Hearing loss is a sudden or
gradual decrease in how well you can hear. Depending on the cause, it can range
from mild to severe and can be reversible, temporary, or permanent. Hearing
loss is also known as hearing impairment, which includes being born without
hearing (congenital hearing loss). This topic focuses only on gradual hearing
loss.
Gradual hearing loss affects people of
all ages and is the third most common long-term (chronic) health problem in
older Americans.1 It affects up to 40% of people age
65 and older and up to 80% of people older than 85.2
If you have hearing loss, you may not be aware
of it, especially if it has developed gradually. Your family members or friends
may be the first to notice. For example, they may notice that you are having
difficulty understanding what people are saying, especially when many people
are talking at the same time or there is background noise, such as a radio
playing.
Hearing loss can affect what and how much you do in the
workplace and at home and can also affect your personal safety. Because it may
result in less social interaction, hearing loss may contribute to loneliness,
depression, and loss of independence. However, hearing aids and other devices
are available to help you hear.
What causes hearing loss?
In adults, the most
common causes of hearing loss are:
Noise. Noise-induced hearing loss can affect
people of all ages and most often develops gradually over many years. Over a
long period of time, the noise you experience at work, during recreation (such
as listening to very loud music), or even during common chores (such as using a
power lawn mower) can lead to hearing loss.
Age. In age-related hearing loss (presbycusis), changes in the inner ear that occur as
you grow older cause a gradual but steady hearing loss. The loss may be mild or
severe, but it is always permanent.
Other causes of hearing loss include
earwax buildup, an object in the ear, injury to the
ear or head, ear infection, a
ruptured eardrum, and other conditions that affect the
middle or inner
ear.
What are the symptoms?
Common symptoms of hearing
loss include muffled hearing and a feeling that your ear is plugged. You may
have difficulty understanding what people are saying, and you may listen to the
television or radio at higher volume than in the past and avoid conversation
and interaction with other people. Other symptoms may include ringing, roaring,
hissing, or buzzing in the ear (tinnitus). Or you may have ear pain,
itching, or irritation, or fluid leaking from the ear. You may also have a
feeling that you or your surroundings are moving when there is no movement
(vertigo).
How is hearing loss diagnosed?
Your doctor will
diagnose hearing loss by asking questions about your symptoms and past health
and by doing a physical exam. If your doctor thinks you have hearing loss, he
or she may use a "whisper" test or tuning fork to test your hearing. If these
tests suggest or show hearing loss, your doctor will do a more complete hearing
(audiologic) test to see whether you have hearing loss, how severe the loss is,
and which part of the ear is affected.
How is it treated?
You treat noise-induced or
age-related hearing loss by using hearing devices (such as hearing aids) and
learning how to live with reduced hearing, such as paying attention to people's
gestures, facial expressions, posture, and tone of voice. In other types of
hearing loss, treating the problem that caused the hearing loss, such as
removing earwax or taking medicine for an infection, results in the return of
normal hearing.
Can you prevent hearing loss?
You can prevent
noise-related hearing loss by avoiding loud noise such as that made by machines
in the workplace, power tools, very loud music, and very loud motorcycles. Wear
hearing protection, such as earplugs or earmuffs, if necessary. To protect
yourself from hearing loss because of injury, avoid putting objects in your
ear, wear seat belts when you drive, and wear helmets when you bike, ski, or
participate in similar activities in which there is the potential for ear
injury.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
In adults, the most common causes of
hearing loss are:
Noise.Noise-induced hearing loss can affect
people of all ages and most often develops gradually over many years. Over
time, the noise experienced at work, during recreation (such as riding
motorcycles), or even common chores (such as using a power lawn mower) can lead
to hearing loss.
Age. In
age-related hearing loss (presbycusis), changes in the
nerves and cells of the inner
ear that occur as you get older cause a gradual but
steady hearing loss. The loss may be mild or severe, but it is always
permanent.
Other causes of hearing loss include:
Earwax buildup
or an object in the ear. Hearing loss because of earwax is common and easily
treated.
Ototoxic medicines (such as certain antibiotics) and
other substances (such as arsenic, mercury, tin, lead, and manganese) that can
damage the ear.
Injury to the ear or head. Head
injuries can also damage the structures in the ear and cause a sudden hearing
loss.
Fluid in
the middle ear after a cold or the
flu, or after traveling on an
airplane.
Otosclerosis, a condition that affects the bones of
the middle ear.
Acoustic neuroma, a noncancerous tumor
on the nerve that helps people hear.
Ménière's disease. Ménière's disease may result in temporary or permanent hearing
loss.
Noncancerous (benign) growths in the ear canal, such as
exostoses, osteomas, and glomus tumors. Exostoses are bone growths that often
develop when the ear canal is repeatedly exposed to cold water or cold air.
Osteomas and glomus tumors are noncancerous tumors. These all can cause hearing
loss if they block the ear canal. A glomus tumor that occurs elsewhere in the
head can also affect hearing.
Other medical conditions that do not affect the ear
directly may also cause hearing loss.
An interruption of the blood flow to the inner
ear or parts of the brain that control hearing may lead to hearing loss. This
may be caused by heart disease,
stroke,
high blood pressure, or
diabetes.
Autoimmune hearing loss can occur in one or both ears and can
come and go or get worse over 3 to 4 months. An
autoimmune disease, such as
rheumatoid arthritis, may be present.
What happens in hearing loss?
We
hear sounds when sound energy goes through the
ear's three main structures. In hearing loss, one or more of these structures
is damaged. These structures are the:
External ear canal.
Middle ear,
which is separated from the ear canal by the eardrum.
Inner ear,
which contains the cochlea, the main sensory organ of hearing.
Which part of the ear is affected determines the type of
hearing loss.
In
conductive hearing loss, sound energy is blocked
before it reaches the inner ear. Examples of conductive hearing loss include
earwax or a growth blocking sound, such as occurs in
otosclerosis.
In
sensorineural hearing loss, sound reaches the inner
ear, but a problem in the inner ear or the nerves that allow you to hear
(auditory nerves) prevent proper hearing. Examples of sensorineural hearing
loss include both noise-induced and age-related hearing loss. More than 90% of
hearing loss is sensorineural, and of this group, age-related hearing loss is
the most common.2
A mixed hearing loss, in which both the conductive and
sensorineural systems are affected, can also occur.
Another type
of hearing loss is central hearing loss. In this type of hearing loss, the ear
works, but the brain has trouble understanding sounds because the parts that
control hearing are damaged. It may occur after a head injury or stroke. This
type of hearing loss is rare.
Undiagnosed and untreated hearing
loss can contribute to
depression, social isolation, and loss of
independence, especially in older adults.
Difficulty
understanding what people are saying, especially when there are competing
voices or background noise. You may be able to hear someone speaking, but you
cannot distinguish the specific words.
Listening to the television
or radio at higher volume than in the past.
Avoiding conversation
and social interaction. Social situations can be tiring and stressful if you do
not hear well. You may begin to avoid those situations as hearing becomes more
difficult.
Depression. Many adults may be depressed because of how hearing
loss is affecting their social life.
Other symptoms that may occur with hearing loss
include:
Ringing, roaring, hissing, or buzzing in the
ear (tinnitus).
Ear pain, itching, or
irritation.
Pus or fluid leaking from the ear. This may result from
an injury or infection that is causing hearing loss.
The type of hearing loss you have often determines how well
you hear in certain situations:
If something is blocking sound from moving to
the inner ear (conductive hearing loss), then the loss will be the same for low
and high tones. As long as people speak loudly enough, you will still be able
to tell the difference between similar sounding words (such as "thigh" and
"high") and be able to hear with a noisy background. Examples of conductive
hearing loss include
earwax or a growth blocking sound, such as occurs in
otosclerosis.
If the inner ear is not
working correctly (sensorineural hearing loss), then high tones (such as
women's or children's voices) will be more difficult to hear than low sounds.
It will probably be difficult to hear when there is background noise. Examples
of sensorineural hearing loss include
age-related and
noise-induced hearing loss.
People who have hearing loss are sometimes not aware of it,
especially when the loss has developed gradually, as is often the case in
noise-induced and age-related hearing loss. Family members or friends often are
the first to notice the hearing loss. Evaluate your hearing by taking a
hearing loss self-test.
When to Call a Doctor
Call 911 or other emergency services immediately if:
Hearing loss occurs with an injury to
the head or ear.
Hearing loss occurs suddenly with other symptoms
such as:
Eye or vision problems, including blurred or double vision or only
being able to see out of one eye.
Slurred speech, not being able
to speak, or difficulty understanding speech.
Difficulty standing
or walking (ataxia).
Severe nausea or vomiting.
Call a doctor immediately if
you:
Develop sudden, severe hearing loss.
Call your doctor if you:
Have hearing loss that you think may be caused
by earwax.
Have hearing loss after taking
medicine.
Have hearing loss after having cold or flu
symptoms.
Have hearing loss after traveling on an
airplane.
Feel your hearing is gradually getting
worse.
Wonder if you need a hearing aid.
Think your
baby or child may not be hearing well.
Watchful waiting
Watchful waiting is when you and
your doctor watch symptoms to see if the health problem improves on its own.
Although hearing loss is not usually dangerous, it can affect your personal
safety. It can also reduce how much you can do in the workplace and at home and
limit you socially. It is important that you talk to your doctor about hearing
loss.
If your doctor suspects or diagnoses hearing loss, he or
she may have you see an ear, nose, and throat specialist (otolaryngologist) or an
audiologist.
Exams and Tests
Your doctor will diagnose
hearing loss by asking questions about your symptoms
and past health (medical history) and by doing a physical exam. He or
she may find during a routine visit that you have some hearing loss.
If you report symptoms of hearing loss or your doctor finds a possible
hearing problem, he or she may ask you about recent or long-term exposure to
loud noise, any medicine you are taking, and physical symptoms (such as muffled
hearing, ringing in your ears, or
vertigo). Your answers to these questions may help
determine the cause of the hearing loss.
You will also have a
physical exam of the
ears. Your doctor will use a lighted instrument (an
otoscope) and may find problems in the ear canal, eardrum, and middle ear,
including
earwax, an object or obstruction in the ear canal,
infection or fluid in the ear, or
injury to the ear.
If your exam, history,
or symptoms suggest a hearing problem, your doctor may do a standard hearing
(audiologic) evaluation.
Standard hearing evaluation
A standard
hearing evaluation may consist of any or all of the
following tests:
The whisper test
checks how well you hear whispered speech across a short distance and how well
you understand speech.
The tuning fork test
helps to separate conductive hearing loss from sensorineural hearing
loss.
Pure tone audiometry checks how well you
hear sounds traveling through the ear canal (air conduction) and through the
bones (bone conduction). A doctor may be able to figure out what kind of
hearing loss you have by comparing how well you hear using these two types of
conduction. You listen to tones through earphones in this
test.
Speech reception and word recognition tests check how well you hear and understand speech.
Acoustic immittance tests (tympanometry and acoustic reflex
tests) measure the amount of sound energy that "bounces" back from the eardrum
(tympanic membrane) and the bones of the middle ear instead of being sent on to
the inner ear.
Otoacoustic emissions (OAE) testing
measures the inner ear's response to sound. Otoacoustic emissions are sounds
made by the cochlea in response to a sound, such as a tone or click-think of
them as a quiet echo. Ear specialists can record and interpret these sounds to
help rule out hearing loss. OAE testing is often used to screen newborns for
hearing problems.
Depending on the suspected cause of hearing loss, you
may also have other tests:
Imaging tests such as a
CT scan or
MRI may be done when an injury or tumor is
suspected.
Auditory brain stem response (ABR) testing may be used to test nerve pathways in the brain if your doctor
suspects an
acoustic neuroma or another nerve problem. This test
measures how well the nerve that helps you hear is working and how fast sound
travels along this nerve.
Early Detection
Some
hearing problems can delay your child's speech and language development. Early
screening for hearing loss can help prevent a variety of learning, social, and
emotional problems that can be related to speech and language
development.3 The
United States Preventive Services Task Force
recommends that all newborns be screened for hearing loss.4 Many states require newborn hearing tests for all babies born
in hospitals. Talk to your doctor about whether your child has been or should
be tested.
Signs of noise-induced hearing
loss are appearing at earlier ages and in children.5
Be sure your child has
regular hearing exams.
Treatment Overview
Treatment for temporary or
reversible
hearing loss usually depends on the cause of the
hearing loss. Treatment for permanent hearing loss includes using hearing
devices.
Although you and your family may view permanent hearing
loss as part of aging, proper treatment is important. Hearing loss may
contribute to loneliness,
depression, and loss of independence. Treatment cannot
bring back your hearing, but it can make communication, social interaction, and
work and daily activities easier and more enjoyable.
Initial treatment
Treatment for reversible hearing loss depends on its cause. It is often
treated successfully. Hearing loss caused by:
Ototoxic medicines (such as aspirin or
ibuprofen) often improves after you stop taking the medicine.
An
ear infection, such as a middle ear infection, often clears up on its own,
but you may need antibiotics.
An autoimmune problem is treated with
corticosteroid medicines, generally prednisone.
Earwax is treated by removing the wax. Do not use a
cotton swab or a sharp object to try to remove the wax, since this may push the
wax even deeper into the ear or may cause injury. For information on how to
remove hardened earwax safely, see the topic
Earwax.
In permanent hearing loss, such as
age-related and
noise-induced hearing loss, hearing devices can often
improve how well you hear and communicate. These devices include:
Hearing aids. Hearing aids make sounds louder
(amplify). They do not restore your hearing, but they may help you function and
communicate more easily. See a picture of the different
types of hearing aids.
Assistive listening devices, alerting devices, and other
communication aids.
Reversible hearing loss, such as
loss that occurs because of earwax or ear infections, is generally cured after
treating its cause. If you continue to have hearing problems in this situation,
work with your doctor. You may need more medicine or surgery, depending on the
cause of your hearing loss.
If you have permanent hearing loss,
such as age-related and noise-induced hearing loss, you probably will continue
to use a hearing aid. Your doctor or other hearing specialist may suggest
occasional
hearing tests to see whether your hearing has changed.
If it has, your hearing aid may need adjustment.
Assistive listening devices. These devices make
certain sounds louder by bringing the sound directly to your ear. You can use
different types of devices for different situations, such as one-on-one
conversations and classroom settings or auditoriums. Commonly used listening
devices include telephone amplifiers, personal listening systems (such as
auditory trainers and personal FM systems), and hearing aids that you can
connect directly to a television, stereo, radio, or microphone.
Alerting devices. These devices alert you to a
particular sound (such as the doorbell, a ringing telephone, or a baby monitor)
by using louder sounds, lights, or vibrations to get your attention.
Television closed-captioning. Television
closed-captioning makes it easier to watch television by showing the words at
the bottom of the screen so that you can read them. Most newer TVs have a
closed-captions option.
TTY (text telephone). TTYs (also called TDD, or
telecommunication device for the deaf) allow you to type messages back and
forth on the telephone instead of talking or listening. When messages are typed
on the TTY keyboard, the information is sent over the phone line to a receiving
TTY and shown on a monitor. A telecommunications relay service (TRS) makes it
possible to call from a phone to a TTY or vice versa.
Treatment if the condition gets worse
Age-related and
noise-induced hearing loss may get worse, especially
if you are continually exposed to harmful noise levels. Talk to your doctor or
hearing specialist about adjusting your
hearing aid. See a picture of the different
types of hearing aids.
If you have severe
hearing loss, a
cochlear implant may be an option. This is a small
electronic device that can help "make" sound if you have severe or total
hearing loss. The implant does the job of the damaged or absent nerve cells
that in a normal ear make it possible to hear.
What to think about
You can prevent your hearing
loss from getting worse by avoiding loud noise as much as possible and using
hearing protectors when you are in
noisy environments, including the
workplace.
Ask your family and friends
to make adjustments when they talk with you, such as facing you so that you can
better see their facial expressions and gestures, and speaking clearly.
Being exposed to loud
noise over and over is one of the most common causes of permanent hearing loss.
It usually develops slowly and without pain or other symptoms, and you may not
notice that you have hearing loss until it is severe.
Be aware of and avoid harmful noise. You can be exposed to harmful noise at work, at home, and in many
other settings. This exposure builds up over time and can result in ear damage
and hearing loss. Harmful noise can come from commonly used tools such as power
lawn mowers and snowblowers or from activities such as riding motorcycles and
snowmobiles. Know what kinds of situations can generate
harmful noise levels, and avoid these situations
whenever possible. For information about
recommended noise limits and hearing protection in
workplaces in the United States, contact the Occupational Safety and Health
Administration (OSHA). (For more information, see the Other Places to Get Help
section of this topic.)
Use hearing protectors. If
you know you are going to be around harmful noise, wear
hearing protectors, such as earplugs or earmuffs.
Cotton balls or tissues stuffed in the ears do not offer much protection. When
used correctly, hearing protectors can go a long way in reducing the level of
sound that reaches the ear. Lawn mowers, power tools, and some basic household
appliances can damage your hearing if you do not wear hearing
protectors.
Control the volume when you can.
Don't buy noisy toys, appliances, or tools when there are quieter alternatives.
Reduce the noise in your life by turning down the volume on the stereo,
television, or car radio, and especially on personal listening devices with
earphones.
Do not wait until you notice a hearing loss to start
protecting yourself from harmful noise. After noise-related damage to the ear
is done, it cannot be reversed. But if you already have some noise-related
hearing loss, it is not too late to prevent further damage and preserve the
hearing that you still have.
Other preventable causes of hearing loss
To lower
your risk of injury-related, medicine-related (ototoxic), and other types of
hearing loss:
Never stick a cotton swab, hairpin, or other
object in your ear to try to remove earwax or to scratch your ear. In general,
the best way to prevent earwax problems is to leave earwax alone. For
information on how to remove hardened wax, see the topic
Earwax.
Ask your pharmacist or doctor
whether the medicine you are taking may cause hearing loss (ototoxic medicine). If you develop a new hearing problem while taking medicine,
tell your doctor.
Always blow your nose gently and through both
nostrils.
During air travel, swallow and yawn frequently when the
plane is landing. If you have an
upper respiratory problem (such as a cold, the
flu, or a sinus infection), take a
decongestant a few hours before landing or use a
decongestant spray just before landing.
Learn and practice proper
underwater descent techniques if you are going to scuba
dive.
Always wear your seat belt in the car, and wear a helmet when
you bike, ski, or skate. These habits can lower your risk of head and ear
injury.
Stop smoking. You are more likely to have hearing loss if
you smoke.
Signs of noise-induced hearing loss are appearing at
earlier ages and in children.5 Be sure your child has
regular
hearing exams and follows the above suggestions to
prevent noise-induced hearing loss.
If you have
hearing loss, you may find that it takes extra effort
and energy to talk with others. Hearing may be especially difficult in settings
where there are many people talking or there is a lot of background noise. The
increased effort it takes to be with other people may cause stress and fatigue,
and you may begin to avoid social activities, feel less independent, and worry
about your safety.
Hearing devices you may want to use
include:
Hearing aids.Hearing aids make all sounds louder (amplify),
including your own voice. Common background noises, such as rustling
newspapers, magazines, and office papers, may be distracting. When you first
get a hearing aid, it may take you several weeks to months to get used to this.
See a picture of the different
types of hearing aids.
Assistive listening devices. These devices make
certain sounds louder by bringing the sound directly to your ear. They shorten
the distance between you and the source of sound and also reduce background
noise. You can use different types of devices for different situations, such as
one-on-one conversations and classroom settings or auditoriums, theaters, or
other large public spaces. Commonly used listening devices include telephone
amplifiers, personal listening systems (such as auditory trainers and personal
FM systems), and hearing aids that you can connect directly to a television,
stereo, radio, or microphone.
Alerting devices. These devices alert you to a
particular sound (such as the doorbell, a ringing telephone, or a baby monitor)
by using louder sounds, lights, or vibrations to get your attention.
Television closed-captioning. Television
closed-captioning makes it easier to watch television by showing the words at
the bottom of the screen so that you can read them. Most newer TVs have a
closed-captions option.
TTY (text telephone). TTYs (also called TDD, or
telecommunication device for the deaf) allow you to type messages back and
forth on the telephone instead of talking or listening. When messages are typed
on the TTY keyboard, the information is sent over the phone line to a receiving
TTY and shown on a monitor. A telecommunications relay service (TRS) makes it
possible to call from a phone to a TTY or vice versa.
Many other communication devices, such as pagers, fax
machines, e-mail, and custom calling features offered by phone companies, can
be helpful. To get more information about selecting and using listening,
alerting, and telecommunicating devices, talk to an audiologist or contact one
of the organizations in the Other Places to Get Help section of this
topic.
A listening technique that also may help you adjust to
reduced hearing is called speech-reading. Speech-reading is paying attention to
people's gestures, facial expressions, posture, and tone of voice. These clues
can help you understand what a person is saying and can make taking part in the
conversation easier. Clues include facing the person you are talking to and
having him or her face you, and making sure the lighting is good so that you
can see the other person's face clearly.
Speech-reading is not
the same as lip-reading. You can know how to speech-read without knowing how to
read lips.
For family and friends of people with hearing loss
A person with hearing loss may feel cut off from conversations and social
interaction. The extra effort and stress needed to take part in conversations
can be tiring for all people involved. If you live with someone who has hearing
loss, you may improve your communication by:
Making sure the person knows you are speaking to him or her.
Use his or her name.
Speaking to the person at a distance of
3 ft (0.9 m) to
6 ft (1.8 m). Make sure that
the person can see your face, mouth, and gestures. Arrange furniture and
lighting so that everyone in the conversation is completely
visible.
Not speaking directly into the person's ear. Your facial
expressions and gestures can provide helpful visual clues about what you are
saying.
Speaking slightly louder than normal, but do not shout.
Speak slowly and clearly. Don't repeat the same word over and over again. If a
particular word or phrase is misunderstood, find another way to say
it.
Telling the person when the topic of conversation
changes.
Cutting down on background noise. Turn off the television
or radio during conversations. Ask for quiet sections in restaurants, and try
to sit away from the door at theaters.
Including the person in
discussions and conversations. Don't talk about the person as though he or she
isn't there.
Other Places To Get Help
Online Resource
DisabilityInfo.gov
Web Address:
www.disabilityinfo.gov
DisabilityInfo.gov provides information and resources for people
with disabilities. This includes programs such as education, employment,
housing, health, and transportation.
Organizations
American Academy of Audiology
11730 Plaza America Drive
Suite 300
Reston, VA 20190
Phone:
1-800-AAA-2336 (1-800-222-2336) (703) 790-8466
Fax:
(703) 790-8631
Web Address:
www.audiology.org
The American Academy of Audiology promotes quality hearing and
balance care through advocacy, education, public awareness, and research. Its
Web site has extensive information on hearing loss and hearing aids.
American Academy of Otolaryngology-Head and Neck Surgery
(AAO-HNS)
1650 Diagonal Road
Alexandria, VA 22314-2857
Phone:
(703) 836-4444
Web Address:
www.entnet.org
The American Academy of Otolaryngology-Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
American Speech-Language-Hearing
Association
2200 Research Boulevard
Rockville, MD 20850-3289
Phone:
1-800-638-8255
Fax:
(301) 296-8580
E-mail:
actioncenter@asha.org
Web Address:
www.asha.org/public
The American Speech-Language-Hearing Association (ASHA)
promotes the interests of and provides services for professionals in audiology,
speech-language pathology, and speech and hearing science. ASHA also advocates
for people with communication disabilities. The Web site has information on
related health topics, self-help groups, and finding a professional in your
area.
Noise and Hearing Conservation, Occupational Safety and
Health Administration (OSHA), U.S. Department of Labor
The Noise and Hearing Conservation section of the OSHA Web site
provides information on U.S. government noise standards, general information on
noise-induced and work-related hearing loss, and how to protect your
hearing.
Bogardus ST Jr, et al. (2003). Screening and
management of adult hearing loss in primary care: Clinical applications.
JAMA, 289(15): 1986-1990.
Yeuh B, et al. (2003). Screening and management of
adult hearing loss in primary care: Scientific review. JAMA, 289(15): 1976-1985.
Joint Committee on Infant Hearing, American Academy of Pediatrics (2000). Principles and guidelines for early hearing detection and intervention programs. Year 2000 position statement. Available online: http://www.aap.org/policy/jcihyr2000.pdf.
U.S. Preventive Services Task Force (2008). Screening for newborn hearing loss. Available online: http://www.ahrq.gov/clinic/uspstf/uspsnbhr.htm.
Niskar AS (2001). Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: The Third National Health and Nutrition Examination Survey, 1988-1994, United States. Pediatrics, 108(1): 40-43.
Other Works Consulted
Biernath KR, et al. (2006). Bacterial meningitis among
children with cochlear implants beyond 24 months after implementation.
Pediatrics, 117(2): 284-289.
Centers for Disease Control and Prevention (2006). Update: Risk of bacterial meningitis in children with cochlear implants. Available online: http://www.cdc.gov/ncbddd/ehdi/cochlear/default.htm.
Isaacson JE, Vora NM (2003). Differential diagnosis
and treatment of hearing loss. American Family Physician, 68(6): 1125-1132.
Reefhuis J, et al. (2003). Risk of bacterial
meningitis in children with cochlear implants. New England Journal of Medicine, 349(5): 435-445.
U.S. Food and Drug Administration (2006). FDA public health notification: Continued risk of bacterial meningitis in children with cochlear implants with a positioner beyond twenty-four months post-implantation. Available online: http://www.fda.gov/cdrh/safety/020606-cochlear.html.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Bogardus ST Jr, et al. (2003). Screening and
management of adult hearing loss in primary care: Clinical applications.
JAMA, 289(15): 1986-1990.
Yeuh B, et al. (2003). Screening and management of
adult hearing loss in primary care: Scientific review. JAMA, 289(15): 1976-1985.
Joint Committee on Infant Hearing, American Academy of Pediatrics (2000). Principles and guidelines for early hearing detection and intervention programs. Year 2000 position statement. Available online: http://www.aap.org/policy/jcihyr2000.pdf.
U.S. Preventive Services Task Force (2008). Screening for newborn hearing loss. Available online: http://www.ahrq.gov/clinic/uspstf/uspsnbhr.htm.
Niskar AS (2001). Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: The Third National Health and Nutrition Examination Survey, 1988-1994, United States. Pediatrics, 108(1): 40-43.
