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Hearing problems after a brain injury

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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 hearing difficulties.

The mechanical process of hearing is carried out by the ear itself which has three sections, the outer, middle, and inner ears.


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 processing. 


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 generators.



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 tonic water.


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 wind


Sensitivity (hyperacusis)

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 condition. 


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.


Meniere's syndrome

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 responsible.


Auditory agnosia

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 problems

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 tinnitus
  • Sleep well
  • Eat well and reduce salt if you have fluid pressure in the ear
  • Stop using drugs such as coffee, cigarettes and alcohol.

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