Mugisha, a middle-aged businessman had a plethora of business calls to make that day. Therefore, the last thing he needed was people responding inaudibly. And yet call after call, and even though the speaker volume was at maximum, he couldn’t hear anything. He decided that the phone had a problem and used another one. He had been using his left ear the whole time. When he used the right ear, the responses became loud and clear. 

It dawned on him that his left ear had developed a hearing impairment and his fear was confirmed when he visited a hospital. After a hearing test, an Ear, Nose and Throat (ENT) specialist said to him, "You are suffering from sensorineural hearing loss.”

Mugisha is now one of the millions of people in the world with hearing impairment.

Causes of hearing impairments

"To understand how hearing loss comes about, we need to first understand some of the anatomical parts working in the ear,” says Dr Achille Manirakiza, a medical resident at the University Central Hospital of Kigali (CHUK).

According to Dr Manirakiza, the ear is not what we see on the outside. It has three parts; the outer, middle and inner parts. The inner part, containing the nerve that works on both the hearing and general body balance is the most affected with deafness. "Therefore, when someone develops hearing loss over time, many factors have to be studied.”

Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, agrees with Dr Manirakiza saying, "There are various reasons for deafness acquired later in life. These may include trauma, excess wax in the ears, as well as chronic bacterial infections of the middle or inner ear.”

Dr Pande also says that viral infections such as herpes zoster, mumps, perforation of ear drum, drugs like quinine, gentamycin, degeneration of auditory nerve responsible for hearing, are some of the common causes.

However, the commonest cause of hearing loss is exposure to loud noise (either recreational or occupational) for a long period of time.

At the same time, one may be confronted with hearing impairment as they begin to advance in age. In an article about hearing loss, WebMD, an American corporation that provides health news and advice, states: "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 what exactly happens when we suddenly stop hearing as well as we did before? Livestrong.com, an American website that advocates for healthy living, explains this in their August 2015 article titled, "How do people go deaf and what are some of the causes?”

The explanation is that the many causes of hearing loss fall into two general categories; conductive hearing loss which refers to disruption of sound waves travelling through the outer or middle ear; and sensorineural hearing loss which may come about when normal function of the inner ear or nerve pathways that transmit sound signals to the brain is disrupted by disease or injury.

Habits and occupations that foster hearing loss

Contrary to popular belief, deafness is not always as a result of natural causes. Dr Pande asserts that certain habits do affect hearing. These include pricking ears with needles, matchsticks and pins, rinsing ears with water and exposure to very cold air. The above mentioned practices could cause severe damage to the eardrum.

Another damaging practice most common to youthful people is listening to loud music. It is now the norm to plug in earphones, ignore the world and blast music at almost an ear-drum-shattering volume. According to Dr Manirakiza, such a habit can lead to deafness.

He isn’t far from the truth. Scientifically, sound is measured in units called decibels. Research in occupational medicine shows that the amount of tolerable noise for human beings falls below 75 decibels. An MP3 at maximum volume on the other hand is said to produce approximately 105 decibels.

Exposure to such sound over a long time, especially when it is done within close proximity can cause hearing loss. This could also explain why people who live within the city are more likely to suffer from noise-induced hearing loss.

In an article about Noise-Induced Hearing Loss, the US National Institute of Deafness and Other Communication Disorders (NIDCD) indicates that noise from heavy city traffic is approximately 85 decibels, motorcycles produce 95 decibels, while sirens produce about 120 decibels.

Other sources of noise include industries, airports as well as bars and clubs.

The resulting hearing impairments, Dr Manirakiza says, could be mild, moderate or severe. Therefore, hearing loss can be as simple as being unable to hear clearly in noisy places or it could be so ghastly that the sufferer will have to use sign language, lip reading and/or hearing aide.

Is hearing loss treatable?

"Treatment of hearing loss depends on its cause,” says Dr Antoine Twahirwa, an ENT specialist at Masaka District Hospital.

At the same time, the treatability of a hearing loss also depends on its level (or severity). Some levels can be reversed with medication, says Dr Manirakiza.

However, realistically experts say that hearing loss which comes as a result of ageing is always permanent and that it can only be managed.

Treatability also depends on how long it took to address the underlying cause. In fact, some of the treatable hearing impairments become irreversible because of the tendency to take health issues for granted.

"The problem with most people is that they will go to the hospital only when they are lying on a stretcher, unable to move or talk,” remarked one medical official.

Always see a doctor about any ear-related condition

"The ear is a very sensitive part of the body. Any injury, severe pain, discharge, tinnitus, should not be neglected because timely treatment of any of these symptoms can prevent deafness,” says Dr Pande.

For instance, if hearing loss is as a result of wax or a foreign body, treatment can be as simple as removing wax or the foreign body. In the case of drugs causing deafness, stopping the drug reverses the condition, says Dr Pande.

Beware that hearing loss doesn’t always start with a grand warning sign. You might not hear a big popping sound or a ringing in the ears. It could be as simple as the need to increase the television volume higher than was formally normal or straining to hear responses during conversations.

Whatever the case, it is advisable to seek timely medical attention. During a screening for hearing impairment early this year sponsored by Rwanda Otolaryngology Head and Neck Surgery Society (ROHNSS) in partnership with the Starkey Hearing Foundation, a US-based NGO, Jean Damascene Bizimana, the youth representative of the Rwanda National Union of the Deaf (RND), said it is crucial for people to turn up for screening exercises since the burden of being deaf is too heavy to carry.

"You can’t understand how difficult communication can be until you have hearing impairment,” Bizimana said.

According to the Ministry of Health, about one million people countrywide have hearing impairment.

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Foods that boost hearing

In the fight to keep your body healthy and functioning properly, minerals play an important role. Calcium builds strong bones the milk commercials tell us and zinc is an important mineral for boosting the immune system. Some minerals, like the ones listed below, are also critical elements in protecting our hearing health.

Potassium

Potassium is responsible for regulating the amount of fluid in your blood and body tissue. That’s important to your hearing health because fluid in the inner ear is dependent upon a rich supply of potassium, especially in that part of the ear that translates the noises we hear into electrical impulses the brain interprets as sound. As we age, those levels naturally drop and contribute to presbycusis – or age-related hearing loss.

Potassium-rich foods include: potatoes, spinach, lima beans, tomatoes, raisins, apricots, bananas, melons, oranges, yoghurt and low-fat milk.

Folic Acid

Folic acid is a critical element in your body’s ability to generate new cell growth. Studies have shown that adults over the age of 50 with low levels of folic acid in their blood are 34% more likely to develop presbycusis. Some studies show folic acid supplements may reduce hearing loss in men by 25%. That might be because the body uses folic acid to metabolize homocysteine, an inflammatory compound that reduces circulation. Good circulation is an important component in keeping the hair cells of the inner ear healthy and working properly.

Folate rich foods include fortified breakfast cereal, liver, spinach, broccoli and asparagus.

Magnesium

Research conducted at the University of Michigan Kresge Hearing Research Institute has shown that people pretreated with magnesium (along with Vitamins A, C, and E) were protected from noise-related hearing loss.

Scientists believe this is because magnesium combats the effects of free radicals emitted during loud noises – almost like a protective barrier for the delicate hair cells in the inner ear. Also, lack of adequate magnesium in the inner ear causes the blood vessels to shrink, depriving it of valuable oxygen.

Foods rich in magnesium include fruits and vegetables, such as bananas, artichokes, potatoes, spinach and broccoli.

Zinc

Zinc boosts body’s immune system and is also responsible for cell growth and healing wounds, so it’s potentially helpful in warding off germs that cause the common cold and, ultimately, those pesky ear infections. Some studies suggest it’s also effective in treating tinnitus in individuals with normal hearing. Zinc does interact antiobiotics and diuretics, though, so be sure to seek a physician’s advice before adding this mineral to your diet.

Foods rich in zinc include beef, port and dark-meat chicken, cashews, almonds, peanuts, beans, split peas, lentils, oysters – and dark chocolate!

On a balanced diet, our bodies usually produce enough of these minerals to keep us healthy and functioning effectively. As always, check with your physician before adding any supplements to your diet.

Agencies