Medical Treatment for Hearing Loss

Hearing loss is not an illness but a symptom of an underlying disorder. When there is a problem in the external or middle ear, a conductive hearing impairment occurs. In most patients with conductive hearing loss, the disorder can be treated surgically or medically (with drugs) to correct the problem. In most patients with sensorineural hearing loss (damage to the inner ear or nerves to the brain), however, the damage is permanent and cannot be corrected medically (with drugs). The use of hearing aids has proven successful in most cases, and cochlear implants are a surgical option for those with profound sensorineural hearing loss. The ability to treat certain types of hearing loss makes proper diagnosis important.

Treating conductive hearing disorders
The type of treatment depends on the underlying cause. In most cases, normal hearing is restored.

• Wax buildup: Removed by a health care provider with a probe, water irrigation or suction device
• Infection: Treated with oral antibiotics or eardrops containing antibiotics and possible corticosteroids.
• Fluid in the middle ear: When caused by infections, the fluid often goes away on its own but sometimes is drained by myringotomy, a procedure in which a small incision is made in the eardrum.
• Blocked eustachian tubes: (The connections between the pharynx and the middle ears) caused by repeated attacks of otitis media, other infections and allergies, typically in young children. The blockage causes fluid to accumulate in the middle ear. Sometimes it needs to be corrected by inserting tubes through the eardrum.
• Infected mastoid bone: This infection of a bone behind the ear is usually treated with antibiotics, but occasionally needs to be treated surgically (mastoidectomy).
• Ruptured eardrums: These often heal on their own but are sometimes treated with an antibiotic to prevent infection and sometimes protected with a plastic patch; if it doesn't heal on its own, surgery may be necessary.
• Otosclerosis: Can be treated by an operation (stapedectomy) which replaces the damaged bones of the middle ear with tiny metal substitutes.

Treating sensorineural hearing problems
Because sensorineural hearing loss involves permanent damage to the cochlea, the hair cells or the nerve, there is no effective treatment. Although the hearing loss is permanent, it is manageable in about 95 percent of cases with hearing aids.

Cochlear implants
An operation known as a cochlear implant can help restore partial hearing to some people with profound sensorineural deafness who do not benefit from even the highest-powered hearing aids. The electronic device is designed to bypass damaged parts of the cochlea and to stimulate the auditory nerve. It consists of a small battery-operated speech processor and microphone worn outside the ear that converts sounds into electrical signals. The signals are transmitted to electrodes that were surgically implanted in the cochlea. The electrodes stimulate the nerve in the ear so that the sound can get to the brain.

The implants don't restore normal hearing. However, most people who have had the surgery can hear sounds. They also report that the implants help them read lips better. One study found that children who received implants, followed by a year of hearing training and speech therapy, were more likely to be fully mainstreamed in school and require fewer support services at school than similarly deaf children without implants.