Deafness, Hearing Disorders and Otosclerosis

Hearing loss is a common ailment. If you look at the entire population, from infants to the elderly, you can assume that on average around ten percent of all people worldwide suffer from hearing disorders. Not everyone has to see a doctor because of this, but at least three percent of the total population require medical treatment.

Deafness, Hearing Disorders and Otosclerosis


The natural degradation of the ability to hear already begins in otherwise completely healthy people shortly before the end of the maturation period. In the hearing organ in particular, which is most functional around the end of the second decade of life, the decline in age that begins in the third decade of life can be seen very early on. See beautyphoon for What is Insect Venom Allergy.

Of course, the regression process varies greatly from person to person and also depends on other loads to which the human being as a whole, but especially the hearing organ, is exposed. By no means is the so-called presbycusis the main cause of all hearing disorders, but all people who reach old age must one day suffer to a greater or lesser extent from the aging of the hearing organ.

It is well known that there are many causes that can cause hearing loss. In addition to the reduction in age already mentioned, the following must be mentioned in particular: Acute and chronic middle ear infections, otosclerosis, various types of accidental damage in the head area, noise damage, various infectious diseases, diseases of the upper airways in infants and small children, ear deformities, damage to the auditory nerves through medication or other harmful agents, congenital hearing disorders, acute hearing loss in middle age, and various others.

Symptoms, Ailments & Signs

The first signs of the onset of hearing loss or hearing disorders are often unfamiliar difficulties in holding a conversation. The person concerned has problems understanding and must therefore ask several times. Conversely, listeners and interlocutors ask to speak a little more quietly. Conversations are increasingly becoming exhausting.

This is especially true for phone calls. The symptoms of hearing loss usually develop slowly and insidiously. Quiet noises that come from nature are hardly noticed. This includes birdsong, the sound of the sea or wind noise. The radio or television must always be turned up louder.

Enjoying leisure activities such as attending events or watching TV shows is only possible to a limited extent due to the hearing problems. Background noise is increasingly making it difficult to have a conversation. As the illness progresses, noises in the household, such as the refrigerator starting or the doorbell ringing, are noticed less and less.

Even morning wake-up noises are no longer heard. Noise-induced hearing loss is a typical symptom of ringing in the ears. Some sufferers feel as if they have a foreign object in their ear.

When hearing loss occurs suddenly, only one ear is usually affected. With otosclerosis that begins slowly, initially only symptoms such as ringing in the ears and cracking noises in one ear occur. In most cases, these symptoms later appear in both ears.

People who suffer from middle ear infections in particular require constant medical treatment. The acute and recurring short phases of inflammation are treated conservatively by every doctor, partly with the usual physical therapy, partly with the help of modern drugs that are counted among chemotherapy or antibiotics. Acute suppuration of the middle ear, which leads to inflammation of the entire mastoid process, was previously only ever treated surgically.


As a rule, these complaints have a very negative effect on the quality of life of those affected. The patients suffer from significant limitations in their everyday life and, in serious cases, are also dependent on the help of other people. The further course of these diseases depends strongly on their cause, so that a general course cannot be predicted.

This can delay development, especially in children, so that complications and symptoms can also occur in adulthood. The diseases do not have to be treated in every case. They also do not always necessarily pose a health risk. A direct and causal treatment of these disorders can only be carried out in a few cases.

Above all, with the help of technical devices and hearing aids, the symptoms can be alleviated and limited. However, a complete hearing loss can usually no longer be made irreversible. There are no special complications during the treatment itself.

In most cases, the life expectancy of the patient is not reduced or otherwise influenced by these symptoms. Often, however, the patients also suffer from psychological complaints and therefore need psychological treatment.

When should you go to the doctor?

A doctor should always be consulted in the case of hearing loss, hearing disorders and otosclerosis. Self-healing will not occur, so those affected are always dependent on medical treatment by a doctor. Early diagnosis with early treatment has a positive effect on the further course of the disease and can prevent further complications.

A doctor should be consulted for hearing loss, hearing disorders and otosclerosis if hearing problems occur that do not go away on their own. This can lead to a hissing or other disturbing noises in the ear, which can significantly reduce the quality of life. In many cases, the feeling of a foreign body in the ear also indicates these diseases and should then also be examined by a doctor. Most of those affected also have inflammation in the middle ear.

In the case of hearing loss, hearing disorders and otosclerosis, an ENT doctor can be consulted. However, it cannot be universally predicted whether a cure will occur. The disease may not be curable.

Treatment & Therapy

Modern therapeutic approaches of the last 20-30 years have brought about a tremendous upheaval. If the mastoid inflammation is not complicated by bone destruction, perforation to the outside, into the inner ear or into the cranium, targeted, high-dose antibiotics are used for treatment after prior detection of the pathogen, and surgical treatment is required for more than 80 percent of acute cases today intervention of simple chiselling of the mastoid no longer.

The remaining 20 percent of patients who still have to be operated on suffer either from pathogens for which the drugs are not effective, or from such mastoid destruction that the antibiotics can no longer reach the focus of the disease in sufficient concentration.

However, if one relies on drug treatment, the specialist doctor must constantly monitor the patient, because if the aftercare is not carried out properly, the intervention that is still necessary is sometimes not carried out at the right time, or the normal hearing function is not restored despite the healing of the inflammation, because formed scars due to insufficient treatment and caused a significant hearing impairment.

The treatment of chronic middle ear processes is far more difficult. Today we distinguish between three pathologically and anatomically different processes in chronic middle ear infections. Only in the case of so-called simple suppuration of the mucous membranes, from today’s point of view, vigorous conservative treatment lasting several weeks with rinses, drops, ointments, powders and the like is appropriate.

If there is no significant improvement after at least six weeks of such intensive specialist therapy, then surgery is required, just as with the other two forms of chronic suppuration of the middle ear, the so-called granulating polypoid and the malignant cholesteatomic.

While radical surgery was performed in earlier decades, albeit in a more gentle form, with the current state of microsurgery, every ear with chronic suppuration must be operated on primarily with the intention of reconstruction.

This means that not only the entire destroyed part and all diseased sections of the middle ear are to be removed, but also the middle ear is to be restored immediately from the existing healthy parts, always using the patient’s own tissue from healthy areas, so that a better hearing, which is as optimal as possible, is achieved.

Any such procedure is commonly called tympanoplasty. There are many forms and types of tympanoplasty. Any operation has two main purposes: to remove suppuration and to improve hearing. There are standard types of tympanoplasty, but of these types of operation, only those that are most gentle on the middle ear and produce the best hearing are used today.

The so-called inner ear reserve is crucial for the success of the operation. If it is still large, a good result can be achieved even after many years of suppuration. But it must be said with absolute certainty that any persistent suppuration of the middle ear causes an ever-increasing deterioration in hearing. The sooner such suppuration can be stopped, the less damage will be done to the inner ear.

The tympanoplastic procedure does not always succeed in the first operation. About a third of cases that show particularly unpleasant granulation formations, show poor healing tendencies or are linked to other diseases (diabetes, bleeding tendency, tuberculosis, poor general condition) must be treated surgically a second time with intensive follow-up care. The second time, the operation through the auditory canal without an external incision is sufficient. Only the reconstructive measures that did not lead to the healing of the tympani during the first intervention should be carried out.

Initially, it is only a question of closing the remaining holes in the eardrum or creating a sound transmission chain that could not be achieved in the follow-up treatment due to insufficient healing tendency. If hearing is to be improved, the function of the tubes must be preserved. In order to achieve this, the specialist doctor has many options today. In most cases, disturbances in the tympanic ventilation through the tube are eliminated before the operation.

Otosclerosis as a cause

Otosclerosis is a non-inflammatory disease that occurs very frequently in people of middle age. It develops gradually and mainly impedes the transmission of sound to the inner ear. About two percent of all people suffer from this disease. The old surgical procedures and the various medications, hormones, vitamins, etc. did not bring any significant improvement.

Only in the last 20 years has one been able to speak of a successful surgical treatment of otosclerosis. While 30 years ago semicircular canal fenestration with various disadvantages was the only operation with lasting success, in the last decade direct operation on the stapes has prevailed.

Of course, this smallest bone in the human organism can only be made capable of transmitting sound again with the help of modern surgical microscopes, the finest instruments and the use of the best medication. The operations can also be carried out on almost deaf people if the diagnosis is confirmed. Today we distinguish a whole range of different interventions on the stirrup, all of which can be carried out through the auditory canal after ventilation of the eardrum. Depending on the degree of change, pure mobilization is sometimes sufficient.

Sometimes only portions of the footplate of the stapes need to be removed, but sometimes the entire bone needs to be removed and replaced with autologous tissue or modern synthetic material1. The results of these interventions are very good. It is particularly gratifying that the patient and doctor already know at the end of the relatively short operation how successful the operation was, because the hearing tests during and after the operation show the hearing result very well.

Accidents & noise damage

Hearing disorders are often caused by traffic accidents. As soon as the first difficult hours of the shock have been overcome, hearing tests can already be used to determine what damage is present in the patient. All accident victims who develop hearing disorders must be treated, advised and, if necessary, operated on by an audiologist.

The earlier help is given, the more certain a good result can be expected. But even minor accidents when diving, diving, boxing, throwing snowballs, etc., which can result in tears and hearing disorders, especially in the case of already damaged eardrums, must be treated immediately by an audiologist in order to avoid inflammation in the middle ear and to achieve primary healing and prevent permanent hearing damage.

Noise damage to the hearing organ is very extensive. Only by recognizing the noise quantity and quality in good time can it be ensured that as little damage as possible occurs. Noise-generating companies must therefore be examined by appropriate experts and measured with regard to the noise level. People’s sensitivity to noise varies greatly between individuals and gender. For example, women are much less sensitive to noise than men. Even brief exposure to noise often causes damage. On the other hand, one does not notice any significant changes even after years.

Sensitive people must be protected from becoming hard of hearing or even deaf either by means of noise protection, by taking breaks from the noise exposure or by changing jobs. Today in Germany there is excellent legislation with noise protection regulations in this respect, which should reduce the noise hazard and provide appropriate help to those who are already noise-damaged.

Diseases as a cause

Even though modern medicine has reduced the danger of the infectious diseases measles, scarlet fever, rubella, mumps, tuberculosis, etc., which were very common in the past, which also affects the consequences, there are still individual cases of hearing disorders caused by infectious diseases. Here, too, timely detection and early treatment are important to prevent permanent damage. Treatment is mostly with medication. In the case of severe disorders that cannot be reversed, sometimes only a modern hearing aid can help.

Many ear diseases and hearing disorders are based on damage to the upper airways in infancy or childhood. Some oversized tonsils and some colds caused damage to the ears in early childhood that is difficult to treat and repair later. Therefore, any obstructed nasal breathing, any tendency to inflammation of the upper airways, any prolonged cold should be treated by a specialist (ear, nose and throat doctor). Then the changes in the area of ​​the upper airways can be corrected in good time and damage to the ear can be avoided.

Many children with hereditary disabilities also have hearing disorders, some of which are caused by malformed ears, and some are also caused by problems that are passed on to the malformed mouth and throat area. Depending on the type and location of the changes, the operation must be performed early enough for the child to learn to hear and speak in good time.

At least until the child starts school, operations should ensure that the hearing function enables the child to participate successfully in lessons. With today’s surgical methods, hearing gains can be achieved that allow adequate hearing function and thus school attendance even in the case of severe deformities. If the rest of the hearing is not sufficient, the child can also use a hearing aid.

Other causes

It has been known in medicine for centuries that certain drugs and medicines cause hearing disorders – some temporary, some permanent. Quinine, arsenic, salicylate, but also abuse of stimulants such as alcohol, coffee and tea and industrial products such as mercury, lead, benzene, phosphorus, sulfuric acid, carbon monoxide and others can cause severe hearing damage. Unfortunately, even today successfully used modern preparations, for example the antibiotic series, are dangerous for the sense of hearing.

This is why such medicines may only be taken under medical supervision with continuous monitoring of the hearing organ and taking international experience into account. The top priority here is to adhere to the correct dosage. Once an ear damage has occurred, there is little that can be done to help and usually only with hearing aids.

The hereditary damage to the sense of hearing, which used to be so often mentioned and all too often accused, is no longer so feared today, since modern diagnostics have cleared up many of the earlier incorrect diagnoses. Nevertheless, the number of congenital hearing disorders should not be ignored. Depending on the degree of the congenital hearing impairment, rehabilitation can begin as early as childhood, since early diagnosis of hearing ability is possible in the first few situations in life.

Prevention & Life

For the hard of hearing, hearing education and hearing training in the special kindergarten are among the first measures. The schools for the hard of hearing include the curriculum of a normal school and can train every child with healthy brain function in such a way that all professions are open to him. But we also know today that 60 to 70 percent of deaf children still have remnants of hearing and can also receive a good education with the help of modern hearing aids, whereby the old method of mouth-reading or lip-reading and learning a generally understandable language are not neglected may be.

Such children, who used to be considered deaf and mute and not very capable of being educated, can now study at universities or technical colleges, and with the right intelligence and sufficient diligence, they can even learn and use foreign languages. Of course, people who are hard of hearing so successful are still isolated cases today, but they show the value of the possible measures and the achievable goal.


Hearing impairment, hearing disorders and otosclerosis are hearing disorders that not only require professional treatment, but also consistent follow-up care. This is initiated by hearing aid acousticians and ENT doctors, but also needs the cooperation of the patient for optimal success. The most important factor in this context is regular hearing tests and the resulting needs-based adjustment of hearing aids and other hearing aids to the current situation.

In addition, hearing aid acousticians also offer special hearing training, which in some cases can be usefully integrated into aftercare. The hearing aid itself is also professionally checked for fit and performance during aftercare and, if necessary, serviced or repaired to ensure the best possible hearing experience. Patients with the diagnoses of hearing loss, hearing disorders or otosclerosis often cannot cope psychologically at first.

Here it is important to strengthen the ability to act in everyday life and self-confidence in the best possible way. A self-help group involved in aftercare can be extremely helpful in this context through the exchange of experiences and tips from other affected people. Another visit to the hearing aid acoustician can also make aftercare profitable.

The expert has a whole range of tools for everyday life and work that can improve individual well-being. With some hearing impairments, it is also helpful to sustainably improve blood circulation in the head area by drinking enough liquid.

Hearing loss as the cause

As the last of the hearing disorders, which is particularly significant, we must mention acute sudden deafness – also called sudden deafness. This very serious condition occurs suddenly, usually in one ear, and is often diagnosed as deafness. Sometimes it is accompanied by dizziness, sometimes without dizziness. Acute sudden hearing loss mostly affects people in the younger and middle years of life, especially people with severe nervous strain.

Patients who experience this sudden numbness with dizziness usually lie in bed and wait for the dizziness to pass. Others who have become hard of hearing believe that a blockage of earwax is the cause and postpone seeing a specialist for the time being. Both act wrong. The top priority is to consult an ear specialist (ENT) immediately.

The cause of acute sudden hearing loss is usually a circumscribed water balance disorder in the inner ear. In our patients who have been operated on so far, we have found that hearing can only be restored in the first four days. If more time has passed, then the operative help usually comes too late. Not all ear doctors operate on such cases because they achieve good results with draining medication and cures or with other treatment methods.

In principle, however, the ability to hear can be restored more reliably and more completely the earlier the patient is treated by a specialist.

This brief compilation of different possibilities of hearing disorders and their origin should serve to point out the manifold factors which are capable of damaging our sensitive organ of hearing. But it should also be shown how modern medicine knows how to help in most cases of illness and how it can report gratifying successes.

You can do that yourself

In the case of hearing loss, hearing disorders and otosclerosis, self-help in everyday life is an important factor for the patient’s quality of life. Which measures are the right ones in individual cases is best discussed in cooperation with the ENT doctor or the hearing aid acoustician.

It is important to use hearing aids in everyday life in addition to classic hearing aids whenever possible. In the case of severe hearing loss, visual aids such as lights for the telephone or ringing the bell should also be considered in order to organize everyday life as needed. People from the environment are often easy to integrate into self-help. Family and friends are asked to communicate slowly, clearly and loud enough. People who do not know anything about the hearing loss must be informed so that they do not speak to the person concerned from behind or too quietly.

Hearing care professional visits should be made regularly. On the one hand, to check the hearing aids for function and fit. On the other hand, because there is modern hearing training that can often significantly improve the ability of people with hearing disorders to act. Anyone who suffers psychologically from their hearing impairment has two main options. Going to the psychologist can work through the problems in several sessions. Self-help groups have the advantage that those affected with the same problems can find an exchange among like-minded people and support each other with advice and action.