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Changes in Hearing After Head Injury

Approximately 1.4 million individuals suffer from traumatic brain injury (TBI) each year in the United States. The most common causes of injury are automobile accidents, falls, assaults/blows, sports-related injuries and explosive blasts. Internal causes of brain injury are strokes, edema, meningitis, tumors and even certain medications. The resulting hearing loss symptoms a person suffers are varied depending on the damage.


Injury from Automobile Accidents

The brain may be shaken within the skull, causing bruises or contusions to form at the sites of impact. Like bruises elsewhere on the body, these will heal with time. Brain injury can occur even when there is no direct blow to the head, such as when a person suffers whiplash. The force may stretch and sever fibers in the brain. Damage to these fibers disrupts the communication between nerve cells, and reduces the efficiency of the brains ability to function. The established pathways may be damaged enough that they do not send the necessary nerve signal properly anymore.


Injury from Bleeding

Damage to blood vessels surrounding the brain is another common source of injury, causing bleeding between the brain and skull. When this type of bleeding stops and the blood vessels heal like any other cut. Bleeding may permanently damage the surrounding brain tissue even after the blood vessels have healed.


What Does the Injury Do?

Minor head injuries cause a wide range of cognitive deficits such as impaired attention, slowed information processing, memory difficulty, difficult word retrieval, deficits in understanding speech and problem-solving. There can be personality changes including increased irritability, anxiety, depression and social inappropriateness. Depression is one of the most commonly reported problems after head injury. Hyper-sensitive vision and hearing are also common side effects of head trauma.


Hypersensitivity to Sound

Hypersensitivity to sound is called hyperacusis. After an individual has suffered a head injury, he or she may become nervous or anxious when they go to stores, movies or restaurants. These individuals may feel that they hear as well as they did prior to the injury, but now they have difficulty focusing on only one sound. It is as if all the sound in the room rushes into the brain without any type of governor or filtering system. People report they hear a solid wall of noise that is constantly closing in on them.

Individuals with hyperacusis have difficulty tolerating sounds that do not seem loud to others, such as the noise from running faucet water, riding in a car, walking on leaves, a running dishwasher, the fan on the refrigerator, shuffling papers and the sound of their own breathing. Although all sounds may be perceived as too loud, high frequency sounds may be particularly troublesome. The quality of life for individuals with hyperacusis can be greatly compromised. For those with a severe intolerance to sound, it is difficult and sometimes impossible to function in an everyday environment with all the ambient noise.


Treatment for Hyperacusis

Hyperacusis may occur without damage to the hearing organ (cochlea). On other occasions, it occurs in conjunction with damage to the cochlea. After head injury or brain injury, it is recommended that you have a hearing evaluation. During the visit, you and your audiologist will discuss any symptoms you are experiencing. You will learn if your hearing symptoms are isolated to the cochlea or throughout the auditory pathways in your brain.

Your audiologist may recommend that you use musician’s earplugs. This special custom fit ear plug filters out sounds of specific frequencies and intensities depending on the severity of your situation. Because they are custom fit to your ears, they are comfortable enough to wear all day. As time progresses, you will be able to wear the earplugs less and less. Some individuals wear the plugs only in the noisy situations that bother them.


Find a Support Group

One of the primary difficulties of living with this disorder is other people’s reactions to what you are experiencing. Those who do not have hypersensitivity to sound simply cannot imagine how their chewing and swallowing noises can be so distracting to another person. Often, protests from the sufferer are misinterpreted as passive-aggressive personal attacks or that the head injured person is faking the problem.

Remember that you are not alone. If you feel that you are having significant difficulty coping with your symptoms, speak to a professional. There are support groups that focus on head injury suffers, which offer information and the opportunity to establish camaraderie with other people who are experiencing similar difficulty. FBN


By Karon Lynn, Au.D.



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