The Hearing-Loss Guide: Useful Information and Advice for Patients and Families


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Damage to the inner ear cochlea may be caused by temporal bone fracture. People who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent. Sound waves reach the outer ear and are conducted down the ear canal to the eardrum , causing it to vibrate. The vibrations are transferred by the 3 tiny ear bones of the middle ear to the fluid in the inner ear. The fluid moves hair cells stereocilia , and their movement generates nerve impulses which are then taken to the brain by the cochlear nerve.

Finally, the signal goes to the auditory cortex of the temporal lobe to be interpreted as sound. Hearing loss is most commonly caused by long-term exposure to loud noises, from recreation or from work, that damage the hair cells, which do not grow back on their own. Older people may lose their hearing from long exposure to noise, changes in the inner ear, changes in the middle ear, or from changes along the nerves from the ear to the brain.

Identification of a hearing loss is usually conducted by a general practitioner medical doctor , otolaryngologist , certified and licensed audiologist , school or industrial audiometrist , or other audiometric technician. Diagnosis of the cause of a hearing loss is carried out by a specialist physician audiovestibular physician or otorhinolaryngologist. A case history usually a written form, with questionnaire can provide valuable information about the context of the hearing loss, and indicate what kind of diagnostic procedures to employ. Case history will include such items as:. In case of infection or inflammation, blood or other body fluids may be submitted for laboratory analysis.

Hearing loss is generally measured by playing generated or recorded sounds, and determining whether the person can hear them. Hearing sensitivity varies according to the frequency of sounds. To take this into account, hearing sensitivity can be measured for a range of frequencies and plotted on an audiogram.

Other method for quantifying hearing loss is a hearing test using a mobile application or hearing aid application , which includes a hearing test. As a result of hearing test , hearing thresholds at different frequencies audiogram are determined. Despite the errors in the measurements, application can help to diagnose hearing loss. Another method for quantifying hearing loss is a speech-in-noise test.

As the name implies, a speech-in-noise test gives an indication of how well one can understand speech in a noisy environment. A person with a hearing loss will often be less able to understand speech, especially in noisy conditions. This is especially true for people who have a sensorineural loss — which is by far the most common type of hearing loss. As such, speech-in-noise tests can provide valuable information about a person's hearing ability, and can be used to detect the presence of a sensorineural hearing loss.

A recently developed digit-triple speech-in-noise test may be a more efficient screening test. Otoacoustic emissions test is an objective hearing test that may be administered to toddlers and children too young to cooperate in a conventional hearing test. The test is also useful in older children and adults and is an important measure in diagnosing auditory neuropathy described above.

Auditory brainstem response testing is an electrophysiological test used to test for hearing deficits caused by pathology within the ear, the cochlear nerve and also within the brainstem. This test can be used to identify delay in the conduction of neural impulses due to tumours or inflammation but can also be an objective test of hearing thresholds. Other electrophysiological tests, such as cortical evoked responses, can look at the hearing pathway up to the level of the auditory cortex. MRI and CT scans can be useful to identify the pathology of many causes of hearing loss.

They are only needed in selected cases. Hearing loss is categorized by type, severity, and configuration. Furthermore, a hearing loss may exist in only one ear unilateral or in both ears bilateral. Hearing loss can be temporary or permanent, sudden or progressive. The severity of a hearing loss is ranked according to ranges of nominal thresholds in which a sound must be so it can be detected by an individual.

It is measured in decibels of hearing loss, or dB HL. The hearing loss of the individual is the average of the hearing loss values over the different frequencies. Hearing loss can be ranked differently according to different organisations; and so, in different countries different systems are in use.

Hearing loss may be ranked as slight, mild, moderate, moderately severe, severe or profound as defined below: [ medical citation needed ]. Hearing loss may affect one or both ears. If both ears are affected, then one ear may be more affected than the other. Thus it is possible, for example, to have normal hearing in one ear and none at all in the other, or to have mild hearing loss in one ear and moderate hearing loss in the other. For certain legal purposes such as insurance claims, hearing loss is described in terms of percentages.

Given that hearing loss can vary by frequency and that audiograms are plotted with a logarithmic scale, the idea of a percentage of hearing loss is somewhat arbitrary, but where decibels of loss are converted via a legally recognized formula, it is possible to calculate a standardized "percentage of hearing loss", which is suitable for legal purposes only. There are three main types of hearing loss, conductive hearing loss , sensorineural hearing loss.

Combinations of conductive and sensorineural hearing losses are called a mixed hearing loss.

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Conductive hearing loss is present when the sound is not reaching the inner ear, the cochlea. This can be due to external ear canal malformation, dysfunction of the eardrum or malfunction of the bones of the middle ear. The eardrum may show defects from small to total resulting in hearing loss of different degree. Scar tissue after ear infections may also make the eardrum dysfunction as well as when it is retracted and adherent to the medial part of the middle ear.

Dysfunction of the three small bones of the middle ear — malleus, incus, and stapes — may cause conductive hearing loss. The mobility of the ossicles may be impaired for different reasons including a boney disorder of the ossicles called otosclerosis and disruption of the ossicular chain due to trauma, infection or ankylosis may also cause hearing loss. Sensorineural hearing loss is one caused by dysfunction of the inner ear, the cochlea or the nerve that transmits the impulses from the cochlea to the hearing centre in the brain.

The most common reason for sensorineural hearing loss is damage to the hair cells in the cochlea. Damage to the brain can lead to a central deafness. The peripheral ear and the auditory nerve may function well but the central connections are damaged by tumour, trauma or other disease and the patient is unable to process speech information. Mixed hearing loss is a combination of conductive and sensorineural hearing loss.

Chronic ear infection a fairly common diagnosis can cause a defective ear drum or middle-ear ossicle damages, or both. In addition to the conductive loss, a sensory component may be present. This is not an actual hearing loss but gives rise to significant difficulties in hearing. One kind of auditory processing disorder is King-Kopetzky syndrome , which is characterized by an inability to process out background noise in noisy environments despite normal performance on traditional hearing tests.

An auditory processing disorders is sometimes linked to language disorders in persons of all ages. The shape of an audiogram shows the relative configuration of the hearing loss, such as a Carhart notch for otosclerosis, 'noise' notch for noise-induced damage, high frequency rolloff for presbycusis, or a flat audiogram for conductive hearing loss. In conjunction with speech audiometry, it may indicate central auditory processing disorder, or the presence of a schwannoma or other tumor. There are four general configurations of hearing loss:. Sloping: lower better thresholds in low-frequency regions and higher poorer thresholds in high-frequency regions.

Rising: higher poorer thresholds in low-frequency regions and lower better thresholds in higher-frequency regions. Trough-shaped "cookie-bite" or "U" shaped : greatest hearing loss in the mid-frequency range, with lower better thresholds in low- and high-frequency regions. People with unilateral hearing loss or single-sided deafness SSD have difficulty in:. In quiet conditions, speech discrimination is approximately the same for normal hearing and those with unilateral deafness; however, in noisy environments speech discrimination varies individually and ranges from mild to severe. One reason for the hearing problems these patients often experience is due to the head shadow effect.

Newborn children with no hearing on one side but one normal ear could still have problems. More children with unilateral hearing loss have to repeat classes than their peers. Taking part in social activities could be a problem. Early aiding is therefore of utmost importance. It is estimated that half of cases of hearing loss are preventable. Noise exposure is the most significant risk factor for noise-induced hearing loss that can be prevented. Different programs exist for specific populations such as school-age children, adolescents and workers.

Noise is widely recognized as an occupational hazard. For example, the Safe-in-Sound Award was created to recognize organizations that can demonstrate results of successful noise control and other interventions. Companies can also provide personal hearing protector devices tailored to both the worker and type of employment.

Some hearing protectors universally block out all noise, and some allow for certain noises to be heard. Workers are more likely to wear hearing protector devices when they are properly fitted. Often interventions to prevent noise-induced hearing loss have many components.

A Cochrane review found that stricter legislation might reduce noise levels. Ear protection, if used correctly, can reduce noise to safer levels, but often, providing them is not sufficient to prevent hearing loss. Engineering noise out and other solutions such as proper maintenance of equipment can lead to noise reduction, but further field studies on resulting noise exposures following such interventions are needed. Other possible solutions include improved enforcement of existing legislation and better implementation of well-designed prevention programmes, which have not yet been proven conclusively to be effective.

My Baby Has a Hearing Loss: A Starting Guide for Parents

The conclusion of the Cochrane Review was that further research could modify what is now regarding the effectiveness of the evaluated interventions. The American Academy of Pediatrics advises that children should have their hearing tested several times throughout their schooling: [38]. While the American College of Physicians indicated that there is not enough evidence to determine the utility of screening in adults over 50 years old who do not have any symptoms, [99] the American Language, Speech Pathology and Hearing Association recommends that adults should be screened at least every decade through age 50 and at 3-year intervals thereafter, to minimize the detrimental effects of the untreated condition on quality of life.

Management depend on the specific cause if known as well as the extent, type and configuration of the hearing loss. Sudden hearing loss due to and underlying nerve problem may be treated with corticosteroids. Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments.

A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent. Some management options include hearing aids , cochlear implants , assistive technology , and closed captioning. This choice depends on level of hearing loss, type of hearing loss, and personal preference. Hearing aid applications are one of the options for hearing loss management.

Hearing loss increases with age. A report by the World Health Organization estimated the costs of unaddressed hearing loss and the cost-effectiveness of interventions, for the health-care sector, for the education sector and as broad societal costs. It examines health and nutritional status of adults and children in the United States.

Data from the United States in found that rates of hearing loss has declined among adults aged 20 to 69 years, when compared with the results from an earlier time period Almost one in four adults who reported excellent or good hearing had a similar pattern 5. Among people who reported exposure to loud noise at work, almost one third had such changes. Post-lingual deafness is hearing loss that is sustained after the acquisition of language , which can occur due to disease , trauma , or as a side-effect of a medicine. Typically, hearing loss is gradual and often detected by family and friends of affected individuals long before the patients themselves will acknowledge the disability.

Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges, living with the adaptations that allow them to live independently. Prelingual deafness is profound hearing loss that is sustained before the acquisition of language , which can occur due to a congenital condition or through hearing loss before birth or in early infancy. Prelingual deafness impairs an individual's ability to acquire a spoken language in children, but deaf children can acquire spoken language through support from cochlear implants sometimes combined with hearing aids.

Unfortunately, this may in some rare cases late implantation or not sufficient benefit from cochlear implants bring the risk of language deprivation for the deaf baby [] because the deaf baby wouldn't have a sign language if the child is unable to acquire spoken language successfully. There has been considerable controversy within the culturally deaf community over cochlear implants.

For the most part, there is little objection to those who lost their hearing later in life, or culturally deaf adults choosing to be fitted with a cochlear implant. Many in the deaf community strongly object to a deaf child being fitted with a cochlear implant often on the advice of an audiologist ; new parents may not have sufficient information on raising deaf children and placed in an oral-only program that emphasizes the ability to speak and listen over other forms of communication such as sign language or total communication.

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Many deaf people view cochlear implants and other hearing devices as confusing to one's identity. They feel a deaf person will never be a hearing person and therefore would be trying to fit into a way of living that is not their own. Other concerns include loss of deaf culture and identity and limitations on hearing restoration.

Jack Gannon, a professor at Gallaudet University , said this about Deaf culture : "Deaf culture is a set of learned behaviors and perceptions that shape the values and norms of deaf people based on their shared or common experiences. Bill Vicar, from ASL University, shared his experiences as a deaf person, "[deaf people] tend to congregate around the kitchen table rather than the living room sofa When two of us meet for the first time we tend to exchange detailed biographies.

There is a strong sense of unity between deaf people as they share their experiences of suffering through a similar struggle. This celebration creates a unity between even deaf strangers. Bill Vicars expresses the power of this bond when stating, "if given the chance to become hearing most [deaf people] would choose to remain deaf. The United States-based National Association of the Deaf has a statement on its website regarding cochlear implants.

Much of the negative reaction to cochlear implants stems from the medical viewpoint that deafness is a condition that needs to be "cured," while the Deaf community instead regards deafness a defining cultural characteristic. Many other assistive devices are more acceptable to the Deaf community, including but not limited to, hearing aids, closed captioning , email and the Internet, text telephones, and video relay services. Sign languages convey meaning through manual communication and body language instead of acoustically conveyed sound patterns.

This involves the simultaneous combination of hand shapes, orientation and movement of the hands, arms or body, and facial expressions to express a speaker's thoughts. Those who are deaf by either state or federal standards have access to a free and appropriate public education. If a child does qualify as being deaf or hard of hearing and receives an individualized education plan, the IEP team must consider, "the child's language and communication needs.

The IEP must include opportunities for direct communication with peers and professionals. In part, the Department of Education defines deafness as " In a residential school where all the children use the same communication system whether it is a school using ASL, Total Communication or Oralism , students will be able to interact normally with other students, without having to worry about being criticized.

An argument supporting inclusion, on the other hand, exposes the student to people who are not just like them, preparing them for adult life. Through interacting, children with hearing disabilities can expose themselves to other cultures which in the future may be beneficial for them when it comes to finding jobs and living on their own in a society where their disability may put them in the minority. These are some reasons why a person may or may not want to put their child in an inclusion classroom.

The communication limitations between people who are deaf and their hearing family members can often cause difficulties in family relationships, and affect the strength of relationships among individual family members. It was found that most people who are deaf have hearing parents, which means that the channel that the child and parents communicate through can be very different, often affecting their relationship in a negative way. If a parent communicates best verbally, and their child communicates best using sign language, this could result in ineffective communication between parents and children.

Ineffective communication can potentially lead to fights caused by misunderstanding, less willingness to talk about life events and issues, and an overall weaker relationship. Even if individuals in the family made an effort to learn deaf communication techniques such as sign language, a deaf family member often will feel excluded from casual banter; such as the exchange of daily events and news at the dinner table.

It is often difficult for people who are deaf to follow these conversations due to the fast-paced and overlapping nature of these exchanges. This can cause a deaf individual to become frustrated and take part in less family conversations. This can potentially result in weaker relationships between the hearing individual and their immediate family members. This communication barrier can have a particularly negative effect on relationships with extended family members as well.

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Communication between a deaf individual and their extended family members can be very difficult due to the gap in verbal and non-verbal communication. This can cause the individuals to feel frustrated and unwilling to put effort into communicating effectively. The lack of effort put into communicating can result in anger, miscommunication, and unwillingness to build a strong relationship. People who have hearing loss can often experience many difficulties as a result of communication barriers among them and other hearing individuals in the community.

Some major areas that can be impacted by this are involvement in extracurricular activities and social relationships.


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For young people, extracurricular activities are vehicles for physical, emotional, social, and intellectual development. These communication barriers make it difficult for someone with a hearing loss to understand directions, take advice, collaborate, and form bonding relationships with other team or club members. As a result, extracurricular activities such as sports teams, clubs, and volunteering are often not as enjoyable and beneficial for individuals who have hearing loss, and they may engage in them less often.

In general, it can be difficult for someone who is deaf to develop and maintain friendships with their hearing peers due to the communication gap that they experience. They can often miss the jokes, informal banter, and "messing around" that is associated with the formation of many friendships among young people. Conversations between people who are deaf and their hearing peers can often be limited and short due to their differences in communication methods and lack of knowledge on how to overcome these differences.

Deaf individuals can often experience rejection by hearing peers who are not willing to make an effort to find their way around communication difficulties. Patience and motivation to overcome such communication barriers is required by both the deaf or hard of hearing and hearing individuals in order to establish and maintain good friendships.

Many people tend to forget about the difficulties that deaf children encounter, as they view the deaf child differently from a deaf adult. Deaf children grow up being unable to fully communicate with their parents, siblings and other family members. Examples include being unable to tell their family what they have learned, what they did, asking for help, or even simply being unable to interact in daily conversation.

Deaf children have to learn sign language and to read lips at a young age, however they cannot communicate with others using it unless the others are educated in sign language as well. Children who are deaf or hard of hearing are faced with many complications while growing up, for example some children have to wear hearing aids and others require assistance from sign language ASL interpreters. The interpreters help them to communicate with other individuals until they develop the skills they need to efficiently communicate on their own.

Although growing up for deaf children may entitle more difficulties than for other children, there are many support groups that allow deaf children to interact with other children. This is where they develop friendships. There are also classes for young children to learn sign language in an environment that has other children in their same situation and around their same age. These groups and classes can be very beneficial in providing the child with the proper knowledge and not to mention the societal interactions that they need in order to live a healthy, young, playful and carefree life that any child deserves.

There are three typical adjustment patterns adopted by adults with hearing loss. The first one is to remain withdrawn into your own self. This provides a sense of safety and familiarity which can be a comforting way to lead your life. The second is to act "as if" one does not even have hearing loss. A positive attitude will help people to live a life with no barriers and thus, engage in optimal interaction. The final and third pattern is for the person to accept their hearing loss as a part of them without undervaluing oneself.

Furthermore, many feel as if their inability to hear others during conversation is their fault. It's important that these individuals learn how to become more assertive individuals who do not lack fear when it comes to asking someone to repeat something or to speak a little louder. In essence, these patterns will help adults with hearing loss deal with the communication barriers that are present.

In most instances, people who are deaf find themselves working with hearing colleagues, where they can often be cut off from the communication going on around them. Interpreters can be provided for meetings and workshops, however are seldom provided for everyday work interactions. Communication of important information needed for jobs typically comes in the form of written or verbal summaries, which do not convey subtle meanings such as tone of voice, side conversations during group discussions, and body language. This can result in confusion and misunderstanding for the worker who is deaf, therefore making it harder to do their job effectively.

Additionally, deaf workers can be unintentionally left out of professional networks, informal gatherings, and casual conversations among their collogues. Information about informal rules and organizational culture in the workplace is often communicated though these types of interactions, which puts the worker who is deaf at a professional and personal disadvantage. This could sever their job performance due to lack of access to information and therefore, reduce their opportunity to form relationships with their co-workers.

Since being able to effectively communicate with one's co-workers and other people relevant to one's job is essential to managerial positions, people with hearing loss can often be denied such opportunities. To avoid these situations in the workplace, individuals can take full-time or part-time sign language courses. In this way, they can become better able to communicate with the deaf and hard of hearing. It is a visual language made up of specific gestures signs , hand shapes, and facial expressions that contain their own unique grammatical rules and sentence structures [] By completing sign language courses, it ensures that deaf individuals feel a part of the workplace and have the ability to communicate with their co-workers and employer in the manner as other hearing employees do.

As a result of poor communication between the health care professional and the deaf or hard of hearing patient, many patients report that they are not properly informed about their disease and prognosis. Poor communication in this setting is often the result of health care providers having the misconception that all people who are deaf or hard of hearing have the same type of hearing loss, and require the same type of communication methods. In reality, there are many different types and range of hearing loss, and in order to communicate effectively a health care provider needs to understand that each individual with hearing loss has unique needs.

For example, assuming every deaf or hard of hearing patient knows American Sign Language would be incorrect because there are different types of sign language, each varying in signs and meanings. A patient could have been educated to use cued speech which is entirely different from ASL. This lack of knowledge can lead them to make assumptions about communicating with someone who is deaf, which can in turn cause them to use an unsuitable form of communication.

Acts in countries such as the Americans with Disabilities Act ADA state that all health care providers are required to provide reasonable communication accommodations when caring for patients who are deaf. These accommodations could include qualified sign language interpreters, CDIs, and technology such as Internet interpretation services. A CDI will transform what the health care professional communicates into basic, simple language. This method takes much longer, however it can also be more effective than other techniques.

Internet interpretation services are convenient and less costly, but can potentially pose significant risks. They involve the use of a sign language interpreter over a video device rather than directly in the room. This can often be an inaccurate form of communication because the interpreter may not be licensed, is often unfamiliar with the patient and their signs, and can lack knowledge of medical terminology.

For example, a common misconception is that exaggerating words and speaking loudly will help the patient understand more clearly. However, many individuals with hearing loss depend on lip-reading to identify words. Exaggerated pronunciation and a raised voice can distort the lips, making it even more difficult to understand.


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Another common mistake health care professionals make are the use of single words rather than full sentences. Although language should be kept simple and short, keeping context is important because certain homophonous words are difficult to distinguish by lip-reading. Health care professionals can further improve their own communication with their patients by eliminating any background noise and positioning themselves in a way where their face is clearly visible to the patient, and suitably lit. The healthcare professional should know how to use body language and facial expressions to properly communicate different feelings.

A study achieved successful regrowth of cochlea cells in guinea pigs. A study has shown that gene therapy targeting Atoh1 can cause hair cell growth and attract neuronal processes in embryonic mice. Some hope that a similar treatment will one day ameliorate hearing loss in humans.

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Recent research, reported in achieved growth of cochlear nerve cells resulting in hearing improvements in gerbils, [] using stem cells. Also reported in was regrowth of hair cells in deaf adult mice using a drug intervention resulting in hearing improvement. Researchers reported in that genetically deaf mice which were treated with TMC1 gene therapy recovered some of their hearing. Besides research studies seeking to improve hearing, such as the ones listed above, research studies on the deaf have also been carried out in order to understand more about audition.

Pijil and Shwarz conducted their study on the deaf who lost their hearing later in life and, hence, used cochlear implants to hear. They discovered further evidence for rate coding of pitch, a system that codes for information for frequencies by the rate that neurons fire in the auditory system, especially for lower frequencies as they are coded by the frequencies that neurons fire from the basilar membrane in a synchronous manner. Their results showed that the subjects could identify different pitches that were proportional to the frequency stimulated by a single electrode. The lower frequencies were detected when the basilar membrane was stimulated, providing even further evidence for rate coding.

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From Wikipedia, the free encyclopedia. Partial or total inability to hear. For other uses, see Deaf disambiguation. See also: Absolute threshold of hearing and Hearing range. Further information: Equal-loudness contour and A-weighting. Main article: Noise-induced hearing loss. The examples and perspective in this section may not represent a worldwide view of the subject. You may improve this section , discuss the issue on the talk page , or create a new article , as appropriate. December Learn how and when to remove this template message.

Main article: Ototoxicity. Play media. Some aids have additional features to improve hearing. For example, some digital aids can clear unwanted background noise. Ask the hearing aid dispenser about any additional benefits or features of the aids available. Your audiologist should advise which model should suit you. Make sure you can confidently put it on, take it off, change the volume level and change the batteries. When you use a hearing aid for the first time, everyday sounds may seem quite loud. It could take you a couple of months to get used to hearing sounds with your hearing aid.

Visit the NHS website to read about hearing aids. Special equipment can be installed in your home to amplify sound and help you hear well. Examples include:. You might be eligible for this equipment on free loan through your local social services department. Your eligibility will depend on your hearing loss and you will be assessed by sensory support staff. Equipment can also be purchased privately. You can buy a range of products from the Action on Hearing Loss online shop. If you have hearing loss, lip-reading can be a very useful aid to hearing.

Going to a local lip-reading class may improve your skills, and your confidence. Lip-reading is a skill which most people use unconsciously to some degree. We usually focus on another person's face and lips if we are having difficulty hearing what they are saying often because of intrusive background noise. We do this in an attempt to search for visual clues as to what the speaker is saying. Find a lip-reading class near you. If your hearing loss has an impact on your day-to-day life then you may be able to claim these benefits or concessions:. Back to top. Age UK uses cookies to ensure that we give you the best experience.

By continuing to use this site, you are agreeing to our policy. To read more about how we use cookies and how you can control them read our cookie policy. Hearing loss. What is hearing loss? What causes hearing loss in older age? How can I be tested for hearing loss? How can a hearing aid help me? How can I get a free NHS hearing aid? Are there different types of hearing aid? How can assistive devices help my hearing? How can lip-reading help my hearing? Are there any benefits I can claim?

The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families
The Hearing-Loss Guide: Useful Information and Advice for Patients and Families The Hearing-Loss Guide: Useful Information and Advice for Patients and Families

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