Common causes of hearing impairment (deafness)

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There are many ways to classify deafness. According to the nature of the lesions, it can be divided into organic deafness and functional deafness. The former has organic lesions of the auditory system, while the latter does not. According to the lesion location, it can be divided into conductive deafness, neural deafness and mixed deafness. According to the time of onset, it can be divided into congenital deafness and acquired deafness. According to the cause of disease, it can be divided into hereditary deafness and acquired deafness.

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1. Hereditary deafness

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According to relevant statistics, hereditary deafness accounts for 50% of all deafness patients. However, due to the complexity of genetic mode, some of them are vertical transmission, some of them are horizontal transmission; some of them are continuous disease, some of them are intergenerational transmission; some of them have normal hearing, but their children have hearing impairment, some of them are deaf, and their children have normal hearing, so it is often difficult to accurately judge hereditary deafness, sometimes it will be covered by other symptoms. At this time, the tracing of family history is very important. Deafness caused by genetic factors can be caused by structural abnormalities of auditory organs, such as auricle deformity, atresia of external auditory canal, etc., or functional abnormalities, including conductive deafness and sensorineural deafness. Some deaf children also have other system abnormalities, forming a characteristic clinical syndrome.

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White frontalis syndrome is characterized by white frontalis, translucent blue in both eyes or one eye, i.e. heterochromatism of iris, and lack of pigmentation in the skin. Trisomy syndrome, also known as congenital stupidity, is characterized by special facial features and mental retardation, wide eye distance, small eye fissure, low external ear on the lateral upper oblique bridge of both eyes, small head circumference, etc.

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Hereditary deafness is not always manifested as congenital deafness, some of them are normal after birth, and only at a certain age can they show the characteristics of deafness. For example, familial sensorineural deafness is an autosomal dominant genetic disease. The child has no hearing impairment after birth. Only when he or she is about 10 years old, the symptoms begin to appear and increase year by year. At present, the gene detection technology of deafness is helpful for the diagnosis of this kind of deafness.

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2. Acquired deafness

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Acquired deafness is mainly caused by diseases, drugs and other environmental factors. Viral infectious diseases: during pregnancy, the mother is infected with some pathogenic microorganisms, such as rubella virus, measles virus, herpes simplex virus, herpes zoster virus, cytomegalovirus, influenza bacteria, Treponema pallidum, etc., which can cause the abnormal development of fetal auditory organs. One of the most aggressive is rubella virus. According to some statistics, in the first three months of pregnancy, the mother infected with rubella, and the incidence of deafness of newborn can reach 60%.

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Although in recent years, with the improvement of medical conditions, the incidence of infectious deafness has declined significantly. However, the degree of deafness is generally heavy and difficult to treat, which should be paid more attention. The common infectious diseases with serious damage to hearing are: cerebrospinal meningitis, typhoid fever, scarlet fever, mumps, viral hepatitis, viral pneumonia, poliomyelitis, etc.

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During pregnancy, if you have diabetes, chronic nephritis, high blood pressure, severe anemia, hypothyroidism, carbon monoxide poisoning, alcoholism, major mental trauma, severe malnutrition, etc., you may also cause fetal hearing impairment. When the newborn is seriously asphyxiated, the first thing to be affected is the hearing organ, so the details of birth, such as the length of labor, the use of oxytocin, the presence or absence of meconium in amniotic fluid, the presence or absence of umbilical cord around the neck after birth, the presence or absence of cyanosis in the skin, and the length of crying, should be fully noticed. When the fetus is not born smoothly, it is forced to use induction equipment. Head trauma, such as fetal head attractor, forceps, etc., or manual induction is too rough. It can also damage the hearing organ or hearing center, resulting in deafness.

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A newborn born less than 37 weeks gestation is called premature. If the birth weight is less than 2500g, it is called low birth weight. A large number of clinical data prove that premature and low birth weight infants are more likely to have hearing impairment, which should be paid attention to. Jaundice begins to appear 2-3 days after birth and subsides 10-14 days later, which is called physiological jaundice. If jaundice appears too early or subsides too late to become pathological jaundice, it is due to the high concentration of bilirubin in the blood. If this pathological state is not corrected in time, the nervous system will be damaged. If the auditory nerve is involved, the sensorineural deafness will be caused.

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Senile deafness is a phenomenon that the hearing ability gradually decreases with age. The main manifestation is high frequency hearing loss. In the early stage of senile deafness, it’s OK to talk with people who are familiar with you. It’s difficult to talk with people who are not familiar with you. In the later stage, it is difficult to talk with all people, which mainly shows that you can hear the voice, but you can’t hear clearly what the other party is saying, especially in noisy environment. It is obviously difficult to answer the phone and watch TV. Deafness in the elderly is actually a degenerative change of the auditory system. A reasonable hearing aid test is very helpful for the elderly deafness.

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In recent years, some new ototoxic drugs have come out one after another. People don’t estimate their ototoxic harm enough, which makes the incidence of drug-induced deafness on the rise, which should be paid great attention to by relevant departments. At present, the ototoxic drugs still in clinical use are as follows: aminoglycoside antibiotics such as streptomycin, gentamicin, kanamycin, micronomicin, neomycin, mopamycin, lincomycin, etc. Non aminoglycoside antibiotics such as chloramphenicol, puromycin, erythromycin, vancomycin, etc. Salicylates such as aspirin, phenacetin, butazone, etc. Diuretics such as furosemide, diuretic acid, Gonzalez, etc. Antitumor drugs and traditional Chinese medicine such as aconitine, heavy metal salts (Gong, lead, arsenic, etc.). The above drugs should be avoided as far as possible. When it is necessary to use them, it is necessary to carefully inquire about the family history before use, so as to eliminate the family specificity; when using them, it is necessary to strictly master the dosage and method, pay close attention to the adverse reactions during use, and regularly test the hearing. In case of tinnitus, deafness, and facial ant sensation, the drugs should be stopped immediately and corresponding treatment measures should be taken.

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The deafness caused by noise and violent earthquake is noise deafness. Sudden high-intensity explosion and long-term exposure to noise can cause damage to inner ear hair cells, resulting in temporary or permanent hearing loss. Therefore, we should pay attention to the treatment of industrial noise pollution, Walkman, MP3 sound can also damage hearing.

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The results of the second national sampling survey of the disabled showed that the main causes of hearing disability at the age of 0-6 were heredity, maternal and pregnant virus infection, neonatal asphyxia, drug-induced deafness, premature delivery and low birth weight infants, and the main causes of disability in the age of 60 and above were old-age deafness, otitis media, systemic diseases, noise and detonation, and drug-induced deafness Deafness and so on; compared with the causes of disability in rural and urban areas, the causes of deafness in rural areas are higher than those in urban areas, such as unexplained deafness, otitis media, hereditary deafness, infectious diseases, maternal and pregnant virus infection and neonatal asphyxia; while the causes of noise and shock, drug poisoning and systemic diseases in urban areas are higher than those in rural areas. Therefore, it is very important to formulate prevention strategies for genetic, maternal infection and other factors that lead to hearing impairment of newborn, as well as the main factors such as otitis media, noise pollution, ototoxic drugs, and hearing disability of the elderly.

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