Hearing Loss

Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas.

Acoustic Neuroma

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Acoustic neuromas are benign tumors that develop very slowly, on the eighth cranial nerve inside the ear, and they can have a major impact on a person. It is known that only about five individuals out of 100,000 actually have acoustic neuromas, but those who do have them may experience symptoms such as facial numbness, vertigo, a slow diminution of hearing in one or the other ear, problems with balance, and possibly tinnitus.

In extreme cases, the tumor itself can grow to a size where it actually becomes life-threatening, so its early detection is very important. The issue with early detection is that, as mentioned, the development of such a tumor is generally slow, which makes the symptoms experienced very gradual in nature.

In many cases, these symptoms are actually just attributed to normal aging and don’t attract any real attention because they’re thought to be a consequence of diminishing capability. Individuals who experience any of the symptoms referenced above should seek medical attention at the earliest opportunity. This is so that if there is an acoustic neuroma in progress, steps can be taken to have it treated before it gets critical.

How Acoustic Neuromas Develop

The cranial nerve where a neuroma begins to develop is the nerve which joins the inner ear and the brain, and it has a profound impact on both hearing and balance. This is why the symptoms of an acoustic neuroma include side effects that are both hearing-related and balance-related. It’s common for people with an acoustic neuroma to have problems with steadiness in their daily routine, even walking around the household.

Hearing can be impacted by the development of tinnitus, and possibly also a direct loss of hearing. As an acoustic neuroma grows larger and larger, it will begin to crowd the brain itself, as well as those nerves which manage facial expression and facial sensitivity. If an acoustic neuroma goes completely undetected and is allowed to continue growing, it can eventually put so much pressure on the cerebellum or brainstem, that a life-threatening situation can occur.

Causes of Acoustic Neuromas

There are two main causes of acoustic neuromas, the first of which is a sporadic form, and the second being related to a syndrome known as neurofibromatosis type II or NF2. Neurofibromatosis II is an inherited condition in which noncancerous tumors grow in the nervous system, and most of the time these noncancerous tumors are acoustic neuromas. For this inherited type of acoustic neuroma, it is fairly common for them to begin development in both of the patient’s ears, before the age of 30. This is a rare disorder that only makes up about 5% of all acoustic neuromas, meaning that the overwhelming majority of acoustic neuromas are of the sporadic form. Unfortunately, doctors and scientists do not yet understand what causes the sporadic form, although at least one risk factor has been identified as exposure to unusually high levels of radiation, primarily in the area of the neck and head.

Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas.

Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas.

Treatment for Acoustic Neuromas

There are three primary approaches to treatment of acoustic neuromas: radiation therapy, surgery, and observation. You can think of observation as ongoing monitoring or watchful waiting. Since acoustic neuromas are not cancerous and grow only slowly, there is usually not an immediate or urgent need for any more drastic form of treatment. What happens after the observation period will depend on how rapidly the acoustic neuroma grows, and what kind of impact it’s having on an individual.

Surgical procedures will take one of three tracks. Translabyrinthine surgery calls for an incision to be made behind the ear, so that a portion of the middle ear as well as the bone behind the ear can be removed, and this approach is generally used on tumors bigger than 3 cm. Sub-occipital surgery operates on the back of the head, and can be used for any sized tumors, and unlike translabyrinthine surgery which causes total hearing loss, sub-occipital surgery holds at least the potential for preserving your hearing. Middle fossa surgery also holds out hope for preserving a patient’s hearing, as it removes a small bone piece over the ear canal, so that tumors of a smaller size can be removed.

Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas, as it sends high radiation dosages directly at the tumor, while also limiting damage or exposure to all surrounding tissue. There are two types of radiation therapy which are generally used in the treatment of acoustic neuromas. The first of these is multi-session fractionated stereotactic radiotherapy (FRS). This delivers small doses of daily radiation over a period lasting several weeks, and is generally the more successful of the two radiation approaches. The second method for radiation therapy is known as single fraction stereotactic radiosurgery (SRS). In this approach, hundreds of small radiation beams are directed at the tumor in one comprehensive session. While this has the advantage of requiring only a single treatment session, it has historically been somewhat less effective than the FRS radiation therapy approach.

Hyperacusis can cause ordinary sounds to not only sound extremely loud but also be painful.

Hyperacusis

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People who have hyperacusis hear things a little differently than people with relatively normal hearing. With this medical condition, ordinary sounds like running water, the ticking of a clock, or the timer alarm on your microwave not only sound extremely loud, but also can actually be painful. This doesn’t mean that their hearing is more acute, or that patients with this condition are able to hear more sounds than the rest of us – it just means that all normal sounds you may hear in a typical day are heard at a higher level of volume. This is not just a temporary inconvenience a with minor impact; it can literally have a profound effect on a person’s quality of life, because the condition doesn’t ever take a break – it’s there all the time.

How Does Hyperacusis Develop?

Scientists are not exactly sure what causes this condition to develop in any one person, but studies which have been conducted seem to point to exposure to one of several triggering conditions as a cause. One of the most prominent of these is noise related to a daily job routine: for instance, someone working in a factory with heavy machinery, or where a repetitive loud noise recurs throughout the eight-hour shift.

Traumatic head injuries are another possible cause of hyperacusis, with many of today’s hyperacusis patients having experienced some significant blow to the head in their past. Chronic ear infections are another culprit, because even though they can be cleared up with medication, the damage they do while the infection is rampaging can persist beyond the duration of the infection itself.

Migraine headaches are thought to be another possible cause of hyperacusis, since many current hyperacusis patients also experience migraines, or have had them in their medical history. There also seems to be a correlation between patients who have contracted Lyme disease or TMJ Syndrome in their past, although it is not known exactly what from those two conditions leads to the development of hyperacusis. Lyme disease is spread by a tick which can commonly be found in fields and woods, and may be brushed up against by a person. Temporomandibular Joint (TMJ) Syndrome is a disorder which causes pain in the muscles and joints of the jaw.

As far as the physiology behind the actual triggering of hyperacusis, that’s the part of the equation that scientists and researchers have yet to confirm. At present, it seems likely that the fibers of the ear which regulate sound have been somehow compromised, and that the auditory nerve has suffered significant damage. Another school of thought holds that the brain’s central processing system affects how the brain evaluates sound, and for some reason magnifies it beyond its true level. And naturally enough, since there are primarily these two major theories about what actually happens in hyperacusis, there is also another group of scientists who believe that a combination of those two is the real answer to the problem.

Relationship to Tinnitus

While most people have probably not heard of hyperacusis, the medical condition of tinnitus is probably much more well-known. While these two conditions are not at all same thing, they do have a relationship, in that both represent departures from the norm in the way that sounds are heard. People with tinnitus experience several different abnormal sounds in their hearing, sometimes even when there is no actual noise being generated in the surroundings.

This can be felt as a ringing noise, or some kind of whistling, hissing, or buzzing, and it’s easy to see how this can be so distracting that a person’s quality of life could easily be diminished. Although hard statistics are not available to support this, it is estimated that more than 60% of patients who have tinnitus also have hyperacusis. So in addition to hearing a persistent buzzing or whistling sound in the ears, a patient who experiences both of these medical conditions would also sense ordinary sounds at several times their true volume.

Having either one of these medical conditions could have a profound impact on your daily life, but just imagine being troubled by both of them at the same time! Patients who are known to suffer from both medical conditions generally find it extremely hard to just get through a normal day. As a result, there’s a strong tendency for such individuals to withdraw from life to a significant extent, and become socially isolated. This in turn, can easily slide into depression and add to the list of medical conditions the individual would have to deal with.

Treatment for Hyperacusis

Treating hyperacusis requires a two-pronged approach, but it does not really result in a cure for the condition. People who have hyperacusis are generally counseled so as to help lower their reactions to loud sounds, and a process known as acoustic therapy helps to retrain the ear to hear sounds at a more normal level. While there are no actual medical or surgical procedures at present which can offer significant help, some success has been achieved by the counseling/retraining program. Not surprisingly, the same approach has been used with tinnitus, with similar success.

Pair of ear plugs used to guard against noise-induced hearing loss

Noise-Induced Hearing Loss

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Noise-induced hearing loss is a condition which currently affects about 10 million Americans. It is the most common preventable cause of hearing loss which is due to damage of the ear’s sensory nerve. The prevalence of noise-induced hearing loss and the number of people affected have steadily grown right along with the development of society—as more and more of man’s creations create noise pollution which damage a person’s hearing.

Probably most people understand the damage that can result from being close to a gunshot, but far fewer people are aware of potential damage from more mundane causes like leaf blowers, lawnmowers, traffic sounds, car alarms, music concerts, and even the stadium noise at a sporting event.

The truth is, any loud noises which are received by the ears over an extended period of time, no matter where they came from, can cause significant damage to the inner ear. Eventually this can lead to dizziness, ringing in the ears, some degree of hearing loss, and even issues unrelated to hearing, such as high blood pressure and an irregular heartbeat.

What is Noise-Induced Hearing Loss?

Noise-induced hearing loss is the condition which results from having an excess of sound energy reaching the inner ear. When the excess sound energy is temporary, any hearing loss is also likely to be temporary and reversible. A good example of this would be attending a loud rock concert where sound undergoes a great deal of amplification, and excess sound energy reaches every person in attendance, regardless of where they’re sitting.

It is fairly typical for someone attending a concert like this to completely recover within the next day or two, because the excess sound energy has dissipated. If that noise were to persist over a longer period of time, however, it is quite likely that the damage to the inner ear would be irreversible, and the listener would be subjected to a permanent loss of hearing.

It is also possible for excess sound energy to be so profound as to rupture a person’s eardrums, rendering them more or less deaf. Still more problems can be created if a person’s eardrums are shattered and he or she also develops severe dizziness, which is usually an sign that there is a perilymphatic fistula, i.e. an inner ear hole, created between the middle ear space and the inner ear fluid. Surgery in such cases may eliminate the dizziness, but the hearing loss is likely to remain permanent.

Pair of ear plugs used to guard against noise-induced hearing loss

Ear plugs can aid against noise-induced hearing loss.

Prevention of Noise-Induced Hearing Loss

Two of the best kinds of protection for the inner ear are the simple devices we know as earplugs and earmuffs. Earplugs are small-sized devices made of various materials, which can easily fit into the outer ear canal to block sound reception. Since they come in many different shapes and sizes, earplugs can be fitted to virtually anyone’s ears, and the fit is very important because there must be an airtight seal in the ear canal to block excess sound energy from reaching the inner ear.

Earmuffs on the other hand, are devices fitted to the head, and they cover the entire outer ear to prevent sound energy from reaching the ear canal. These devices usually have an adjustable band which allows for a tight fit, and as in the case of earplugs, a tight fit is very important so as to make a good seal against excess sound energy.

The choice of which of these devices to use for any given situation is contingent upon which kinds of sounds need to be blocked. Earplugs are much more effective in providing protection from noises in the low frequency spectrum, whereas earmuffs offer better protection against noises on the high end of the spectrum. Either one will reduce the sound energy that reaches the inner ear by between 15 and 30 dB of sound, and when the two devices are used in tandem, a person wearing them can expect to have twice as much protection than by using either one alone.

Treatment for Noise-Induced Hearing Loss

Anyone who suspects that they may have sustained noise-induced hearing loss should seek professional advice from a doctor who has been trained in ear and hearing disorders. This kind of doctor will be able to diagnose the specific condition affecting a person’s hearing, and can recommend the most effective kind of treatment program.

Unfortunately, there is no real cure for noise-induced hearing loss, because damage to the inner ear is irreversible. There are various devices available which can help restore hearing if only one ear has been affected, and there are also amplification systems such as hearing aids, which can be used in certain situations.

There’s also a great deal of very promising research being conducted by such organizations as the National Institute on Deafness and Other Communication Disorders. One of the specific areas being researched now is how using antioxidants may be able to prevent hearing loss due to noise-induced causes, and may actually be able to restore relatively normal hearing.

Early results have already demonstrated that vitamin D and aspirin can reduce the effects of hearing loss when they are used prior to the event which produces excess sound energy. Other research conducted on laboratory animals has shown that exposure to loud noises does not result in hearing loss when the animals are provided with vitamins A, C, and E before being exposed to a loud noise.

A woman in an airplane suffers from hyperacusis, plugs her ears.

Hyperacusis: Does Pink Noise Help?

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If you’ve never heard of the term ‘hyperacusis,’ it refers to a condition in which a person’s normal tolerance to sounds in their everyday environment is severely diminished. With hyperacusis, the sound of a car braking at a traffic light can sound like a horrible screech, and a group of people applauding a speaker can sound like a huge thunderclap in a storm. In short, it’s as though someone was toying with the volume control of Life, and left it stuck on the highest setting – just about everything sounds extremely loud.

On the flip side, someone who has hyperacusis usually has lost most of the dynamic range generally associated with hearing, which means there isn’t much difference in the loudness of various sounds. For example, an actual explosion might sound very much like a book dropping off the edge of a table.

Most hyperacusis patients have a sensation of inner ear pain or a feeling of pressure in the ears which is similar to what you might feel when making a rapid descent in a commercial jetliner. On an airplane, this feeling can be easily overcome by yawning or chewing gum, but a hyperacusis patient feels this ear pressure all the time. This constant discomfort can have an enormous impact on a person’s life, affecting their job as well as their home life and relationships.

For someone with hyperacusis, operating a lawn mower, listening to the radio in the car, or running a vacuum cleaner at home may not be possible. This condition has less to do with volume, and more to do with particular sound frequencies, which can make attempts to muffle out noise entirely futile as well.

What can be done to help people who have hyperacusis?

Noise Has Color

The pink spectrum of noise is the one which most closely matches the broad range of sounds which we hear in our normal environment. That’s why treatment for patients with hyperacusis generally involves building up a tolerance to pink noise, rather than white noise, which includes higher frequencies. The higher frequencies are the ones most troubling for hyperacusis patients, so trying to build a tolerance to white noise is not nearly as effective an approach.

The goal of any program of sound therapy is to slowly and incrementally build up a tolerance to noise, but this can be a very frustrating and difficult experience for someone with hyperacusis. Many patients find that they just don’t have the patience to undergo this kind of slow therapy, and search for something that will produce faster, less uncomfortable results. If nothing helps, a patient may have few options other than to wear earplugs a majority of the time during waking hours.

A man with hyperacusis sits with headphones on, listening to pink noise at the doctor's office.

It’s important to find the right kind of sound therapy for your hyperacusis, and many patients have found that pink noise has helped them.

How Sound Therapy Works

The whole idea of sound therapy is to get a person re-familiarized and tolerant of the noises which populate our day-to-day world. Sounds are delivered to the ears by one of the several methods, like listening to CDs with recorded everyday sounds. But this can be an inconvenient kind of session for the hyperacusis patient because therapy sessions should last at least two hours per day, and if you’re stuck with one CD for that long, it can get to be uncomfortable and restrictive.

An alternative method of sound delivery calls for custom-fitted sound generators made for your head and ears and having pre-recorded pink noise sounds played for the duration of your therapy sessions. With a sound generator, you’d be free to walk around and do other things, but it can be quite expensive. Whereas a pink noise CD costs less than $100, a sound generator delivering the same pink noise sounds might cost several thousand dollars.

Counseling: A Critical Part of Hyperacusis Therapy

Whichever kind of sound delivery system you choose, there is another essential part of sound therapy: counseling. Having a trained counselor or advisor can make all the difference sometimes, which can ease the difficulties and frustrations that come with sound therapy.

To begin, any sound therapy program requires a high degree of self-motivation from the participant, since no amount of cajoling will persuade a patient to undergo the uncomfortable sessions required. There will be days when the patient wants to shorten or skip the course, or even quit the process altogether. Those are times when a skillful counselor can serve as a cheerleader, and convince the patient to keep eyes on the prize and continue to forge ahead.

It is quite normal for hyperacusis patients to feel that the therapy is hurting them instead of helping since pink noise can be torturous to their hyper-sensitive ears. At times, it takes some skilled counseling to assure a patient that the process is doing them some good, and not harming their ears at all.

It is often a long and uncomfortable process getting re-acquainted with the sounds of our everyday world, but for the patient who sticks with it, it is possible to lessen and maybe even cure the adverse effects of hyperacusis.

The word "tinnitus" is spelled out with wooden block letters.

Tinnitus: Treatment and Symptoms

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According to the most recent report, tinnitus affects around 50 million people in America (to some extent). For the most part, people learn to live with the condition, but there are solutions available. This being said, some medications will make the issue worse which is why we recommend talking to a medical professional before you take action. For example, large doses of aspirin are a bad idea, and thousands of people go wrong every year thinking it will work.

What Is Tinnitus?

Firstly, we should address how tinnitus affects us and the best way to describe it would be a constant noise disturbance coming from inside your ears. Whether it’s a ringing or a whistling, the tinnitus patient is the only person who hears the sounds, making the condition border on maddening.

For most people, it’s a high-pitched ringing that causes the frustration, but you should know it doesn’t generally mean anything larger. Although there are misconceptions that tinnitus is a signal of something deeper in the ears or brain, this isn’t normally the case. As mentioned, only the sufferer will hear the noise, but there are rare cases where the noise comes from a musculoskeletal movement which will allow others to hear it too.

Symptoms

Ultimately, the only real symptom is the problem itself: the perpetual ringing in your ears. However, it’s important to note that the pitch and formation of the sound can differ from one person to the next. While some people note a low-pitched screech, others will suggest a clicking, chirping, hissing, whistling, whooshing, buzzing, pulsing, static, roaring, and perhaps even a musical tone to the sound.

Through the day and night, the volume can fluctuate, and patients notice it most at night. Tinnitus worsens at night mostly because they have nothing else to distract them. When at work and talking to people, we’re concentrating on other things but, when we’re trying to go to sleep, the ringing becomes the center of attention.

A young woman holds her hand up to her ear, looking like she is in pain. Tinnitus can be unbearable if left untreated.

Tinnitus can be caused by number of things, including loss of the ability to hear certain frequencies, a traumatic experience with loud noises, or a product of the aging process. However, there are a number of treatment options available that help patients with the physiological and psychological effects of tinnitus.

Causes

A little later, we’re going to take you through the treatment for tinnitus, but we first need to know the cause of the condition. With the word ‘tinnitus,’ we have a term that describes the actual sound regardless of its cause, which is important to remember. For proper treatment, it’s important to locate the cause to prevent the condition from returning.

If we were to look at averages and the most common problem, this would come down to damage/loss of the sensory hair cells in the cochlea of the inner ear. While the aging process is typically responsible for this, it can also occur after exposure to loud noises for an extended period. However, the sound we experience will alter depending on the loss of certain audio frequencies.

Once the brain receives fewer external stimuli around the lost frequency, it must adapt and replace the sound itself, and this is thought to be the reasoning for tinnitus. Since the auditory system isn’t providing all the right sound frequencies, the brain has to pick up the slack.

Elsewhere, other causes include traumatic brain injuries, ear infections, head/neck injuries, foreign object in contact with the eardrum, cardiovascular diseases, middle ear issues, temporomandibular joint (TMJ) disorders, and diabetes. As we said earlier, some medications will exacerbate the tinnitus, and these include some antibiotics, diuretics, aspirin, and ibuprofen.

Treatment

If left untreated, tinnitus can lead to social isolation, depression, anxiety, and other problems, so treatment is important. With tinnitus, the first step will always be to locate the cause of the issue. After doctors run their tests and discover the problem, they’ll care for the ear infection, drop the ototoxic medications, treat the TMJ problems, etc.

There is no apparent cure for tinnitus induced by old age, so the focus moves to dealing with the sound and making it more bearable. With tinnitus retraining therapy (TRT), this retrains the auditory system, so the tinnitus sounds are accepted rather than disrupting your hearing. Although success isn’t guaranteed, 80% of people find some level of relief from tinnitus with TRT.

If this doesn’t work, your doctor will start dealing with the side effects such as depression, anxiety, and social isolation. With cognitive behavioral therapy (CBT), this ensures depression doesn’t get on top of tinnitus patients. Finally, ENT doctors suggest sound therapy, which exposes patients to constant low background noise to counteract the unpleasant inner ear audio disturbances. With some, they find relief in hearing aids because they amplify external sounds and drown out the tinnitus.

Girl holds hand on her ear because of her tinnitus, which is becoming worse due to an increase in her serotonin.

Tinnitus Symptoms Affected by Serotonin

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Girl holds hand on her ear because of her tinnitus, which is becoming worse due to an increase in her serotonin.

Serotonin in anti-depressants is affecting tinnitus patients.

Imagine hearing a buzzing, clicking, or ringing sound that isn’t actually there. This nonexistent sound comes and goes as it pleases. This is tinnitus, a condition where a sound is only perceived by the affected individual. For millions of Americans, tinnitus is a pressing issue and an irritation. Tinnitus symptoms can be hard to live with and now it seems that the serotonin in a common antidepressant medication is making it worse.

How Tinnitus Symptoms Occurs

There are actually two different types of tinnitus – subjective and objective. If a person is hearing sounds that nobody else can, that is classified as subjective tinnitus. This is both an auditory and neurological issue caused by hearing loss and it accounts for 99 percent of all reported tinnitus cases.

Objective tinnitus is a bit different and much rarer than subjective tinnitus. This form of the condition is when a patient hears sound generated by the body’s internal structures and circulatory system. This type of sound can be heard by another who is close enough to the affected individual.

How Serotonin Affects Tinnitus

The constant irritation caused by tinnitus can take its toll. In fact, the hearing condition has a close association to psychiatric disorders. Scientists have found that depression and anxiety are connected to the severity of tinnitus. With this link being so apparent, researchers at the Oregon Health and Science University decided to see how a common anti-depressant affect the condition.

The anti-depressant is called selective serotonin reuptake inhibitors. It is used to treat depression, anxiety, and social phobia. This drug prevents a neurotransmitter called serotonin from breaking down in the body. Serotonin is a known to boost mood and happiness.

Through the examination of brain tissue in mice, the researchers were able to find out that high serotonin levels make tinnitus worse. The dorsal cochlear nucleus (the part of the brain that the scientist examined) is responsible for sensory integration. It is also the area of the brain where tinnitus develops. As serotonin levels increased, the brain’s neurons become hyperactive and hypersensitive.

What Researchers Had to Say About the Study

“We saw that the activity of those neurons went through the roof,” said senior author Laurence Trussell, Ph.D., a professor of otolaryngology at the OHSU School of Medicine and scientist at the OHSU Vollum Institute.

While tinnitus may be the cause of depression, the medication for the mental disorder only seems to make it worse. This can lead to the mental illness becoming even more of a recurring condition.

“If you’re a physician treating a patient for depression who also has hearing loss or tinnitus, you may want to be careful about prescribing a drug that compounds their feelings of anxiety,” said Trussell. “The SSRI may be enhancing the thing you’re trying to fix.”

Unfortunately, there is no cure for tinnitus symptoms. New technologies are being developed every day and researchers are looking into other options. Dr. Trussell’s team hopes to find a way to develop an antidepressant that does not affect the severity of the condition.

Preventing Tinnitus

Tinnitus stems from hearing loss, obstructions in the middle ear, head and neck trauma, and other conditions. If you want to prevent tinnitus, the simplest way is to avoid situations that may harm your hearing. Loud noises can cause severe trauma that leads to hearing loss. You’ll also want to keep your ears clean and clear of foreign objects. See a qualified otolaryngologist if you want to evaluate your hearing.

Details of cognitive hearing aids and battery in closeup.

Cognitive Hearing Aids: Understanding Speech Better

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Details of cognitive hearing aids and battery in closeup.

The cognitive hearing aids can change how people hear.

Cognitive issues usually accompany hearing loss. That’s because hearing impairment makes it difficult for some to understand what others are saying. As you can imagine, this makes it hard to hold a conversation. During moments where a person with hearing loss is in a crowded or noisy place, understanding speech becomes an increasingly taxing. In order to solve this issue, scientists are developing cognitive hearing aids. The hope is that these devices can filter background noise and enhance voice recognition to make it easier for people to understand speech.

How Hearing Aids Work

Hearing aids are the primary medical devices used to improve hearing. They are used by people who have hearing damage or have developed hearing loss at some point in their lives. Around 48 million Americans report having hearing loss. Unfortunately, only 20 percent of these people actually use hearing aids.

While these devices cannot fully correct hearing loss, they make is easier to understand and process sound. Some hearing aids can cancel noise and the wind, enhance your spatial region, and highlight voice. These devices still have a long way to go. While some hearing aids are capable of suppressing background noise, they have trouble focusing on the speech of a specific person.

Working on Cognitive Hearing Aids

The goal of creating cognitive hearing aids is to focus on hearing one speaker over voices of many others. Hearing aids that can focus on a singular person can make it easier to understand someone in a crowded place. The cognitive hearing aids would have to connect to the brain to understand where to focus. They would also be quite the achievement.

At the Columbia University School of Engineering and Applied Science, researchers came together to determine how they can achieve this kind of auditory focus with hearing aids. The scientists looked at deep neural network models, which helped them separate multiple voices and determine which one the brain is focusing on. The speaker is then amplified so the user can hear them better. Ultimately, this improves auditory attention decoding (AAD).

“This work combines the state-of-the-art from two disciplines: speech engineering and auditory attention decoding,” says Nima Mesgarani, associate professor of electrical engineering and lead of the study. “We were able to develop this system once we made the breakthrough in using deep neural network models to separate speech.”

Previous studies helped the research team develop this new method. “Translating these findings to real-world applications poses many challenges,” notes James O’Sullivan, a postdoctoral research scientist working with Mesgarani and lead author of the study.

“Our study takes a significant step towards automatically separating an attended speaker from the mixture,” O’Sullivan continues. “To do so, we built deep neural network models that can automatically separate specific speakers from a mixture. We then compare each of these separated speakers with the neural signals to determine which voice the subject is listening to, and then amplify that specific voice for the listener.”

Final Thoughts on the Study

“Our system demonstrates a significant improvement in both subjective and objective speech quality measures — almost all of our subjects said they wanted to continue to use it,” Mesgarani says. “Our novel framework for AAD bridges the gap between the most recent advancements in speech processing technologies and speech prosthesis research and moves us closer to the development of realistic hearing aid devices that can automatically and dynamically track a user’s direction of attention and amplify an attended speaker.”

Hopefully, the cognitive hearing aids will convince those with hearing loss to use these devices. Hearing impairment can occur around the age of 65 years old. Using these devices can significantly improve their quality of life.

Baby with the potential for hearing loss lying in bed.

Early Intervention Proves Positive for Babies With Hearing Loss

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Baby with the potential for hearing loss lying in bed.

Early intervention can prevent difficulties with hearing loss.

Unfortunately, there are many cases of infants with significant hearing loss. This loss of sound can occur at birth. Other times, hearing loss in infants develop slowly, becoming worse over time. It can be hard to pinpoint the cause of damage to the middle and outer ear. A loss of sound may occur due to birth defects, a buildup of fluid and ear wax, or because of a rupture to the eardrum. Researchers at the University of Colorado made a recent discovery, showing that early intervention of hearing loss can help your child later in life.

Early Intervention for Hearing Loss

Lead author Christine Yoshinaga-Itano is an audiologist and research professor in the Institute of Cognitive Science. With funding from the Centers for Disease Control (CDC), Yoshinaga-Itano’s team worked to assess the impact of Early Hearing Detection Intervention (EHDI) 1-3-6 guidelines. The Joint Committee on Infant Hearing developed these guidelines 17 years ago. These guidelines suggest that the following steps should be taken:

  1. All newborns should be screened for hearing loss within the first month.
  2. If the test is positive for hearing loss, parents should see a specialist within three months for an evaluated.
  3. Within six months, parents should start early interventions based on their child’s diagnosis.

About 96% of U.S. infants undergo the screening process. For one reason or another, some parents only go through with the first step. Several difficulties prevent parents from affording or meeting the requirements to improve their child’s hearing.

In a previous study, Yoshinaga-Itano looked at children with hearing loss in Colorado. The state has done well to promote early intervention for hearing loss.

Yoshinaga-Itano notes that “We showed that failure to diagnose hearing loss early can create an environmentally induced and preventable secondary disability, making children function much like children with cognitive delay.”

How Intervention Affects Speech

The research team at the University of Colorado at Boulder looked at 448 infants with hearing loss in both ears. The age of these children ranged from 8 to 39 months. Almost 58 percent of the kids have met the EDHI 1-3-6 guidelines.

To measure the impact of meeting these guidelines, the researchers how well these children learn vocabulary and language. The team measured the number of words the kids used when either speaking or using sign language via the Vocabulary Quotient (VQ) score. The difference was startling. Children who met the guidelines score significantly better than those who didn’t.

“We can’t change how much hearing a child has at birth or the educational background of a parent, but we can develop better systems,” says Yoshinaga-Itano. “Policymakers need to do whatever they can to make transitions from one step to another as seamless as possible so parents can meet the 1,3,6. And parents should know that there is an urgency to assuring that children who are deaf or hard of hearing have access to language as quickly as possible.”

Hopefully, the new study can show the need for parents to seek early intervention for their child. Like most diseases, the earlier you catch it, the easier it is to treat.

Different Cochlear implant devices used for hearing preservation.

Hearing Preservation: Keeping Cochlear Implants in Working Order

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Different Cochlear implant devices used for hearing preservation.

There may be better methods to hearing preservation for those with cochlear implants.

Hearing aids are enough to combat mild-to-moderate damage. While this option works for a majority of people with hearing loss, it simply isn’t enough for those who have suffered trauma to their hearing nerve. In the case of nerve deafness, a cochlear implant is necessary for hearing preservation.

People with this severe degree of deafness need as much help as they can get. That’s why scientists strive to improve the technology that returns hearing to normal. Let’s look at the latest study from the Mount Sinai Hospital, which narrows down the best practice for cochlear implants.

Hearing Preservation: Finding the Better Option

Cochlear implants are medical devices that connect directly to the auditory ear. By bypassing the damaged structures of the inner ear, the implant can improve the hearing of people with severe hearing loss. They help more than 188,000 people worldwide.

Lead investigator and researcher at Mount Sinai, George Wanna, MD, Site Chair, Department of Otolaryngology-Head and Neck Surgery at New York Eye and Ear Infirmary of Mount Sinai (NYEE) and Mount Sinai Beth Israel, found that a certain design of cochlear implants worked better than others. After examining 230 patients with every type of cochlear implant, Dr. Wanna’s team of researchers discovered that implants without wires in the electrode worked best.

These implants are called lateral wall electrodes. Not only do they provide better hearing for those wearing them but they do less damage to the ear. The device is less likely to cause internal fractures to the inner ear, making it less traumatic. In order to prove this point even further, the team tested several different brands of the same cochlear implant, finding the same results.

Dr. Wanna had this to say about the study, “”This is the largest clinical study done in the world on conventional electrodes and will have major implications for doctors and their patients who need their long-term hearing restored. This study is a breakthrough for patients with hearing loss, and improvements in practice and techniques will allow them to enjoy many hearing benefits such as music enjoyment, listening in complex environments, and sound localization.”

Other Findings

The research team at Mount Sinai also made another important discovery – the best surgical approach to inserting the cochlear implant. Most implants are surgically inserted under the skin and behind the ear by drilling through the bone. What the research team found was that other options, without drilling through the bone were better.

The two surgical approaches the team examined are called the “round window” and “cochleostomy.” The round window approach involves surgeons opening the membrane without removing the bone or drilling into the inner ear. On the other hand, the cochleostomy approach does drill into the bone.

“The cochleostomy approach causes fibrosis and scarring, leading to hearing loss over time,” said Dr. Wanna. “Our results also revealed that using oral steroids also helped in the long term to preserve hearing by preventing inflammation.”

Dr. Wanna and his team hope surgeons will put this information to good. This research can help by giving patients the best implants available for hearing preservation. “This is an exciting time in this field, and the advancement in hearing technology and continued improvements in techniques and outcomes will benefit patients and their families,” said Dr. Wanna.

Dementia - Medical Concept on Red Background with Blurred Text and Composition of Pills, Syringe and Stethoscope.

Hearing Could Be an Early Indicator of Dementia

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Dementia - Medical Concept on Red Background with Blurred Text and Composition of Pills, Syringe and Stethoscope.

Can scientists detect dementia before it’s too late?

As we grow older the risk of developing debilitating conditions increases. As a result, staying healthy becomes more and more of a pressing concern for older adults. The truth is that the body doesn’t work as well as it used to and some of our functions may potentially fail as we age. Thankfully, scientists and researchers are always looking into how to treat and detect these situations before they arise.

Take dementia for instance. There are several causes of this degenerative disorder, including neurological diseases, vascular disorders, brain injuries, and more. However, there is one commonality that patients with these diseases share – their age. Approximately 5 percent to 8 percent of adults over 65 have some form of dementia. Even worse, that risk doubles every five years after people reach the age of 65.

One important aspect of treating this disease is detecting it early. Researchers have found a new way to determine if patients are affected by the disease.

Symptoms of Dementia

Dementia comes in two different forms. The first is cortical dementias, which usually shows up in the form of Alzheimer’s or Creutzfeldt-Jakob disease. This form of dementia can cause server memory loss, cognitive issues and may impair your ability to remember words.

The second form of dementia is subcortical. The diseases that are most commonly associated with this are Parkinson’s disease, Huntington’s disease, and HIV. Patients with these diseases are very likely to difficulty thinking quickly or starting a task.

Detecting the Disorder

The hard part about detecting dementia is that these changes may not appear at first or can develop slowly over time. This can lead to some people not detecting signs of the disorder until it is too late. The biggest indicator of the condition in its early stages is memory and thinking problems. Now, scientists at the Baycrest-University of Memphis are saying that hearing and communication issues are a sign as well.

The brainstem and the auditory cortex are the regions of the brain known to process speech. Once thought to resistant to dementia’s effects, the region has shown trouble processing speech from sound to words. In order to look more into this change, researchers used an electroencephalogram (EEG) to measure the brain’s electrical activity in the brainstem and auditory cortex. With 80 percent accuracy, they were able to predict mild cognitive impairment (MCI), a condition that can develop into Alzheimer’s.

“This opens a new door in identifying biological markers for dementia since we might consider using the brain’s processing of speech sounds as a new way to detect the disease earlier,” says Dr. Claude Alain, the study’s senior author and senior scientist at Baycrest’s Rotman Research Institute (RRI) and professor at the University of Toronto’s psychology department.

Dr. Alain continues, stating that “Losing the ability to communicate is devastating and this finding could lead to the development of targeted treatments or interventions to maintain this capability and slow progression of the disease.”

There is no cure for dementia but with continued study, scientists can find new and innovative ways to help people with the disease live normally.

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