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Below is a brief explanation of each of the three basic types of hearing loss: 1) sensorineural, 2) conductive, and 3) mixed.
The vast majority of people with hearing loss have sensorineural hearing loss. This occurs when there is a problem with the sensory (hair cells) and/or neural structures in the inner ear. Most often, sensorineural hearing loss involves damage to the tiny hair cells that are activated by sound waves to vibrate and release chemical messengers that stimulate the auditory nerve. The auditory nerve is made up of many nerve fibers that then carry signals to the brain that are interpreted as sound. While sensorineural hearing loss usually involves damage to the tiny hair cells, it also can result from damage to the auditory nerve.
Conductive hearing loss is mechanical in nature. That means that something—a physical condition or disease—is stopping sound from being conducted from the outer or middle ear to the inner ear, where nerves are stimulated to carry sound to the brain. Often, the cause of conductive hearing loss can be identified and treated. Medical treatment of conductive hearing loss often allows for partial or complete improvement in hearing.
A mixed hearing loss means there is a sensorineural hearing loss along with a conductive hearing loss component. In addition to some irreversible hearing loss caused by a problem with the inner ear, there also is an issue with the outer or middle ear, which makes the hearing loss worse. But it may be possible to successfully treat the conductive hearing loss, as explained above. Following treatment, the individual also may benefit from hearing aids to help manage the remaining sensorineural hearing loss.
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Aspartame, is a low-calorie sugar substitute. The Food and Drug Administration (FDA) first approved the use of aspartame in dry food products in 1981 and its use in beverages in 1983. Since the approval of aspartame, our diet-conscious society has caused its use to grow exponentially. Now found in many products labeled as “sugar free” or “diet,” aspartame is found in thousands of processed food products and drinks. But it is not always called aspartame – it can be marketed under many different brand names such as AminoSweet, NutraSweet, Equal, Natrataste or Spoonful.
Some researchers suspect aspartame might have a connection to tinnitus. Though a definitive link between the two has yet to be proven, the reason aspartame is considered suspect is that some components of it may be toxic to the brain and the inner ear – two organs that are particularly sensitive to neurotoxins. Specifically, phenylalanine, aspartic acid and methanol become toxic after periods of long storage or exposure to heat.
Beyond the toxicity, aspartame is known as an “excitatory neurotransmitter.” It increases electrical activity in the brain, specifically in the auditory cortex. As those with tinnitus already have an elevated level of electrical activity in the brain, more electrical activity is the last thing they need.
Despite claiming that aspartame is safe, the FDA released results of an epidemiological survey which appeared in the Journal of Applied Nutrition in which 551 persons who reported toxicity effects from aspartame ingestion were surveyed. Among the adverse effects found, 13 percent reported having tinnitus, along with 9 percent that reported a “severe intolerance for noise” and 5 percent that reported significant hearing loss.
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According to the American Speech-Language-Hearing Association (ASHA), only 20 states require health insurance cover hearing aids, but most of them only cover children. In other states, those with private insurance sometimes find that the cost of the exam is covered, and nothing else.
Insurance companies view hearing aids as elective. But for those who have hearing loss, hearing aids are a lifeline. Without them, quality of life drops dramatically; people with hearing loss become isolated and have trouble engaging in life. Hearing loss affects everything from family relationships and employment to mental and physical health.
The arbitrary nature of declaring a medical device elective is certainly convenient for insurance companies. Meanwhile the real reasons insurance companies don’t cover hearing aids, while a closely guarded secret in the insurance industry, are wide open to be speculated upon.
Spreading the cost of an unlikely risk over a large group of people means everyone pays a reasonable amount. One example would be the risk of a perfectly healthy person falling suddenly and seriously ill. Since that is not likely to happen, that is considered an insurable risk. That means the odds are in the insurance company’s favor they will never actually have to pay up. When you add up insurance premiums, administrative fees and other costs, the insurance company makes a profit. But hearing loss is not an unlikely risk. It is a likely risk for growing numbers of Americans. To most insurance companies, hearing loss is [unfortunately] not considered insurable.
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The prevalence of medical errors is higher among older patients with failures in clinical communication considered to be the leading cause of medical errors, according to the Journal of the American Medical Association (JAMA). A previous study reported that improved communication between the medical teams and families could have prevented 36 percent of medical errors. Colm M. P. O’Tuathaigh, BA, PhD, of University College Cork, Cork, Ireland and colleagues conducted an analysis of interview data collected in 100 adults, 60 years and older, to examine communication breakdown in hospital and primary care settings among adults reporting hearing loss.
Of these adults, 57 reported some degree of hearing loss; 26 used a hearing aid device. Of the 100 adults, 43 reported having misheard a physician, nurse, or both in a primary care or hospital setting. When asked to elaborate on the context of mishearing in a clinical setting, the scenarios included (in descending order of citation frequency): general mishearing, consultation content, physician-patient or nurse-patient communication breakdown, hospital setting, and use of language.
“This qualitative analysis confirms that age-related hearing loss has a negative effect on clinical communication across both hospital and primary care clinical settings,” the authors write. “We recommend that content-related and setting-related factors identified as barriers to communication in adults with hearing impairment be incorporated within a patient-centered approach to clinical communication with this patient population.”
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