 Can you imagine yourself not able to hear anything? Well, many develop hearing loss as the age. So, I am Dr. Arun Draikar, a consultant in TIT surgeon. I am here to discuss a few things about hearing loss. Hearing loss is a poor perceptibility or sensitivity of hearing. Any people can get this type of hearing loss. The causes of hearing loss include if we see the human right from the birth. So in the embryo stage or when the baby is in the mother's womb, the baby is exposed to more autotoxic medications or any antibiotics. So that affects the development of cochlea, which is the main center for the sound processing in the inner ear. So this is under the category of congenital hearing loss. So as the child ages, so because of the persistent cold or nasal infections or even because of the adenoids, the child can have a slight decrease in the hearing. So that's called a secret rivatitis media and that is easily treatable with medications and if it is in very late stage, we can just consider using grommets. A persistent cold can lead to a perforation on the ear drum, so that leads to a condition called as separative reticent media. Depending on the duration of the illness, we classify it as acute or chronic. The third category includes the hearing loss, which is caused because of infections, hypertension, diabetes or any viral infections or any vaso-spastic causes like sudden occlusion of the blood vessel which supplies the vestibular cochlear nerve, can present with sudden sensorineal hearing loss or any exposure to very loud sounds can cause noise induced hearing loss. And the commonest thing is the age-related hearing loss which sets in after the age of 45 to 50 years. That's a natural deterioration of the sensitivity of hearing. The first sign of hearing loss is poor perception or the appreciation of the direction from where the sound is coming. So the individual who presents to us with the hearing loss usually complains that he is not able to pick up the conversation or when they're in a group of people, they'll be usually missing out certain sounds, certain words in the speech and they need a higher TV volume to understand the programs. Or another sign of, first sign of hearing loss is that they'll have autophony. That means they will be hearing their voice a little louder than usual. So that's called as autophony. The person who comes with the hearing loss, we usually do a clinical examination of the ear, so which includes autoscopy to see the status of the ear drum. The ear drum looks fine, so then we usually go ahead with the audiometry test to assess the sensitivity of the individual's hearing. So if we suspect any mid-layer causes, we do an impedance audiometry. So that picks up if there is any blockage of the eustachian tube or the mid-layer cleft problems can be diagnosed with the impedance audiometry or the oscicular intactness can be diagnosed with the impedance. Hearing loss can be treated at various stages. So initially when we diagnose the hearing loss in a baby, so we do a test called as baratest, that is, brainstem ear response audiometry. So this helps in identifying whether the nerves from the cochlea till the mid-brain. If there is any lapse in the connection, which will be easily picked up by the baratest, so accordingly we can proceed with the cochlear implant in children at the age of 2 to 3 years, that is, we call it as prelingual candidates. So we usually go ahead with cochlear implantation for stimulation of the hearing. So as in adults, when they have a discharge or ruptured ear drum, so that needs a reconstruction of the ear drum. So that procedure is called as tympanoplasty or if there is any damage to the ossicles of the mid-layer. So we do an ossicular reconstruction that's called as ossicular plasty and if there is any involvement of the bone, that is a mastoid bone, so that needs complete disease clearance, that's called as mastodontomy and it depends on the type of disease, whether it is a safe or unsafe. So safe type is when there is only perversion of the ear drum without any signs of disease spreading towards the bone. So normally when it spreads to the bone, we usually call it as a ticoantral disease, so that needs a complete accentration of the mastoid bone, we remove the ear cells of the mastoid and if required for further monitoring of the cavity, we are going to reduce the posterior wall of the external canal so that the ear canal gets much with the mastoid. Hearing loss can be prevented by following various methods, something like the individuals, those are exposed to very noisy surroundings, it's better to wear earplugs or ear maskers or dampeners, so to just avoid exposure to very loud sounds for prolonged duration and other ways of preventing hearing loss is to avoid taking more of amine and glycoside antibiotics which have a very strong autotoxic potential where it damages the neurons on a prolonged usage, so that can lead to hearing loss. So by avoiding certain antibiotics and continuous exposure to sounds and avoiding smoking or any consumption of alcohol, again avoiding helps in preventing hearing loss.