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Therapy for auditory disorders is largely the province of the
otolaryngologist and the audiologist. The neurologist interested in
neuro-otology however, should have some knowledge of therapy to promote
appropriate referrals. The nature of the treatment program depends, of
course, on the exact diagnosis, that is the type of hearing loss and the
age of the patient. Both medical and surgical therapies are appropriate
depending upon the nature of the disorder. Medical or surgical therapy
is used in conductive losses due to otitis media. Surgery is the primary
therapy for hearing loss caused by otosclerosis, usually manifest as a
conductive type of hearing loss, as described earlier. However, almost
every type of non-conductive hearing loss may be helped by a variety of
amplification devices and/or counseling.
Amplification
Contrary to a commonly held misconception, sensorineural hearing loss
may be helped by the use of a hearing aid. It should be recognized,
however, that hearing aids only compensate for loss of sensitivity, but
the matter in which increased loudness is achieved may reduce distortion
and significantly increase discrimination in certain situations. Modern
hearing aids use the latest microcircuitry and signal-processing
techniques, such as digital filtering, to improve significantly the
effectiveness of amplification.
In addition to hearing aids, devices such as
telephone amplifiers, television/radio access systems, personal
listening systems, and alerting devices are designed to improve
communication in difficult listening situations. There are many
assistive devices on the market and new systems and modifications are
appearing at an accelerating rate.
We note that the hearing aid is the most important
rehabilitative tool available for the management of sensorineural
hearing loss, however, counseling should represent a central focus of
any management strategy for the hearing-impaired adult. In addition, the
hearing-impaired should receive counseling both before and after the
provision of amplification.
Cochlear implantation
Lastly, cochlear implants have proven to be extremely beneficial for
those individuals with severe to profound hearing loss who receive
minimal benefit from amplification (Waller and Roland, In press; Balkany
et al, 1994).
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