Managing hearing loss in children and adults: Singapore context

Hearing loss is common in Singapore, with as many as 360,000 persons affected. With Singapore's ageing population, this prevalence is expected to increase. Modern hearing devices have the potential to restore hearing in most patients. Cochlear implants can restore hearing in those with even profound total hearing loss, by stimulating the auditory nerve directly without the need for viable cochlear hair cells. A holistic approach to managing deafness is necessary, including addressing psychosocial issues. Many of the problems experienced by the hearing-impaired are caused by the ignorance and lack of understanding from other people around him/her. "Reverse education therapy" refers to the effective education of these people, to directly benefit the hearing-impaired. In children, hearing restoration together with early detection and effective rehabilitation enable up to 80% to 90% of those born with significant hearing loss to cope well in mainstream education. The infrastructure to support them and facilitate their integration into mainstream society is necessary, and some of these are in place in Singapore. Leisure time noise-induced hearing loss in children is becoming increasingly important. In adults, societal support and understanding are just as important, particularly towards the elderly and pre-lingually deafened adults. Public education in Singapore is necessary, including that on the recognition of the abilities of successfully treated individuals, as well as that on showing more compassion, support and patience towards those who have not benefited sufficiently from treatment. In the future, there is potential for the clinical application of cochlear hair cell/auditory nerve preservation and regeneration.