Every year, about 0.15% of people go to the hospital for a traumatic brain injury (TBI). Some common causes of TBI are vehicle accidents, sports, assaults, blasts, and gunshot wounds. TBI can have a wide range of consequences: from mood disorders and anger management issues, to cognitive difficulties and sensory anomalies.
TBI occurs most commonly in males between the ages of 15–35. This is likely because this demographic is also more prone to risk-taking behavior and participation in contact sports. American football was frequently in the news a few years ago when the Will Smith movie Concussion dramatized Dr. Bennet Omalu’s discovery that chronic brain damage was a factor in the deaths of many NFL players.
Variety of TBI
A minor TBI is commonly called a “concussion.” In these cases, the main injury is a contusion (bruise) of the brain. With more severe concussions, bleeding (hemorrhaging) may occur. The symptoms of concussion are usually temporary, lasting from a few days to a month or more, but eventually subsiding. More severe TBI may result in lifelong symptoms.
TBI doesn’t have to be caused by a single blunt-force trauma. It can be the result of hundreds of minor hits, like those commonly sustained by American football players. It can even be caused purely by sound blasts, even when hearing protection is worn. This can be a common problem for veterans, who may be exposed to many loud blasts over the course of their military career.
Hearing loss is a common outcome of TBI. Those with TBI may suffer hearing loss due to damage along any point of the auditory pathway, from the outer ear to the auditory cortex in the brain. This can result in a variety of symptoms of several kinds.
Ears are Vulnerable to Injury
The most common ear injuries related to TBI occur to the eardrum, middle ear and cochlea. These parts of the ear are close to the outside of the head, and are easily injured directly from trauma.
The stereocilia, inside the cochlea, are the most vulnerable to damage. These tiny, hair-like cells are very delicate. When they are damaged, the result is hearing loss and/or tinnitus.
Vestibular damage is also common, with 40–60% of TBI patients having dizziness in the aftermath of the incident. This may be temporary or, in fewer cases, permanent. The sensitive crystals inside the labyrinth can be dislodged as a result of TBI, confusing the nervous system and resulting in dizziness and balance issues.
Brain-Related Hearing Loss Due to TBI
Inside the brain itself, trauma can result in stretching or shearing within the brainstem, which can affect the ability to locate sounds in the environment, or distinguish between competing environmental sounds. This is commonly called “hidden hearing loss,” because it will not be observed in a typical hearing test. The controlled environment of a hearing test allows a person with TBI to clearly hear the pure tones presented to them, without competing sounds. Outside this environment, they may have trouble comprehending speech when background sound is present, or identifying various sounds in the environment.
Treating Hearing Loss Due to TBI
If hearing loss is an issue after TBI, it’s important for a patient’s loved ones to help create an atmosphere that facilitates communication. Especially if the patient is experiencing mood disorders, which is common, communicating effectively with loved ones is very important in the recovery process.
- Reduce background sounds. Turn off televisions and radios, and try to avoid noise from appliances.
- In group conversation, have one person talk at a time to avoid competing sound signals.
- Make sure the area is well-lit, and face the person when you talk to them. Visual cues can aid in listening ability and emotional connection.
- Assistive listening devices may be available that can help. Consult your audiologist about the available devices that might be of use.
Someone who has suffered TBI, even if it presumed to be minor, should seek the care of a medical professional immediately. Early interventions can sometimes prevent permanent damage.
If you or a loved one may have hearing loss or hidden hearing loss in the aftermath of a TBI, or for any other reason, make an appointment for a hearing test today and find out how treatment can significantly improve your quality of life.