March 3rd is National Ear Care Day, and this year's theme is "Healthy Listening Without Hindering Communication". The ear is an important organ for human perception of sound and a bridge for communication and interaction with the outside world. The structure of the ear is complex and intricate, allowing us to enjoy wonderful music, hear the call of loved ones, and perceive changes in the surrounding environment. As an otolaryngologist, I come into contact with many patients who are troubled by hearing problems every day. They are of different ages, but the impact of hearing loss is equally widespread and profound, including the loss of communication skills with others, delayed language development, and possible problems such as loneliness and depression. To protect hearing, we first need to understand how we hear sound. Our ears are divided into three parts: outer ear, middle ear, and inner ear. The outer ear is composed of the auricle and the external auditory canal, which are responsible for collecting sound and transmitting it to the middle ear. The middle ear includes the tympanic membrane and three small bones (malleus, incus, and stapes), which together form the sound conduction chain that transmits sound from the outer ear to the inner ear. The inner ear is the main site of sound perception, including the vestibule, semicircular canals, and cochlea. When sound vibrations are transmitted to the cochlea, the hair cells in the cochlea convert the sound signal into a neural signal, which is then transmitted to the cerebral cortex for processing. Damage to any part of the outer, middle, or inner ear can lead to hearing loss. According to the location of the lesion, hearing loss can be divided into three categories: conductive hearing loss, sensorineural hearing loss, and mixed hearing loss. As age increases, the hair cells and auditory nerves in the cochlea gradually deteriorate, leading to age-related hearing loss. This is the primary cause of hearing disability in our country. This type of hearing loss is usually progressive, with the first impact being the perception of high-frequency sounds, such as difficulty hearing bird calls or phone ringing. Noise exposure is one of the main causes of hearing loss in modern society. Long term exposure to high volume environments such as construction sites, bars, KTVs, etc. can cause damage to hair cells in the inner ear. Hair cells are a very fragile part of the auditory system, and once damaged, they cannot regenerate. Long term exposure to noise levels above 85 decibels (such as drill sounds, airplane takeoff sounds) may cause irreversible damage to hearing. In addition, improper use of headphones, such as listening to music at high volume for extended periods of time, is also a significant cause of noise induced hearing loss among young people. Ear diseases such as otitis media, external auditory canal infection or blockage, and ear tumors can affect the transmission of sound by compressing, damaging, or invading ear structures, leading to hearing loss. Ototoxic drugs refer to drugs that may cause damage to the ear, especially the inner ear. These drugs may damage hair cells in the cochlea, vestibular system, or auditory nerve, leading to hearing loss, tinnitus, or balance disorders. The effects of ototoxic drugs may be temporary or permanent, depending on the type, dosage, duration of use, and individual sensitivity of the drug. Common ototoxic drugs include aminoglycoside antibiotics (such as gentamicin, streptomycin, etc.); Platinum based chemotherapy drugs (cisplatin, etc.); Loop diuretics (such as furosemide); Salicylic acid salt drugs. If there are hearing loss patients in the family due to genetic factors, the risk of hearing loss in offspring may be higher. Hereditary hearing loss may exist at birth (congenital) or gradually manifest during the growth process. The pathogenesis is caused by abnormal ear development or metabolic disorders resulting from mutations in the deaf gene or newly occurring deaf gene from the parents, ultimately leading to hearing loss. Other reasons for head trauma include severe impact on the head, which may cause rupture of the eardrum, dislocation of the ossicles, or damage to the auditory nerve. Sudden deafness is a type of hearing loss that occurs suddenly and is typically associated with viral infections, circulatory disorders, or immune system issues. Chronic diseases, such as diabetes and hypertension, may affect the blood supply of the inner ear and cause hearing loss. How to protect hearing? Firstly, control the volume. When using headphones, the volume should be kept below 60% of the maximum volume, and the daily usage time should not exceed 60 minutes (following the 60/60 rule). In noisy environments, try to use noise cancelling headphones to avoid masking noise by increasing the volume. Secondly, reduce noise exposure. Try to avoid prolonged exposure to high noise environments. If unavoidable, earplugs or earmuffs should be worn to reduce noise damage to hearing. Thirdly, take regular breaks. After prolonged use of headphones, it is recommended to allow the ears to rest for a period of time to avoid auditory fatigue. Set aside a period of time every day to be in a quiet environment and help with ear recovery. Fourth, regularly check your hearing. Regularly conduct hearing tests, especially for individuals who have been exposed to noisy environments for a long time. If hearing loss or tinnitus is found, seek medical attention promptly to avoid worsening of the condition. Fifth, a healthy lifestyle. A balanced diet, consuming foods rich in vitamins A, C, E, and magnesium such as fish, nuts, and leafy vegetables, can help protect hearing. Quit smoking and limit alcohol consumption. Smoking and excessive alcohol consumption may damage the blood vessels in the inner ear, thereby affecting hearing. 4. It is not difficult to achieve unobstructed communication. Most cases of conductive hearing loss and some cases of mixed hearing loss can be treated with ear surgery to achieve a certain level of hearing. For those who cannot undergo surgery or have no hope of improving their hearing due to various reasons, suitable hearing aids can be worn. Traditional hearing aids mainly rely on amplifying sound to assist hearing-impaired individuals, while modern hearing aids can intelligently adjust based on individual hearing conditions through digital signal processing technology, providing a clearer and more natural auditory experience. Artificial auditory implants (cochlear implants, brainstem implants, bone conduction implants, etc.) have brought hope for the restoration of hearing in patients with severe hearing loss and total deafness. These devices are essentially special electronic devices that convert mechanical sound signals in the environment into electrical signals, which are then transmitted to the patient's cochlea to stimulate the auditory nerve or directly stimulate the brainstem auditory area, resulting in hearing. Only with healthy hearing can we listen to the sounds of the world without hindrance. May everyone be able to listen healthily and communicate without hindrance, let us pay attention to hearing health together and enjoy a beautiful life. (Xinhua News Agency) Author: Gu Xiaodong, Deputy Chief Physician of the Eye, Ear, Nose and Throat Hospital Affiliated to Fudan University