Hearing and Ear Care

Importance of a healthy lifestyle

As we age, our hearing can suffer through normal use or excessive noise in the workplace or at home. Because it happens gradually, often we're not aware of how bad it might be. If you're experiencing any of these problems you may have suffered some hearing loss.

Symptoms of Hearing Loss

• Do you complain people are mumbling?
• Do others tell you they have to repeat things before you hear them?
• Is it difficult to hear close conversations in noisy places like restaurants or pubs?
• Do you hear better with one person than a group?
• Is your television or music higher than others think necessary?
• Do you find conversations tiring because you need to concentrate?
• Do you struggle to hear telephone conversations?

Suffering with just one of these issues can mean some loss of hearing. For more information visit the website Royal National Institute for the Deaf at www.rnid.org.uk

You can download their range of free, expert fact sheets covering a range of topics, including Hearing aids, Tinnitus, Ear Health, Equipment and Benefits.

You can also take a short hearing test on the website, that may help you identufy hearing loss. You can contact the information line an d speak to an advisor

In 2023 it is expected that 14.2 million adults with hearing loss greater than 25dBHI across the UK

Common hearing and ear problems

Hearing impairment has many causes but the most common are due to the effects of impaired circulation of the blood (vascular) or exposure to noise. The most common cause of all is simply getting older. Less common causes are infections, ototoxic drugs which are damaging to the auditory system and disorders resulting from an unhealthy lifestyle.

There is a significant link between hearing loss and diabetes, with diabetics being more than twice as likely to experience hearing loss as non-diabetics. It is believed this is caused by damage to the nerves and blood vessels of the inner ear. If you have diabetes, you should have your hearing screened regularly.

There are over 18 million people in the UK suffer from some form of hearing loss.

Your ears and your hearing

Our hearing mechanism, more properly called the auditory system, is an amazing structure and unbelievably complex. The auditory system has three main parts: the outer, middle and inner ears.

The outer ear collects sound and directs it to the middle ear via the eardrum. The middle ear converts sound into mechanical vibrations for transmission to the tiny but amazing structure of the inner ear. The inner ear converts the middle ear sound vibrations into incredibly complex nerve impulse patterns which travel, via the auditory nerve, to the hearing centres of the brain.

Ultimately, it is our brain which hears all the sounds of the world around us, including the most important and complicated of all..the human voice.

Hearing Assessments

If you suspect that you have a hearing loss or find it hard to hear a conversation, particularly in a noisy environment, you should not ignore this. You have two options: either you should contact your doctor or arrange for a hearing test at a private hearing care centre. Most private centres provide a free-of-charge and thorough hearing assessment by a professionally qualified person with very little waiting for an appointment which is usually timed for your convenience.

Alternatively, your doctor can give advice on hearing tests and arrange the test itself but usually this means being referred to your nearest hospital Audiology Department. A hospital appointment for hearing tests can take some time to arrange as you may be put on a waiting list before being offered an appointment.

The most important advice which would be given to you by any hearing care professional is that you should never delay in having your hearing professionally assessed if you are experiencing any hearing difficulties.

Your hearing is just as important as your eyesight. At any age, good hearing and good eyesight are important to the quality of your life and general wellbeing.

Rehabilitation to better hearing and a more enjoyable life

Once a hearing impairment has been identified, you will be offered a full assessment of your needs by an audiology professional who will explain which hearing aid systems would be most suitable for you. You will then be offered a separate appointment for the fitting of your hearing aid system. It is at the fitting appointment that personalised and important advice is given about the gradual period of adjustment to a more enjoyable life with hearing aids. This is called auditory or aural rehabilitation and is a very important stage requiring the advice and support of your hearing care professional.

One of the differences between the NHS and private hearing aid services is the amount of time it is possible to devote to advising and assisting you. With private hearing aid services, you will generally be provided with more time at your appointments and with a greater range of aftercare services. It is not always possible for a NHS hospital audiology department to provide their services, although they certainly do their best to provide a high standard of care. With private hearing aid services, you receive aftercare services whenever needed.

General advice about ear and hearing problems

Hearing is one of our most important senses and, without good hearing, quality of life can be seriously affected. If you or a member of your family, regardless of age, is experiencing hearing difficulties, it is very important to seek advice. You can do this by consulting your doctor or by making an appointment at a private hearing care centre. Doing nothing about a hearing problem should never be an option.

Prominent Ears

Ears are the first part of the human body to reach their adult size, which is why protruding ears can be very noticeable in children. The only way to permanently ‘pin back’ ears is through ear reshaping surgery known as Pinnaplasty or otoplasty.

Otoplasty is seen as a form of cosmetic surgery and is generally only available to adults through the NHS in very exceptional circumstances, where the adult can demonstrate that they are experiencing severe psychological distress.

However, it is accepted that children and teenagers are likely to suffer severe emotional stress as a result of prominent ears and they are far more likely to be offered this type of surgery through the NHS.

When Otoplasty should be carried out?

The human ear is fully developed at around three years old and otoplasty is an option from the age of five, when the cartilage in the ears is strong enough to hold stitches. However, at the age of five, a child may not be aware of their prominent ears and, as the benefits are purely psychological, many people decide to wait until the child is old enough to decide on the surgery with the help and support of their parents or guardians.

The end result

The majority of patients who have otoplasty are pleased with the results and do not need further surgery, although some people may require minor adjustments to be made if the shape of the ears is not satisfactory.

A small scar may be visible behind each ear after the operation but this will fade, becoming very faint over time. Very rarely, the patient may develop an infection in the cartilage, which may cause scar tissue to form. It will not normally be necessary to operate further as the infection can be treated with antibiotics.

A small number of patients may develop a blood clot in the ear, called a hematoma. This may be extracted in a simple procedure if it does not dissolve naturally. If you or your child has prominent ears, you are advised to consult with your GP in the first instance.

Pre-payment of NHS prescription charges

The current cost of a prescription is £9.90 per item. If you do have to pay for your prescriptions, you may find it helpful to buy a prescription pre-payment certificate (PPC). A PPC will save you money if you need more than three prescription items in three months or more than 13 items in 12 months. From April 2025, a three-month PPC costs £32.05 and a 12-month PPC costs £114.50.

Any Qualified Provider

The Any Qualified Provider (AQP) scheme was introduced in England in April 2012 to give patients more choice about which health services they can use within the NHS. For some conditions, the scheme entitles you to choose from a range of approved providers, such as hospitals and high street providers.

Adult hearing services were voted to lead the implementation of the AQP scheme in an attempt to increase the number of people given access to hearing aids, as well as information about other hearing services or assistive technology.

Under the scheme, you and your GP can choose a service based on criteria such as location, waiting list or outcomes.

Services provided through the AQP scheme are free for patients to use, and access is based on clinical need. You can find out more about the scheme on www.nhs.uk.