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Clinical Review Science, medicine, and the future

New interventions in hearing impairment

BMJ 2000; 320 doi: (Published 04 March 2000) Cite this as: BMJ 2000;320:622
  1. Karen P Steel (, professor
  1. MRC Institute of Hearing Research, University Park, Nottingham NG7 2RD

    Hearing impairment is the most prevalent sensory deficit in the human population, with about 1 in 800 children born with a serious hearing impairment and more than 60% of people aged over 70 suffering sufficient hearing loss to benefit from a hearing aid (fig 1). 1 Sign language may be useful for a tiny proportion of those affected, those with profound childhood deafness, but for the vast majority of people with impaired hearing this is not an option, and social isolation combined with economic and educational disadvantage is the common outcome. Cochlear implants have improved the hearing of many adults and children with profound deafness, and surgery can relieve middle ear problems such as otosclerosis (which affects only a small proportion of hearing impaired people), but there is no medical (as opposed to surgical) treatment available for most people with sensorineural hearing impairment. In this article, I summarise recent progress in understanding the biology of deafness and outline some possibilities for alternative treatments that may be available in the future.

    Fig 1.

    Progression of hearing impairment with age. Values are percentages in each age band of UK population with hearing impairment at the level indicated. Data from Davis 199511


    The views expressed in this article have been developed over many years and are based on my personal experience of research in the subject, discussions with scientists and clinicians as well as with people affected by deafness, and extensive reading of the literature, only a tiny proportion of which has been cited here.

    The role of genetics in deafness

    Our growing awareness and understanding of the role of genetics in deafness has given us hope that medical treatments may one day be developed. It is generally thought that about half the cases of childhood deafness are due to a single gene mutation, while the rest are due to …

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