Hearing is a gift to living beings to enjoy the various sounds of nature, the chirping of birds, sounds of water fall and the music of your loved one’s heart beat. Ears are our music box that help us in hearing. Any damage to these auditory organs can deprive us of the joys of hearing.
Hearing loss is a condition in which a person is unable to listen to sounds of 25 dB or better in one ear or both. Such people cannot enjoy the sounds of nature or a conversation like a person with normal hearing. Profound hearing loss leads to deafness, in which a person has very little or no hearing.
‘Hard of hearing’ is a phrase that is used for people who have mild to moderate hearing difficulties and these people can benefit with the use of hearing aids and implants. On the other hand, disabling hearing loss occurs when a person cannot hear
The condition of hearing loss can either be temporary or permanent. Although hearing loss develops gradually with age, it can also be sudden. We can blame our modern lifestyle to some extent for making this condition increasingly common. Increased use of earphones and exposure to loud noises for a prolonged period of time are some of the main causes of development of hearing problems in the people. Those who are living in the city have more chances of developing hearing difficulties than people who live in the serene country.
Hearing loss generally happens over time and it is difficult to determine it. However, like any other condition there are some signs and symptoms of hearing disability we just have be aware of them and these are:
It is possible to develop hearing loss only in one ear. Given below are the signs and symptoms of hearing loss occurring in one ear:
Hearing loss in adults is much easier to diagnose than in children. Parents should look out for following signs in their children to determine whether they have any hearing difficulty:
Babies undergo hearing test in the few weeks of their birth and any problem in hearing is diagnosed during this check-up. However, parents should be careful and look out for hearing difficulty signs and symptoms in their babies:
Hearing loss can be sensorineural, conductive or mixed. In sensorineural type of hearing loss, there is difficulty in the transmission or generation of nerve impulse to the ear. Conductive hearing loss occurs when there is some mechanical problem in the conduction of sound waves. When a combination of sensorineural and conductive hearing loss occurs, it is called mixed type of hearing loss.
Only conductive hearing loss caused due to accumulation of ear wax or infection can be treated with the help of medicines. For all other types of hearing loss, hearing aids and implants are required, which can be fitted surgically or non-surgically.
Treatment of any disease is based on alleviating its cause. Conductive hearing loss is caused either due to congenital malformation of the ear or due to any disease in the ear. Congenital absence, dysfunction or malformation of ear structures like those of middle ear and internal ear. Ear diseases that result in hearing loss include infections and tumors. Eustachian tube, a canal that joins middle ear with nasopharynx, can become dysfunctional or a foreign object can become lodged in the ear canal or a trauma to the head or ear can also result in conductive hearing loss. It is generally temporary in nature and can be reversed, especially if it is being caused due to infection.
Infections can be acute or chronic. Acute infections can be treated with antibiotics or anti fungal medicines depending on the causative organism. However, in case of chronic infection, if medicines fail to provide any relief, surgical treatment can be an option.
Conductive hearing loss occurring due to head trauma in which the middle ear structures are damaged, can be treated with the help of surgery. When conductive hearing loss occurs due to genetic disorder in which the bones of middle ears are malformed, it gives rise to a condition known as otosclerosis. This situation can be treated by the help of surgery. Some studies show that exposure to measles virus in the womb can increase a genetically predisposed baby’s chances of developing otosclerosis.
Some of the commonly seen ear infections that can give rise to hearing loss are as follows:
(i) Otitis externa, a condition in which there is inflammation or infection of the ear canal.
(ii) Otitis media, a group of inflammatory diseases affecting the middle ear
(iii) Viral infection
(iv) Ear wax accumulation
(v) Fluid retention
Drugs used for treating conductive hearing loss arising due to the above mentioned reasons are as follows:
A. Antibiotics
Antibiotics are the drugs that are used for killing or inhibiting the growth of bacteria. The following classes of antibiotics are used for treating otitis media and otitis externa:
1. Fluoroquinolones
These are the drugs that stop multiplication of bacteria by binding with their genetic material. Drugs belonging to this class are:
2. Penicillin-like antibiotics
Penicillin is the first antibiotic discovered and belongs to beta-lactams family of antibiotics. There are a number of medicines that belong to this group and follow the same mechanism. These medicines inhibit the synthesis of cell wall which inhibits cell division. Eventually, the weak cell wall ruptures and the bacteria is killed.
3. Cephalosporins
These medicines are bactericidal in nature. They disrupt the cell wall synthesis of bacteria and with a compromised cell wall, the bacteria die.
4. Macrolides
These are a class of antibiotics that arrest the synthesis of proteins in bacteria, due to which the bacteria get killed.
5. Sulfonamide
These are the antibiotics that disrupt the synthesis of folic acid in the bacteria in the absence of which they cannot divide and multiply. They are bacteriostatic in nature because they arrest the growth of bacteria.
6. Bactrim
Bactrim refers to a combination of two antibiotics, sulfamethoxazole and trimethoprim. These antibiotics complement each other’s actions. Sulfamethoxazole disrupts the synthesis of folic acid in the bacteria which arrests its growth. Trimethoprim interferes with the synthesis of genetic material in the bacterium and kills it.
B. Anti-infective drugs
a. Acetic acid
Acetic acid has been long known to act as an anti-infective agent. It works by crossing the cell membrane and rupturing the bacterial call.
b. Chloroxylenol
It is another anti-infective that is used for treating mild infections of ear. It works by disrupting the cell wall and inhibiting the action of various cellular enzymes.
C. Local anesthetic
Ear infections can cause a lot of pain and to counteract it, local anesthetics are added to ear drops.
a. Benzocaine
Benzocaine is a common local anesthetic that is added in cough syrups as well as ear drops to counteract pain. It works by desensitizing the nerve endings at its place of application due to which a person is unable to feel the pain.
D. Anti- fungal
Sometimes, ear infections are caused by fungus and to cure it, anti-fungal medicines are used.
1. Azoles
Azoles are a class of anti-fungal drugs that are involved in curing fungal infections. They inhibit the synthesis of ergosterol in the fungal membrane due to which a faulty membrane is formed. This hinders the multiplication of fungus.
E. Topical Calcineurin Inhibitors
Although this class of drugs is used for suppressing the immune system as in case of organ transplantation, but tacrolimus has been shown to provide relief from eczema. Itchiness is a common problem in case of ear infections, which can be treated with the help of tacrolimus.
Tacrolimus is known to inhibit calcineurin which is an enzyme involved in activating the T-cells of the immune system. Tacrolimus can be used topically for decreasing the inflammatory response which will decrease itchiness.
F. Analgesics
Ear infection can be quite painful. If even after using ear drops there is no relief in pain, analgesics can be taken.
1. Non-steroidal Anti-inflammatory Drugs (NSAIDs)
This group of drugs block the synthesis and release of a chemical, known as prostaglandins. This chemical induces pain and inflammation. An enzyme called cyclooxygenase enzyme (COX) enzyme is required to produce prostaglandins. NSAIDs block COX enzyme and thus inhibit the release of prostaglandins. By doing so, it relieves the abdominal pain experienced in abdominal migraine.
G. Steroids
Steroids are organic molecules that are known to perform a number of functions in the human body, anti-inflammatory being one of them. They can be prescribed to a person with otitis media or otitis externa for speedy recovery. They can be used alone or in combination with antibiotics for speedy recovery. They are even added to ear- drops for local and fast action.
H. Ear wax Dissolving Agents
Hearing loss can also be caused due to blockage of ear canal by ear wax. It is thought to be secreted by our body to protect the inner structures of ear. However, if it is not removed regularly, it gets accumulated in the canal and can lead to conductive hearing loss. It should be noted that ear wax should never be removed at home using a hair pin, cap of a pen and other such objects. It should only be removed by a doctor under hospital setting. Annual removal of ear wax is enough to maintain normal hearing.
If a person has blocked ear canal due to ear wax, ear drops are prescribed to him for softening the wax to facilitate its easy removal. The ear drops prescribed under such situation contain the following ingredients:
This is a type of hearing loss that cannot be treated with the help of medicines. If the condition is mild to moderate, hearing aids might provide some help.
A. Hearing Aid
Hearing aids are electronic devices that run on batteries and improve hearing abilities. They are small in size and can be worn easily in or behind the ear. They help in making the sounds louder which can be heard by the person having hearing difficulty. These are the parts of electronic hearing aids:
It should be noted that only 1 in 5 people can benefit from hearing aids. Generally, these are prescribed to people with damaged inner ear or auditory nerve that sends impulses to the brain.
After consulting with a doctor, a patient can get a hearing aid after getting examined by an ENT specialist and an audiologist. People should refrain from ordering a hearing aid through mail-order. If a person suffers from hearing loss in both the ears, it would be nice to wear hearing aids in both ears.
Hearing aids can be divided into two categories:
1. Analog Hearing Aids
These are the devices that increase the loudness of continuous sound waves and amplify all sounds in a similar fashion. Some of these devices have programmable chips that allow the user to adjust the amplification process according to the environment he is in. [1] These devises convert sound waves converted into electrical signals and amplify them. They are economical, and the volume can be controlled with the help of simple controls.
These devices are increasingly becoming less common.
2. Digital Hearing Aid
They have all the elements of analog hearing aids but differ in the mechanism of operation. Sound waves are converted into digital signals by these devices and are exactly duplicated. There are computer chips present inside that analyze speech and other sounds. They also offer more flexible services and can transmit sound that meet the needs of the user. [2]
There are mainly 3 styles of hearing aids, based on the size, placement and how efficiently they enhance the loudness of the sound. They are:
B. Hearing Implants
Hearing implants are used when hearing aids become ineffective. By using a surgical procedure these electronic devices are placed inside the skull of a person. They are of following types:
Cochlear implants comprise of a microphone like device that collects sounds and converts it into electrical signals, that are transmitted directly to the brain through the auditory nerve.
The device has two parts, an external part and a surgically implanted inner part. There is a receiver that is placed below the skin for picking up sound signals. The implanted processor is connected to one of the bones of the middle ear or is attached adjacent to the membrane of cochlea. It improves hearing abilities by increasing the movement of the natural hearing pathway. They have an advantage of being completely hidden and can be used even while swimming or bathing.
Only conductive hearing loss can be treated with the help of medicines. For sensorineural hearing loss, hearing aids and implants are the only treatment options available along with surgery.
Following are some of the medicines which can be used for managing conductive hearing loss arising from otitis media or otitis externa:
| Name of the Country | OTC Drug(s) Available |
| Argentina | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Australia | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Austria | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Canada | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| China | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Croatia | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Czech Republic | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Denmark | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| France | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Germany | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Greece | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Hungary | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| India | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Ireland | Acetylsalicylic acid (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Italy | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Japan | Aspirin (oral) Acetaminophen (oral)Argentina Ibuprofen (oral) Ear wax dissolving ear drops |
| Mexico | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Philippines | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| Russia | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Singapore | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| South Africa | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| South Korea | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Spain | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| Switzerland | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| The Netherlands | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Diclofenac (oral) Ear wax dissolving ear drops |
| UK | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
| USA | Aspirin (oral) Acetaminophen (oral) Ibuprofen (oral) Ear wax dissolving ear drops |
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