DEAFNESS IN WOMEN

“My daughter-in-law speaks so slowly that at times we feel, we are deaf”.

“She says she can’t hear but when we travel by train she hears every spoken word.  Isn’t that funny?”

“She doesn’t get ear pain or ear discharge.  I feel she is faking her deafness”.

 OTOSCLEROSIS

If a female between the age of 20 and 40 complains of deafness in one or both the ears, speak so softly that her listeners doubt deafness in them. These should arouse the suspicion of Otosclerosis.  The third middle ear bone – Stapes gradually gets fixed in Otosclerosis so the mechanical vibrations do not reach the inner ear in the same strength.

Otosclerosis is more common in females but males are not totally spared (80 % women against 20 % men).  It begins to manifest in a conceivable age group, i.e between 20 and 40 years.  Deafness gallops after each delivery.  It may manifest after the first delivery if the woman became pregnant at an early age.  Otosclerosis is one disease where the disease is well studied and understood but the causative factor still remains obscured.  As if this ignorance is not enough, the progress of the disease cannot be checked.  Otosclerosis appears to be strongly hereditary or familial in nature.  Transmission of the disease occurs mostly from one generation of females to another generation of females e.g. female can receive this kind of deafness from mother, maternal or paternal – grand mother or aunty (Mausi or Fui).  It is interesting to note that blood groups of the affected females of the same family are also the same.

We hear through air conduction i.e. air striking the drum producing mechanical vibrations of the bones behind (detail in chapter on ‘Mechanism of Hearing’).  This helps us in realising the depth and pitch of our voice, thereby adjusting the volume of our speech.  Conductive loss takes away this judgment.  Put your fingers in your own ears and speak.  You will find echoism in your ears and it appears as if you were speaking very loudly but, if you ask your listener or record your voice, the opinion will be contrary.  Same phenomena occur in Otosclerosis and this woman begins to speak softly.  In a crowd, train and at parties she hears better than others since the people at such places talk little louder and the low pitch extraneous sounds bothering the normal individuals are not heard by these females.

Often with the advancing age or after deliveries, these females complain of whistling in ears or occasional giddiness. This is due to the inner ear involvement.  Earlier an Otosclerosis manifests, poorer is the prognosis and more likelihood of an early inner ear involvement. As I had mentioned earlier, inner ear involvement is Sensori Neural type and the deafness resulting from that is irreversible.

TREATMENT OF OTOSCLEROSIS

The only treatment is surgery. One can alternately suggest a hearing aid.  Most of the time hearing aid is not suggested because the patient is a young female.  The psychology of the patient, in-laws, and her parents literally prevents us from even mentioning the word `hearing aid’.

Ear surgery is done under local aneasthesia (just by making the ear numb. Not to make the patient fully unconscious).  It is carried out through the ear canal. There is no cut, scar, or disfigurement. Surgery is carried out through a microscope, which magnifies the affected bone 10-15 times.  The Stapes is removed and an `artificial bone’ (prosthesis) is replaced.  The prosthesis is made up of plastic like material (Teflon), wire or steel.  The instant improvement in hearing right on the operation table appears as a miracle to the patient.  Perhaps no other surgery is as quickly rewarding as this. Only one night hospitalisation is required.

Before the operation head shampoo is advised as for another ten days the patient is advised to restrict vigorous head movement and water going inside her ear. Post – operatively, plane travel, going to a mountain or a valley is restricted for a month to avoid pressure changes in the middle ear. At times Tab. Otoflour 3 times a day for a long period is prescribed with a hope that it will restrict the progress of Otosclerosis. A little caution will not be out of place. progress of Otosclerosis may engulf the Teflon prosthesis and again resulting into deafness. Though such prognosis is not common.

It is said that when a man speaks softly consider it as politeness but when a woman speaks softly doubt an Otosclerosis.

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DECISION MAKER

” Why do you sit on the piano stool when everybody knows that you can’t play piano ?”

” As long as I am sitting on that stool, others are spared from compulsory listening to piano

*

Friend, “Is your wife slightly deaf?”

Husband, “ Slightly? Yesterday night patrol tank burst near our house with a big blast. She turns in her bad and told me-stop coughing”