by Neil Bauman, Ph.D.

A high school teen wrote:

Thank you for taking the time to answer 10 questions which I hope will enrich my knowledge on the subject of hearing loss in teenagers. I would love to learn some new information to not only better my understanding on the topic, but to better the lives of my peers and allow them to live more hearing-friendly lives. Here are my questions:

Question 1: In words that any teenager could understand, what are the risk factors that are most likely to cause hearing loss at a young age?

By far the most common risk to hearing is exposing your ears to loud sounds, especially for extended periods of time. The louder the sound and the longer you listen to it, the greater the risk of resulting hearing loss and tinnitus (ringing or other sounds in your ears). Keeping all sounds below 80 dB (decibels) will eliminate this risk.

A second risk factor is hearing loss resulting from middle ear infections. Ear infections are quite common from birth up through elementary school, but ear infections at any age can cause hearing loss. Fortunately, hearing loss from ear infections in often temporary and hearing comes back when the “gunk” (to use a fancy medical term) drains out of your middle ears via your Eustachian tubes in the back of your throat. However, if the doctor prescribes an antibiotic to kill the infection, the antibiotic can itself may cause hearing loss. (See below).

A third risk factor is taking one of the many drugs that can damage your ears. These are called ototoxic drugs. There are hundreds of these ototoxic drugs. Some can cause hearing loss within a few days, while others require taking the drug for extended periods over several to many years. The end result is  the same—hearing loss, tinnitus and/or balance problems.

Those are 3 of the main risk factors for young people. Of course there are many others such as infectious diseases (measles, mumps, chickenpox, etc), viruses, genetics (I was born with a severe hereditary hearing loss), trauma to your ears, etc.

Question 2: How frequently do you hear about teenagers with some degree of hearing loss?

The statistics reveal that about 1 in 5 teens has a significant hearing loss (19%). That means a LOT of school age young people have some hearing loss whether they realize it or not. Since hearing loss typically begins in the very high frequencies, people typically aren’t aware they have a hearing loss until it works its way down into the speech frequencies. By that time the person has a significant hearing loss that makes it hard for them to understand speech, particularly in noisy situations.

Question 3: In your opinion, what is the most common type of hearing loss in teenagers?

There are two common kinds of hearing loss—conductive and sensorineural.

A conductive loss is a mechanical loss in the middle ear. Such losses are often temporary or can be treated medically. A typical cause is gunk (fluid) in your middle ears caused by a middle ear infection. This is probably the most common kind of hearing loss in young children.

The second kind of hearing loss is a sensorineural hearing loss. This is an inner ear hearing loss. A common cause in teens is exposing their ears to loud sounds. About 90% of adults with hearing loss have a sensorineural hearing loss.

Question 4: What kind of research is being done to try and find a cure for hearing loss?

The all time best “cure” for hearing loss is prevention of hearing loss in the first place. Don’t expose your ears to loud sounds, especially for extended periods of time.

One line of current research is looking at anti-oxidants and other things that can help prevent hearing loss after being exposed to loud sounds—such as soldiers are exposed to (gunfire, explosions, etc.)

Another line of research is finding the genes responsible for various genetic hearing losses. Once doctors know which genes are responsible, they want to see if they can find a way to alter the genetic mutations to prevent such hearing losses in the future.

Yet another line of research is delving into the secrets to regenerating hair cells in the inner ear. If this proves successful, some degree of hearing may be restored. Quite a bit of effort is being poured into this line of research and researchers are optimistic they will have results within the next 20 years or so.

Question 5: What kinds of activities/hobbies do teens participate in that are most damaging to their hearing?

Loud noisy situations are the main culprits. This can range from loud music concerts, listening to iPods/MP3 players at high volumes, attending loud sports venues (crowded stadiums, race car tracks, etc), using loud recreational vehicles (motorcycles and ATVs), using firearms without wearing ear plugs, etc.

Question 6: Tinnitus is usually a common warning symptom of hearing loss. Is this treatable?

Tinnitus may be a sign of hearing loss or impending hearing loss, or it can be a stand-alone condition. About 70% of the people with hearing loss have tinnitus associated with it.

There are a number of ways to treat tinnitus—none of which work for everyone. Most people with tinnitus are never able to eliminate it completely. Rather, they learn techniques to reduce the volume and intrusiveness of their tinnitus so that it doesn’t bother them. This is called becoming “habituated” to your tinnitus.

Question 7: Many people believe that iPods and MP3 players are dangerous to people’s hearing. What is your opinion on this?

Without a doubt, this is true IF you crank the volume way up. Some of these devices can put out 110 dB of sound. That is much too loud for hearing health. However, if you listen to these devices at volumes such that the music peaks are always below 80 dB, then there is no problem with them damaging your hearing. At least that is the current thinking. A good rule of thumb is to listen to your music at the same volume as you hear people talking.

Incidentally, having your ears exposed to sustained sounds at 80 dB all the time is not the best either. Our ears (and our brains) like respite from noise. It is best to not expose your ears to sustained sounds for long periods for your general well-being. Silence at times is good.

Question 8: How would having hearing loss affect a teenager’s daily life?

Hearing loss affects your daily life in many different ways—too numerous to mention here. However, here are four significant ways.

First, you feel left out when you can’t hear the chit-chat around you, so you tend to withdraw from your friends and family. This can lead to depression and other psychological problems. Also, when you can’t hear others, they tend to leave you out, and this makes you feel unwanted and worthless. Loneliness and poor feelings of self-worth are real problems with hard of hearing people of any age.

Second, you have much more difficulty in school maintaining good grades since you miss a lot of what the teacher says and most classroom discussion.

Third, you have much more difficulty making and maintaining good relationships with the opposite sex. Dating can be a real “minefield” when you can’t hear well.

Fourth, you have difficulty understanding the radio, TV, telephone and movies so you tend to avoid those activities. This leaves a big hole in your social development.

Question 9: For a teenager with hearing loss, what would be the best treatment for their condition?

If you have a conductive loss, then seeing an ear specialist (ENT or otologist) is a good first step. Often an ear specialist can help fix the loss since conductive losses are really just mechanical problems in the middle ear and often can be successfully treated medically or surgically.

However, if you have a sensorineural hearing loss, there is typically nothing medically that can be done at this time (apart from getting a cochlear implant if you have little to no hearing left). In this case, the best “treatment” is to have a complete audiological evaluation by an audiologist to determine exactly your type and degree of hearing loss. Then, get, and wear, properly-fitted hearing aids if your audiologists recommends them, and do the following things.

A. Use assistive devices when your hearing aids don’t help you much such as in noisy situations, or where you are at a significant distance from the speaker. Assistive devices include personal amplifiers, FM systems, loop systems, etc. (Incidentally, you can listen to most assistive devices with ear buds if you are not wearing hearing aids.)

B. Learn to speechread (lip read). Speechreading together with your residual hearing can really make a difference. I used my speechreading skills all through school and college. It was critical to my success.

C. Finally, learn and use the many, many coping strategies that help you hear better. These include such simple things as get close, have the light on the speaker’s face, cut out background noise, speak face to face, and so on.

Question 10: What is your advice to every teenager to protect their hearing on a day to day basis?

Turn the sound down! Don’t become addicted to loud sound in the first place. Don’t listen to iPods/MP3 players at volumes more than 80 dB. Either avoid loud venues, or wear properly-rated ear protectors when in noisy environments. You can get good foam ear protectors at almost any drug store for a few bucks. Get ones rated at 25 or 30 dB of protection. Just doing these things can help prevent most noise-induced hearing loss in teens.

Thank you for taking time out of your busy day to help me further my education, understand my condition, and also educate my peers about protecting something that most people take for granted. You have my gratitude for sharing your wealth of knowledge and your time.

You’re welcome. I wish more teens were as interested as you in protecting their precious hearing, because once it is gone, it is gone! Thus, the time to learn good hearing conservation habits is right now before it is too late.