According to experts, up to ten per cent of the population in Thailand may have some sort of hearing problem. Adults with a history of ear infections, long-term use of antibiotics, or diabetes are particularly susceptible to hearing problems and should get regular checkups. Anybody who experiences a diminished ability to hear, who has an attack of giddiness, or who hears ringing in their ears should also seek medical attention.
In Thailand, the most common hearing problems stem from ear infections, working among loud noises, using ototoxic drugs and trauma of the ear. Listening to loud walkmans can also contribute to hearing loss. Bumrungrad Hospital’s Dr Sirikun Vannasaeng says that many people don’t realise that they have lost some of their ability to hear. "Sometimes hearing impairment is minimal, and there is a gradual deterioration so people [don’t recognise they have a problem] until their symptoms reach a certain degree."
All problems are not alike
There are two groups of hearing problems. The most common are conductive, meaning they occur from the middle ear outwards, and can lead to a hearing loss of up to fifty per cent. These problems can be corrected by wearing a hearing aid, or surgery. The cost of a hearing aid depends on the type worn – they can range from less than Bt10,000 (for the old-fashioned "bodyworn" ones) up to around Bt60,000 (for the more sophisticated in-the-ear models), and usually last up to around five years.
The second are sensory problems, involving the nerve leading from the ear to the brain. These may be correctable by having more sophisticated surgery, costing around Bt3,000 in a government hospital, or up to Bt20,000 in a private one, or they may be permanent. Samitivej Hospital’s Dr Nattapong Kumut says that in the near future, cochlea implants may be available in Thailand to help those with sensory loss who cannot be helped by hearing aids. "This could help people with complete hearing loss, but will be very expensive."
What testing involves
Various tests are available. The HRC and Chulalongkorn University’s Dr Manut Utoomprurkporn suggests flicking your fingers together close to your ears as an initial test. "It’s a very simple way to screen your hearing yourself." It’s also important to remain aware of other indicators of impaired hearing, such as a ringing mobile phone that others can hear but you can’t. Dr Manut says this is the most common complaint today among patients coming to see him.
At a doctor’s surgery, the most basic test is carried out during a routine checkup, and involves flicking a tuning fork held near a patient’s ear. The next step is an audometry, a half-hour behavioural test where the degree and type of hearing loss (conductive or sensory) can be determined. This test can also be used to fit a hearing aid.
Then there’s tympanometry, a twenty-minute test which provides information about any conductive problems a patient may have, and an otoacoustic (OAE) test. The latter involves bouncing soundwaves into the patient’s ear to check the condition of their ears’ nerves.
Finally, the one- to two-hour audiobrainstem response test is an objective test of hearing ability that’s reliable and painless. It is not always required in addition to the others.
Don’t stay quiet
Despite the availability of testing, and the affordability of it in Thailand compared to other countries, Dr Manut says that many Thais avoid getting their hearing tested. "First, people don’t like other people to know they have a problem. Second, they believe there is no way of treating their problem, and third – particularly for elderly people – they accept it without even trying to find a cause."
So don’t fall into one of these groups. Getting your hearing corrected may be easier and cheaper than you think, and it may improve your quality of life far beyond what you expect.