BEAUTY DISSECTED

By Dr Firdous Quader Minu
M.B.B.S, D.L.O ENT, Head-Neck
& Cosmetic Surgeon,
Phone: 01199845531

Management and rehabilitation of hearing loss
In the last two weeks we gave an overview of sociological and clinical predicaments associated with loss of hearing in the geriatric population. This week we focus on management and rehabilitation.
It has been reported that of all persons with hearing loss only 5 per cent can be helped medically. The rest are left to different forms of rehabilitation.
Persons suffering from wax impaction or any other kind of disease can be treated accordingly by most ENT specialists.
Presbyacusis or sensory neural hearing loss is not considered as a disease but as a normal phenomenon of aging. Mostly this needs to be managed by rehabilitating the patient so they can continue to lead a normal life.
Hearing aid
Hearing aids are the principle resource for improving communication and reducing hearing handicaps in persons with presbyacusis. A hearing aid is simply a miniature, personal loudspeaker system designed to increase the intensity of sound and to deliver it to the ear with as little distortion as possible. There are several basic types of hearing aids available -- Body worn, behind-the-ear hearing aids, in the ear hearing aids, in the canal hearing aids, completely in the canal hearing aids.
Adaptation to hearing aid is at times difficult and successful adjustments depend on a large degree on the personality of the individual. Often the senior adult is resistant to amplification because of the social stigma associated with hearing loss.
Factors of motivation, personal adjustment, and family support are more related to hearing aid satisfaction than the adequacy of hearing aid fit or auditory discrimination ability.
Aural rehabilitation: Speech reading\auditory training
Speech reading is the use of visual cues to aid speech understanding by recognition of lip movements and also interpretation of body language. It is taught in conjunction with auditory training and hearing aid orientation. This is usually done in senior citizen centres, and university audiology clinics, and community speech and hearing centres. This service is not yet available in Bangladesh due to lack of properly trained personnel.
Assistive listening devices
Amplified telephones, low frequency doorbells and telephone ringers, and close captioned television decoders are just a few examples of currently available devices for the hearing impaired. Again these are not available in our country.
While “treatment” of presbyacusis with hearing aid, assistive listening devices, and\or aural rehabilitation does not “cure” the impairment to normal, such approaches do represent the best treatments available at this time. They will improve effectively the ability of most elderly persons to communicate effectively and reduce the handicapping consequences of hearing loss.
Management in Bangladesh
Although we have advanced enormously in the medical field proper management of presbyacusis is still far away. Patients are diagnosed but rehabilitation is still not done properly as most of the general population fail to understand the matter as a serious problem.
Caregivers of the elderly need to realise the implication of hearing loss and how it affects the quality of life. Steps should be taken for counselling of the patient and caregiver for better understanding of the situation. Centres dealing with different types of rehabilitative facilities should be set up by the government and NGO's.
Proper diagnosis with proper understanding will definitely improve the quality of life of our elderly population and keep them more productive.