La perte auditive
La perte auditive arrive généralement vers la soixantaine, et pousse certaines personnes dans un retranchement psychologique et moral important, en se créant une « bulle d’isolation », car la communication avec le monde extérieur devient de plus en plus difficile.
Agacé ou apeuré de faire répéter ou de ne pas suivre une discussion en famille ou entre amis, la perte auditive influe sur notre état de santé général et peut avoir à terme, de graves conséquences sur notre ouverture d’esprit, ce qui entraine souvent, un déclin cognitif important, et à un certain âge, cela peut être problématique.
Bien heureusement, les appareils auditifs sont aujourd’hui très performants et procurent des sensations sonores très proches d’une audition naturelle. N’attendons pas d’en arriver à un stade inquiétant, consultez-nous par la prise de rendez-vous (lien pour prendre le RDV), ou consultez votre médecin ORL le plus proche.
La perte auditive n’arrive, bien entendu, pas d’un coup ; avec le temps, l’oreille humaine perd de sa motricité, comme tout organe, mais bien heureusement, elle prévient par des signes bien significatifs, qui devraient vous alerter : gêné lorsque vous parlez à plusieurs, ou dans un environnement bruyant, vous faites répéter de plus en plus et vous dites que ce sont les autres qui parlent trop vite ou qui n’articulent pas, vous augmentez le son votre télévision et votre entourage vous le fait savoir,…
Tous ces signes doivent vous alerter et vous devez comprendre que « mal entendre » n’est plus un tabou, car des solutions auditives existent et s’adaptent à votre mode de vie.
La perte auditive peut aussi arriver de manière précoce, et peut-être intensifiée par votre environnement sonore, en vous exposant aux nuisances sonores : travailleur dans le bruit, écouteurs mis au volume maximum pendant de nombreuses heures, concerts ou festivals à répétition…
La perte auditive est la première maladie professionnelle !
Pensez à protéger vos oreilles, parlez-en à votre employeur.
Les conséquences d’une perte auditive non traitée sont diverses : perte d’attention, diminution de la compréhension de la parole, perte de mémoire, renfermement sur soi, capacité professionnelle réduite, isolement, stress, dépression…
Tester son audition, doit être le premier réflexe à adapter, dès lors que l’on dépasse la soixantaine, car à cet âge, la perte auditive est liée à la dégénérescence des cellules de l’oreille interne, qui véhiculent l’information sonore vers le cerveau.
Cette perte auditive est caractérisée par une perte importante dans les sons aigus, qui s’exprime chez plusieurs personnes par une incompréhension de la parole dans des environnements bruyants (restaurant, réunion de famille, …) et se traduit souvent par des confusions phonétiques :
Exemple : au lieu d’entendre « bateau », on peut entendre « château », « gâteau », « râteau » …
Comme pour la vue, lorsque l’on prend de l’âge, on voit moins bien de près : presbytie, en audition, lorsque l’on prend de l’âge on perd la perception des aigus, c’est la presbyacousie.
On parle donc, de personne presbyacousique.
Explication d’un test auditif tonal / Audiogramme tonal :
Ces deux courbes sont représentées sur un graphique, établi de la manière suivante :
- Sur l’axe vertical, est représentée l’intensité en décibels (dB HL), plus on descend plus c’est fort
- Sur l’axe horizontal, sont représentées les fréquences en Hertz (Hz) définissant chaque son, grave pour les fréquences basses et aigus pour les fréquences hautes.
Ainsi, un audiogramme tonal, consiste à mesurer pour chaque son, à quelle intensité le patient commence à entendre : c’est le seuil d’audition.
Ce test auditif s’effectue sur chaque oreille séparément, afin d’obtenir le seuil d’audition pour chaque oreille.
Pour un « normo-entendant », les 2 courbes doivent être alignées sur le zéro (axe horizontal en haut), néanmoins, on considère qu’une audition est dite normale ou subnormale, lorsque les courbes sont situées entre 0 dB et 20 dB, en dessous, il s’agit de perte auditive.
L’espace qui sépare les courbes bleue et rouge avec l’axe du 0 dB, représente la perte auditive.
On peut donc en conclure sur ce graphique, qu’il s’agit bien d’une perte auditive bilatérale, localisée principalement sur les fréquences hautes / sons aigus. On parle alors de presbyacousie.
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D’un point de vue quantitatif, un malentendant ou hypoacousie, est décrit de la manière suivante :
- Surdité légère, pour une perte de 20dB à 40dB,
- Surdité moyenne, pour une perte de 40dB à 60dB
- Surdité sévère, pour une perte de 60dB à 80dB
- Surdité profonde, pour une perte de 80dB à 120dB
Une personne atteinte de cophose ou anacousie, est définie par une perte audition totale et aucun appareillage auditif classique permet de retrouver une amélioration auditive.
L’hypoacousie est un type de surdité caractérisé par une baisse auditive partielle, en fonction du degré de surdité, comme vu précédemment.
Ne pas confondre avec l’hyperacousie, qui correspond à une hypersensibilité des sons environnants.
La perte auditive peut être qualifiée de plusieurs façons différentes :
- Lorsque la perte concerne une ou les deux oreilles, on parle respectivement de perte unilatérale ou bilatérale
- Lorsque la perte auditive est identique pour toutes les fréquences ou bien qu’elle soit différente pour chacune des fréquences, on parle respectivement de perte homogène ou hétérogène.
L’oreille humaine est un organe extrêmement complexe, et nous permet de percevoir les sons, bruits, paroles, qui nous entourent, afin de pouvoir communiquer avec notre environnement sonore.
Généralement, nous percevons les sons par des ondes sonores, qui se propagent dans l’air, captées par le pavillon de l’oreille et renvoyées vers le tympan, qui vibre et fait articuler la chaine ossiculaire (ou osselets) de l’oreille moyenne, transmettant les vibrations sonores vers l’oreille interne, où est situé l’organe principal de l’audition, la cochlée, qui perçoit et transmet l’information sonore au cerveau via le nerf auditif.
De ce fait, on peut donc définir les causes d’une perte auditive, en localisant la source pathologique :
- Lorsque le transport du son est affecté, de l’oreille externe à l’oreille moyenne, on parle de surdité de transmission
- Lorsque l’audition est altérée par la mauvaise perception des sons arrivant à l’oreille interne, par la cochlée, on parle de surdité de perception
- Lorsque l’audition est affectée par une surdité de transmission et de perception, on parle alors de surdité mixte.
