Article by Hearing Partners, contributed by Sadrina Shah, Clinical Audiologist at Hearing Partners
Thank you for reading this post, don't forget to subscribe!Hearing loss refers to a partial or complete inability to hear sounds in one or both ears. The degree of severity can be classified as mild, moderate, severe or profound.
Contrary to popular belief, hearing loss can affect individuals of all ages, not just the elderly. In Singapore, it’s estimated that 500,000 individuals are diagnosed with hearing loss.
In this article, we’ll discuss the types of hearing loss and their causes, and uncover the link between this condition and dementia. We’ll also share the signs of hearing loss and methods of diagnosis, treatment and prevention.
Types of Hearing Loss
There are 3 main types of hearing loss and each relates to a specific part of the hearing system where damage has occurred.
| Sensorineural | Conductive | Mixed | |
|---|---|---|---|
| Part of the ear that is affected | Inner ear or cochlear and/or its associated nerves | Middle or outer ear | Inner and middle ear |
| Causes | Middle ear: Outer ear: | Mix of causes from sensorineural and conductive hearing loss | |
| Impact | Decrease in the perceived loudness of a sound | Depends on the cause | |
| Treatment | No treatment; condition is permanent | Depends on the cause |
Signs of Hearing Loss
Some common signs of hearing loss include (but are not limited to):
- Difficulty hearing soft or distant speech
- Difficulty understanding the speaker in noisy environments
- Needing to read someone’s lips to understand what is being said
- Speaking louder than usual
- Tinnitus
- Turning the television volume higher than usual
- Vertigo
Degree of hearing loss
The degree of severity of your hearing loss can range from mild to moderate, severe and profound.
- Mild: Speech may be unclear in noisy environments; the television volume may also be turned higher than normal
- Moderate: Communication may be challenging without a hearing aid
- Severe: Sounds in the environment can be difficult to hear; communication strategies like lip-reading, sitting close to the speaker and requesting for the speaker to speak slowly and clearly may be necessary to facilitate a conversation even with a hearing aid
- Profound: Listening is difficult even with a hearing aid; communication strategies similar to those employed by individuals with severe hearing loss are necessary to facilitate a conversation
Hearing Loss and Dementia
According to the Lancet Commission, hearing loss is a significant modifiable risk factor for dementia (8%). It can result in social isolation and a decrease in cognitive stimulation, subsequently leading to cognitive decline.
In fact, it was found that the severity of hearing loss correlates to the risk of dementia:
- Mild hearing loss: 2 times the risk
- Moderate hearing loss: 3 times the risk
- Severe hearing loss: Up to 5 times the risk
By managing hearing loss, approximately 1 in 13 cases of dementia can possibly be delayed or even eliminated.
Diagnosing Hearing Loss
Aside from understanding the individual’s medical history, the following steps are often taken to diagnose hearing loss:
- Physical examination
A physical examination of the ear canal, tympanic membrane, nose and nasopharynx will be carried out. A neurologic examination may also be performed.
- Hearing tests
An audiometry test will be done to determine the type and extent of the hearing loss. If it’s identified to be a case of conductive hearing loss, a tympanometry test may be carried out to assess the function of the middle ear and the integrity of the eardrum.
- Radiological imaging
Computed Tomography (CT), Magnetic Resonance Imaging (MRI) or other imaging scans may be carried out to test for acoustic neuroma – a benign tumour that may cause hearing loss.
Treatment for Hearing Loss
Depending on the type and cause of hearing loss, the condition may be treated or managed using different methods or devices.
Hearing aids
Suitable for: Sensorineural and conductive hearing loss
Hearing aids are devices that detect and amplify sounds in the environment to allow the user to hear better and more clearly.
The 2 main types of hearing aids are behind-the-ear (BTE) and in-the-ear (ITE), where the device casing can be worn either behind the ear or inside the ear canal.
These devices are suitable for varying degrees of hearing loss, from mild to profound.
Hearing aids
Suitable for: Sensorineural and conductive hearing loss
Hearing aids are devices that detect and amplify sounds in the environment to allow the user to hear better and more clearly.
The 2 main types of hearing aids are behind-the-ear (BTE) and in-the-ear (ITE), where the device casing can be worn either behind the ear or inside the ear canal.
These devices are suitable for varying degrees of hearing loss, from mild to profound.
Cochlear implants
Suitable for: Sensorineural hearing loss
Cochlear implants are hearing devices that are surgically inserted into the inner ear. They’re designed to take on the function of the damaged hair cells of the cochlea and transmit sound to the auditory nerves that aren’t damaged.
Cochlear implants are suitable for those experiencing moderate to severe sensorineural hearing loss and can be worn by both children and adults.
To be eligible for this procedure, the individual must experience limited benefits from wearing hearing aids and have poor speech intelligibility scores.
Cochlear implants
Suitable for: Sensorineural hearing loss
Cochlear implants are hearing devices that are surgically inserted into the inner ear.
They’re designed to take on the function of the damaged hair cells of the cochlea and transmit sound to the auditory nerves that aren’t damaged.
Cochlear implants are suitable for those experiencing moderate to severe sensorineural hearing loss and can be worn by both children and adults.
To be eligible for this procedure, the individual must experience limited benefits from wearing hearing aids and have poor speech intelligibility scores.
Medication
Suitable for: Conductive hearing loss
Individuals who suffer from hearing loss due to ear infections may be prescribed topical antibiotics. In some cases, medications may also be stopped or switched out for an alternative if they’re the potential cause of hearing loss.
Surgery
Suitable for: Conductive hearing loss
Surgery may be the recommended treatment option for hearing loss resulting from:
- Perforated eardrums
- Bony growths in the ear canal
- Ear bone fixations or deformities
- Recurring ear infections
Preventing Hearing Loss
While options for treating and managing hearing loss are available, prevention is always better than cure. Here are some ways to prevent hearing loss from occurring:
Practice good habits
You can prevent hearing loss by incorporating good habits into your daily life. This includes:
- Consuming a nutritious diet to improve your ear function
- Engaging in physical exercises to reduce the risk of age-related hearing loss and to maintain the auditory function of the cochlear
- Engaging in hearing exercises to sharpen your skills in listening and identifying sounds
- Keeping your ears dry to prevent ear infections and earwax buildup
Avoid habits that may harm your ears
Certain habits can be harmful to your hearing health. To maintain good hearing, it’s important to avoid these habits:
- Placing small objects in your ear as doing so can damage your eardrums
- Smoking – it increases the risk of hearing loss and tinnitus
- Listening to loud sounds frequently as it can lead to noise-induced hearing loss (NIHL) and tinnitus
In general, you’re advised to limit your exposure to sounds over 85 decibels* to 8 hours a day. If you’re unable to avoid prolonged exposure to such sounds, wearing ear protection and resting your ears periodically can help to mitigate the effects.
*This includes noise from a food blender, lawnmower and hairdryer. Additionally, if you have to raise your volume to speak to another person standing approximately 0.9m away from you, the noise level may be over 85 decibels.
Seek professional hearing care services
While removing excess earwax may seem like a simple task you can do at home, you may potentially damage your eardrum or the lining of your ear canal. As such, it’s recommended to seek a general practitioner (GP) or Ear, Nose and Throat (ENT) specialist for ear cleaning or earwax removal.
Moreover, it’s a good idea to take a hearing test periodically to monitor your hearing health. This can allow you to detect any warning signs of hearing loss and take the appropriate actions to manage it.
FAQs About Hearing Loss in Singapore
Is hearing loss considered a disability in Singapore?
Yes, it is. According to SG Enable, hearing loss (partial or complete) is classified as a sensory disability in Singapore.
What is noise-induced hearing loss?
NIHL can be caused by frequent exposure to loud sounds such as loud music from your devices or at concerts, or by a one-time exposure to an intense sound such as an explosion.
In 2021, it was reported that approximately 5 in 100,000 people in Singapore suffer from NIHL.
Can acupuncture be used to treat hearing loss?
While acupuncture is believed to help with tinnitus and sensorineural hearing loss caused by age or noise, there is no scientific evidence to support this belief.
How much do hearing aids cost in Singapore?
On average, the price of a hearing aid in Singapore falls between $800 to $8,000 per piece. This depends on the brand, model and functions of the device.
Hearing aids with technologically-advanced features such as Oticon™ and its BrainHearing™ technology tend to be more expensive than others as it allows for an improved listening experience.
Are there subsidies for hearing aids in Singapore?
Yes, there are 2 subsidies for hearing aids in Singapore – the Seniors’ Mobility and Enabling Fund (SMF) and the Assistive Technology Fund (ATF). You can apply through an application administrator or assessor (e.g. a therapist or social worker) from institutions such as a hospital or social service agency.
If you’re eligible for these schemes, you can receive up to 90% subsidies on the cost of the device, subject to a subsidy cap.