinct from those symptoms associated with traditional hearing loss. Things like cranking the volume up on your devices and not being able to hear well in loud environments. That’s why diagnosing auditory neuropathy can be so challenging.
Auditory neuropathy, however, has some distinctive symptoms that make recognizing it easier. When hearing loss symptoms manifest like this, you can be pretty sure that it’s not standard noise related hearing loss. Of course, nothing can replace getting an accurate diagnosis from us about your hearing loss.
The more unique symptoms of auditory neuropathy include:
- Sounds seem jumbled or confused: Once again, this is not an issue with volume. You can hear sounds but you just can’t understand them. This can apply to all sorts of sounds, not just spoken words.
- Sound fades in and out: The volume of sound seems to go up and down like somebody is messing with the volume knob. This could be an indication that you’re dealing with auditory neuropathy.
- Difficulty understanding speech: Sometimes, you can’t understand what someone is saying even though the volume is just fine. Words are confused and unclear.
What triggers auditory neuropathy?
The root causes of this condition can, in part, be defined by its symptoms. It might not be completely clear why you have developed auditory neuropathy on a personal level. Both adults and children can experience this condition. And, broadly speaking, there are a couple of well defined possible causes:
- Damage to the cilia that transmit signals to the brain: If these little hairs in your inner ear become compromised in a specific way, the sound your ear detects can’t really be passed on to your brain, at least, not in its complete form.
- Nerve damage: There’s a nerve that transmits sound signals from your inner ear to the hearing portion of your brain. The sounds that the brain attempts to “interpret” will seem unclear if there is damage to this nerve. When this happens, you might interpret sounds as garbled, indecipherable, or too quiet to differentiate.
Auditory neuropathy risk factors
Some people will experience auditory neuropathy while other people won’t and no one is quite certain why. That’s why there isn’t an exact science to combating it. However, there are close connections which may indicate that you’re at a higher risk of developing this condition.
It should be noted that these risk factors are not guarantees, you might have all of these risk factors and still not experience auditory neuropathy. But the more risk factors shown, the higher your statistical probability of developing this disorder.
Risk factors for children
Factors that can increase the risk of auditory neuropathy for children include the following:
- Other neurological conditions
- Preterm or premature birth
- Liver conditions that cause jaundice (a yellow appearance to the skin)
- A lack of oxygen during birth or before labor begins
- A low birth weight
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
Risk factors for adults
For adults, risk factors that increase your likelihood of developing auditory neuropathy include:
- Certain infectious diseases, such as mumps
- auditory neuropathy and other hearing conditions that run in the family
- Various types of immune disorders
- Overuse of medications that cause hearing issues
Generally, it’s a good plan to minimize these risks as much as possible. If risk factors are there, it may be a good idea to schedule regular screenings with us.
How is auditory neuropathy diagnosed?
A standard hearing exam involves 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 very much with auditory neuropathy.
One of the following two tests will typically be done instead:
- Auditory brainstem response (ABR) test: Specialized electrodes will be attached to specific places on your head and scalp with this test. Again, don’t be concerned, there’s nothing painful or unpleasant about this test. These electrodes track your brainwaves, with specific attention to how those brainwaves react to sound. The quality of your brainwave responses will help us determine 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. A little microphone is placed just inside your ear canal. Then, we will play an array of clicks and tones. Then your inner ear will be measured to see how it responds. The data will help determine whether the inner ear is the issue.
Once we do the appropriate tests, we will be able to more successfully diagnose and treat your auditory neuropathy.
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 condition can be managed in a few possible ways.
- Hearing aids: Even if you have auditory neuropathy, in milder cases, hearing aids can amplify sound enough to allow you to hear better. Hearing aids will be an adequate solution for some individuals. But because volume usually isn’t the problem, this isn’t typically the situation. Due to this, hearing aids are often coupled with other therapy and treatment solutions.
- Cochlear implant: Hearing aids won’t be able to solve the problem for most people. In these instances, a cochlear implant may be required. Signals from your inner ear are transmitted directly to your brain with this implant. They’re rather amazing! (And you can find all kinds of YouTube videos of them working for patients.)
- Frequency modulation: In some cases, it’s possible to hear better by increasing or reducing specific frequencies. With a technology called frequency modulation, that’s exactly what occurs. Basically, highly customized hearing aids are utilized in this strategy.
- Communication skills training: In some cases, any and all of these treatments could be combined with communication skills training. This will help you communicate using the hearing you have and work around your symptoms instead of treating them.
It’s best to get treatment as soon as you can
As with any hearing condition, timely treatment can produce better outcomes.
So if you think you have auditory neuropathy, or even just regular old hearing loss, it’s essential to get treatment as quickly as possible. You’ll be able to go back to hearing better and enjoying your life after you make an appointment and get treated. Children, who experience a lot of cognitive growth and development, particularly need to have their hearing treated as soon as possible.