Have you ever had your vehicle break down in the middle of the highway? That really stinks! Your car has to be safely pulled off the road. Then you likely open your hood and have a look at the engine. Who knows why?
What’s strange 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 it’s only when the experts check out things that you get a picture 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 inform you as to what’s wrong.
With hearing loss, this same type of thing can occur. The symptom itself doesn’t necessarily reveal what the underlying cause is. There’s the common culprit (noise-related hearing loss), sure. But in some cases, it’s something else, something such as auditory neuropathy.
What is auditory neuropathy?
Most individuals think of extremely loud noise such as a rock concert or a jet engine when they consider hearing loss. This type of hearing loss is called sensorineural hearing loss, and it’s a bit more involved than simple noise damage.
But in some cases, long-term hearing loss can be caused by something else besides noise damage. While it’s less prevalent, hearing loss can sometimes be caused by a condition called auditory neuropathy. When sound can’t, for whatever reason, be effectively carried to your brain even though your ear is receiving that sound perfectly fine.
Auditory neuropathy symptoms
The symptoms of traditional noise related hearing loss can often look a lot like those of auditory neuropathy. You can’t hear well in noisy settings, you keep turning up the volume on your television and other devices, that sort of thing. This can often make auditory neuropathy hard to diagnose and manage.
However, auditory neuropathy does have some unique properties that make it possible to identify. These presentations are pretty strong indicators that you aren’t dealing with sensorineural hearing loss, but with auditory neuropathy instead. Of course, nothing can replace getting an accurate diagnosis from us about your hearing loss.
Here are some of the more unique symptoms of auditory neuropathy:
- Sound fades in and out: The volume of sound seems to go up and down like somebody is playing with the volume knob. If you’re experiencing these symptoms it could be a case of auditory neuropathy.
- Trouble understanding speech: Sometimes, you can’t understand what a person is saying even though the volume is normal. The words sound garbled or distorted.
- Sounds sound jumbled or confused: This is, once again, not a problem with volume. You can hear sounds but you simply can’t make sense of them. This can pertain to all sorts of sounds, not just spoken words.
Some causes of auditory neuropathy
These symptoms can be articulated, in part, by the underlying causes behind this specific condition. It might not be entirely clear why you have developed auditory neuropathy on an individual level. This disorder can develop in both adults and children. And there are a couple of well defined possible causes, generally speaking:
- Nerve damage: The hearing center of your brain gets sound from a specific nerve in your ear. The sounds that the brain tries to “interpret” will sound confused if there is damage to this nerve. Sounds may seem garbled or too quiet to hear when this occurs.
- Damage to the cilia that send signals to the brain: Sound can’t be sent to your brain in full form once these little fragile hairs have been compromised in a specific way.
Auditory neuropathy risk factors
Some individuals will develop auditory neuropathy while others won’t and no one is quite certain why. As a result, there isn’t a tried and true way to counter auditory neuropathy. Still, there are close associations which might reveal that you’re at a higher risk of developing this condition.
It should be mentioned that these risk factors are not guarantees, you could have all of these risk factors and not experience auditory neuropathy. But the more risk factors present, the higher your statistical probability of developing this condition.
Risk factors for children
Factors that can increase the risk of auditory neuropathy for children include the following:
- A low birth weight
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- Liver conditions that result in jaundice (a yellow look to the skin)
- Other neurological disorders
- Preterm or premature birth
- A lack of oxygen during birth or before labor begins
Risk factors for adults
Here are a few auditory neuropathy risk factors for adults:
- Overuse of medications that cause hearing issues
- Mumps and other specific infectious diseases
- Immune diseases of various types
- auditory neuropathy and other hearing conditions that run in the family
Minimizing the risks as much as possible is always a smart plan. Scheduling regular screenings with us is a smart plan, particularly if you do have risk factors.
Diagnosing auditory neuropathy
A typical hearing exam involves listening to tones with a pair of headphones and raising a hand depending on which side you hear the tone on. When you have auditory neuropathy, that test will be of extremely limited use.
Rather, we will typically recommend one of two tests:
- Otoacoustic emissions (OAE) test: This diagnostic is made to measure how well your inner ear and cochlea react to sound stimuli. We will put a little microphone just inside your ear canal. Then a battery of tones and clicks will be played. Then your inner ear will be measured to see how it reacts. If the inner ear is an issue, this data will reveal it.
- Auditory brainstem response (ABR) test: Specialized electrodes will be connected to certain spots on your scalp and head with this test. Again, don’t worry, there’s nothing painful or unpleasant about this test. These electrodes place particular focus on measuring how your brainwaves respond to sound stimuli. Whether you’re dealing with sensorineural hearing loss (outer ear) or auditory neuropathy (inner ear) will be established by the quality of your brainwaves.
Once we run the appropriate tests, we will be able to more effectively diagnose and treat your auditory neuropathy.
Is there treatment for auditory neuropathy?
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 there are several ways to manage this disorder.
- Hearing aids: Even with auditory neuropathy, in moderate cases, hearing aids can amplify sound enough to allow you to hear better. For some individuals, hearing aids will work just fine! But because volume isn’t usually the issue, this isn’t usually the situation. Hearing aids are often used in conjunction with other treatments because of this.
- Cochlear implant: Hearing aids won’t be capable of solving the problem for most individuals. In these instances, a cochlear implant might be needed. This implant, essentially, takes the signals from your inner ear and carries them directly to your brain. They’re rather amazing! (And you can watch many YouTube videos of them working for patients.)
- Frequency modulation: In some cases, amplification or reduction of specific frequencies can help you hear better. That’s what happens with a technology called frequency modulation. Basically, highly customized hearing aids are utilized in this approach.
- Communication skills training: Communication skills exercises can be put together with any combination of these treatments if needed. This will let you work with whatever level of hearing you have to communicate better.
The sooner you get treatment, the better
As with any hearing condition, timely treatment can lead to better outcomes.
So if you think you have auditory neuropathy, or even just ordinary hearing loss, it’s important to get treatment as quickly as you can. 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.