Hearing Loss Mechanisms And Prevention

This book systematically discusses the pathogenesis, prevention, and the current and potential clinical treatment of hearing loss, as well as the latest advances in hearing research. Hearing loss is a prevalent sensory disorder, which according to a 2015 World Health Organization (WHO) report affected 9% of the global population in 2015. As populations continue to age, more and more people are suffering from the condition, with 60% of those aged between 65 and 75 affected. Hearing loss seriously affects patients’ ability to work ability and quality of life, and as such deafness has become an increasingly urgent social problem around the globe. Sensorineural hearing loss is mainly caused by damage to the hair cells (HCs), and the subsequent loss of spiral ganglion neurons (SGNs). Damage to the HCs in the inner ear can result from exposure to loud noises and environmental and chemical toxins as well as genetic disorders, aging, and certain medications. This book provides ENT specialists and researchers, as well as individuals affected a comprehensive introduction to the field of hearing loss.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

Exposure to loud noise continues to be the largest cause of hearing loss in the adult population. The problem of NIHL impacts a number of disciplines. US standards for permissible noise exposure were originally published in 1968 and remain largely unchanged today. Indeed, permissible noise exposure for US personnel is significantly greater than that allowed in numerous other countries, including for example, Canada, China, Brazil, Mexico, and the European Union. However, there have been a number of discoveries and advances that have increased our understanding of the mechanisms of NIHL. These advances have the potential to impact how NIHL can be prevented and how our noise standards can be made more appropriate.

The past decade has brought great advances in our understanding of the mechanisms underlying auditory pathologies. This volume presents recent developments in research and their potential translation to the clinical setting. It brings together the basic and clinical sciences very nicely in that while most chapters are written by basic scientists, each topic has a pretty direct clinical application or implication.

Hearing loss is the most common form of sensory impairment in humans, affecting 360 million persons worldwide. In parallel, tinnitus disorder, the perception of a phantom sound often described as a ringing or buzzing, affects around 10–15% of the general population and interferes with daily life. Hyperacusis, defined as a hypersensitivity to moderate-intensity sounds often co-occurs with tinnitus suggesting a common mechanism of dysfunction for these two perceptual disorders. Whereas some drug candidates are in the process of being developed, nowadays no effective treatment exists to cure hearing loss and tinnitus. The topic of this book was selected with the goal of emphasizing mechanisms that induce hearing loss and tinnitus which lead the selection of promising targets for hearing disorder treatment. Hair cells (HC) are the sensory cells of the inner ear required for both auditory and vestibular functions in all vertebrates. HC are progressively lost during ageing and they are in addition sensitive to physical and acoustic traumas, infectious diseases and chemicals present in commonly used treatments such as anticancer, antimalarial or antibiotics. As adult mammals--including humans--cannot regenerate dead HC, all the possible injury could result in irreversible and permanent hearing loss. It has been shown, however, that a limited capacity to regenerate HC exists in mouse at an early stage of development. The regenerative capacity of HC then appears simply “repressed” in adult mammals, and one could expect it will be possible to re-activate it with an appropriate therapeutic approach which is still to be defined. Immune-mediated inner ear disease has been introduced and accepted as one SNHL pathophysiology; it responds to immunosuppressive therapy and is one of the few reversible forms of bilateral SNHL. Macrophages are always present in the spiral ligament of the lateral wall and are activated in response to various types of stimuli, including noise exposure, ischemia, mitochondrial damage, and surgical stress. Recent studies have also revealed another type of immune cell, called perivascular melanocyte-like macrophages (PVM/Ms), in the stria vascularis. The book will include a review of inflammatory/immune cells in the cochlear lateral wall, the pathways involved in cochlear damage and their potential as therapeutic targets. The final chapter provides an overview of current animal model of tinnitus and hyperacusis. Nowadays no effective treatment exists to cure tinnitus and hyperacusis. One major obstacle to arises from the fact that tinnitus is a subjective phenomenon, the only possible diagnosis relies on self-reports of the subjects. The main constraint of the use of animal models is the subjective character of tinnitus. This chapter describe the advancement in animal models which play an important role in revealing the underlying mechanisms and treatment for tinnitus and hyperacusis.

The loss of hearing - be it gradual or acute, mild or severe, present since birth or acquired in older age - can have significant effects on one's communication abilities, quality of life, social participation, and health. Despite this, many people with hearing loss do not seek or receive hearing health care. The reasons are numerous, complex, and often interconnected. For some, hearing health care is not affordable. For others, the appropriate services are difficult to access, or individuals do not know how or where to access them. Others may not want to deal with the stigma that they and society may associate with needing hearing health care and obtaining that care. Still others do not recognize they need hearing health care, as hearing loss is an invisible health condition that often worsens gradually over time. In the United States, an estimated 30 million individuals (12.7 percent of Americans ages 12 years or older) have hearing loss. Globally, hearing loss has been identified as the fifth leading cause of years lived with disability. Successful hearing health care enables individuals with hearing loss to have the freedom to communicate in their environments in ways that are culturally appropriate and that preserve their dignity and function. Hearing Health Care for Adults focuses on improving the accessibility and affordability of hearing health care for adults of all ages. This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages.