Have you ever been in the middle of the road and your car breaks down? That really stinks! You have to pull your car safely to the side of the road. And then, for whatever reason, you probably open your hood and take a look at your engine.
What’s strange is that you do this even though you have no clue how engines work. Maybe whatever is wrong will be totally obvious. Ultimately, a tow truck will need to be called.
And a picture of the problem only becomes obvious when mechanics diagnose it. Just because the car is not starting, doesn’t mean you can tell what’s wrong with it because vehicles are complicated and computerized machines.
The same thing can occur sometimes with hearing loss. The cause isn’t always evident by the symptoms. There’s the common cause (noise-related hearing loss), sure. But in some cases, it’s something else, something such as auditory neuropathy.
What is auditory neuropathy?
When most people think about hearing loss, they think of loud concerts and jet engines, excessive noise that harms your hearing. This form of hearing loss, called sensorineural hearing loss is somewhat more complex than that, but you get the idea.
But sometimes, this type of long-term, noise related damage is not the cause of hearing loss. A condition called auditory neuropathy, while less common, can sometimes be the cause. This is a hearing condition in which your ear and inner ear receive sounds just fine, but for some reason, can’t fully convey those sounds to your brain.
Auditory neuropathy symptoms
The symptoms of conventional noise related hearing loss can often look a lot like those of auditory neuropathy. Things like turning up the volume on your devices and not being able to hear very well in loud environments. That’s why diagnosing auditory neuropathy can be so difficult.
Auditory neuropathy, however, has some specific symptoms that make recognizing it easier. These presentations are pretty solid indicators that you aren’t experiencing sensorineural hearing loss, but auditory neuropathy instead. Obviously, nothing can replace getting a real-time diagnosis from us about your hearing loss.
Here are a few of the more unique symptoms of auditory neuropathy:
- Sound fades in and out: The volume of sound seems to rise and fall like somebody is playing with the volume knob. If you’re experiencing these symptoms it may be a case of auditory neuropathy.
- The inability to make out words: In some cases, the volume of a word is normal, but you just can’t understand what’s being said. Words are confused and muddled sounding.
- Sounds seem jumbled or confused: This is, once again, not a problem with volume. The volume of what you’re hearing is completely normal, the issue is that the sounds seem jumbled and you can’t make sense of them. This can go beyond the speech and apply to all kinds of sounds around you.
Some causes of auditory neuropathy
The root causes of this condition can, in part, be defined by the symptoms. On a personal level, the reasons why you may experience auditory neuropathy might not be completely clear. Both adults and children can experience this disorder. And there are a couple of well described possible causes, generally speaking:
- Damage to the cilia that transmit signals to the brain: If these little hairs in your inner ear become compromised in a particular way, the sound your ear senses can’t really be sent on to your brain, at least, not in its full form.
- Nerve damage: The hearing portion of your brain receives sound from a particular nerve in your ear. The sounds that the brain attempts to “interpret” will sound unclear if there is damage to this nerve. When this happens, you might interpret sounds as jumbled, indecipherable, or too quiet to discern.
Auditory neuropathy risk factors
Some individuals will develop auditory neuropathy while other people won’t and no one is quite certain why. As a result, there isn’t a definitive way to counter auditory neuropathy. Still, there are close associations which might reveal that you’re at a higher risk of developing this disorder.
Keep in mind that even if you have all of these risk factors you still may or may not experience auditory neuropathy. But you’re more statistically likely to experience auditory neuropathy the more risk factors you have.
Children’s risk factors
Here are a few risk factors that will raise the likelihood of auditory neuropathy in children:
- Liver disorders that lead to jaundice (a yellow look to the skin)
- An abundance of bilirubin in the blood (bilirubin is a normal byproduct of red blood cell breakdown)
- Preterm or premature birth
- Other neurological disorders
- A low birth weight
- A lack of oxygen during birth or before labor begins
Adult risk factors
Here are some auditory neuropathy risk factors for adults:
- Some medications (specifically improper use of medications that can cause hearing problems)
- Specific infectious diseases, such as mumps
- Various types of immune disorders
- auditory neuropathy and other hearing disorders that are passed on genetically
Limiting the risks as much as possible is always a good idea. If risk factors are present, it may be a good plan to schedule regular screenings with us.
Diagnosing auditory neuropathy
A normal hearing test consists of listening to tones with a set of headphones and raising a hand depending on what side you hear the tone on. When you have auditory neuropathy, that test will be of very limited use.
Rather, we will usually suggest one of two tests:
- Auditory brainstem response (ABR) test: Specialized electrodes will be connected to specific spots on your scalp and head with this test. Again, don’t worry, there’s nothing painful or unpleasant about this test. These electrodes track your brainwaves, with specific attention to how those brainwaves respond to sound. The quality of your brainwave reactions will help us determine whether your hearing issues reside in your outer ear (such as sensorineural hearing loss) or further in (such as auditory neuropathy).
- Otoacoustic emissions (OAE) test: This diagnostic is made to determine how well your inner ear and cochlea react to sound stimuli. A little microphone is placed just inside your ear canal. Then, we will play a series of clicks and tones. The diagnostic device will then measure how well your inner ear responds to those tones and clicks. If the inner ear is a problem, this data will reveal it.
Diagnosing your auditory neuropathy will be much more effective once we run the applicable tests.
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! Generally speaking, there’s no “cure” for auditory neuropathy. But there are several ways to manage this condition.
- Hearing aids: Even with auditory neuropathy, in milder cases, hearing aids can boost sound enough to enable you to hear better. For some people, hearing aids will work perfectly fine! That said, this is not typically the case, because, again, volume is almost never the problem. Hearing aids are often used in combination with other treatments because of this.
- Cochlear implant: Hearing aids won’t be able to solve the problem for most people. In these situations, a cochlear implant could be required. This implant, basically, takes the signals from your inner ear and transports them directly to your brain. The internet has plenty of videos of individuals having success with these amazing devices!
- Frequency modulation: Sometimes, amplification or diminution of specific frequencies can help you hear better. With a technology called frequency modulation, that’s exactly what occurs. 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 allow you to work with whatever level of hearing you have to communicate better.
It’s best to get treatment as soon as you can
As with any hearing disorder, timely treatment can result in better outcomes.
So if you suspect you have auditory neuropathy, or even just normal 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 daily life! Children, who experience a lot of cognitive growth and development, particularly need to have their hearing treated as soon as possible.