Brain injury effects
Hearing problems after a brain injury
A brain injury can damage both
mechanical and neurological processes and result in a variety of
The mechanical process of hearing is carried out by the ear
itself which has three sections, the outer, middle, and inner
The outer ear, consisting of the lobe and ear
canal, protects the more fragile parts inside.
The middle ear begins with the eardrum - sound
makes this thin membrane vibrate. The vibration is transferred via
three small bones to the inner ear.
The inner ear has a tube called the cochlea
which is wound tightly like a snail shell. From here the
neurological process begins - the vibration are turned into
electrical impulses and sent to various parts of the brain for
The trauma involved in a traumatic brain injury (TBI) most
commonly affects the mechanical process. An eardrum may rupture,
any of the small bones could break or there could be bleeding or
bruising of the middle ear.
Sometimes damage to the parietal or temporal lobes can disrupt
the neurological process. Thankfully many hearing difficulties are
not permanent and can be reduced or eliminated with treatment.
Diagnosis of hearing problems
Accurate diagnosis and treatment are essential, so see
your doctor who will probably refer you to an audiologist or
an ear/nose/throat specialist. Some audiologists run
specialist clinics to help manage particular conditions with
specialist hearing aids or therapeutic noise
Tinnitus is experienced as noises which are commonly like a
buzzing, hissing or ringing in the ears. It is usually caused by
damage to the mechanical process of hearing. It can worsen with
exposure to loud noises, excessive stress, caffeine, alcohol,
nicotine, some illicit drugs and medications, and quinine found in
Some audiologists run clinics to help manage tinnitus. Other
treatments include tinnitus retraining therapy, cognitive
behavioural therapy, and learning coping strategies.
Hearing aids can be adapted with a soft noise generator as
long-term exposure to gentle sound can desensitize the ears very
effectively. This 'white noise' contains every frequency audible to
humans, and can be likened to the sound of distant surf or
Trauma to the inner ear can cause certain noises or pitches to
become extremely loud or soft, causing many problems in situations
such as dining out, taking a walk, washing the dishes, using a
vacuum cleaner or listening to music. Often the problem is not
diagnosed as the person has trouble convincing others that the
problem exists. An audiology test will often show that hearing is
'normal', but it is the sensitivity or inability to handle rapid
changes in volume that is the issue. There are no 'cures' for
hyperacusis but there are many effective strategies to manage this
Ear plugs and ear muffs can help in some situations. Time
activities such as dining out or shopping in quieter off-peak
periods. Avoid stimulants such as nicotine and caffeine. A proper
diet, good sleep and exercise play their part in better overall
health which can make a difference.
Hearing clinics can provide therapy with a specially programmed
hearing aid to manage the hyperacusis by desensitizing the ears
with long-term exposure to gentle sound.
This syndrome is caused by excessive pressure in the chambers of
the inner ear. Nerve-filled membranes stretch which can cause
hearing loss, ringing, vertigo, imbalance and a sensation of
pressure in the ear.
It is incurable, but treatment can alleviate the symptoms with
medication such as diuretics or steroids, electrical stimulation or
simply limiting movement. There are various surgical procedures
that may decrease the pressure or remove/deaden the nerves
This rare condition involves problems with recognizing nonverbal
sounds but still being able to speak normally. It usually involves
injury to the temporal-parietal parts of the brain, and often
resolves itself over time.
Practical tips for any hearing
There are practical steps you can take to lessen many hearing
problems, many of which will help with other aspects of a traumatic
brain injury and other brain disorders:
- Avoid noisy stressful environments where possible
- Talk with those you trust about the problem
- Exercise regularly
- Listen to gentle music to cover constant noise caused by
- Sleep well
- Eat well and reduce salt if you have fluid pressure in the
- Stop using drugs such as coffee, cigarettes and alcohol.