Hearing Loss as a result of Head Injury
Violence against women and girls is one of the most prevalent, persistent and devastating human rights violations in our world. Violence against females has a devastating impact on its victims, from psychological, emotional, social, and physical trauma. This article will outline the impact of violence or head trauma on the auditory and vestibular system, and contribute to raising awareness of the violence against women and girls, and its devastating impact.
Hearing loss as a result of head injury, known as post-traumatic hearing loss, has been observed in the medical and audiology clinical settings, and reported extensively in literature. However, there is little to no reports on hearing loss as a result of gender-based violence (GBV) among GBV victims. What literature reports is the prevalence of blows to the head as a result of GBV. In one study, 92% of women reported having been injured by receiving blows to the head, and 40% lost conscious as a result. It would not be surprising if the victims have reported auditory and/ or vestibular dysfunctions symptoms as concussion or head injury is consistent with auditory and vestibular dysfunction.
A concussion is a mild form of Traumatic Brain Injury (TBI) which can be caused by a blow to the head, whiplash-type injury, or a bump. The common causes of TBI are motor vehicle accidents, falls – especially in the elderly, sports injury, and violence.
Impact on the auditory and vestibular system
As the area of injury is often the ear or the side of the head, the ear is most vulnerable. The ear contains both the auditory and vestibular organs, thus, both may be affected by head injury. The impact of trauma on the auditory and vestibular system varies from one patient to another. Ear trauma as a result of head injury can occur anywhere along the auditory pathway. From the outer ear (including the eardrum), the middle ear (including the ossicles), and the inner ear which includes the cochlear hair cells, the semicircular canals, and the auditory cortex on the brain.
While some of these damages may be temporary or reversible, some are permanent. These damages include a ruptured eardrum, middle ear filled with blood, ossicle chain disruption, disruption of blood flow to the inner ear organs, and trauma to the auditory cortex. These damages result in different types and degrees of hearing loss and vestibular disorders. For example, a ruptured eardrum leads to a conductive hearing loss and can be reversed. However, damage to cochlear hair cells which leads to a sensorineural hearing loss, may be permanent.
Because the trauma generally happens at the ear area, symptoms of dizziness and vertigo are commonly reported by head injury victims. Literature has shown that vestibular disturbances require a minor head injury, as opposed to hearing disturbance and tinnitus. Thus it is important to ask all victims about both vestibular and auditory symptoms. Other symptoms are tinnitus, headache, and nausea.
The head injury patient or victim may experience difficulty understanding speech, hypersensitivity to sound, ringing in ears (tinnitus) and dizziness. The clinician should perform both subjective and objective examination of vestibular and auditory functions in order to determine the site of lesion and possible treatment.
Management of head injury
The management and treatment of head injury, such as that due to violence, is individualized to the diagnosis. What healthcare professionals should note is the variety of issues that can result from head injuries — these include a wide range of psychological, social, emotional, and physical issues. Thus, when presented with a head injury victim (e.g. GBV victims), it is of paramount importance to ensure a comprehensive assessment of issues that might have resulted from the event, such as auditory and vestibular dysfunction. This will allow for a timely and holistic management of the victims.