Posts tagged hearing impairment
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.
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.
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.
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 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.
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.
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.
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.”
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.
As adults grow older, they become more likely to develop hearing and balance disorders. Hearing loss can result from a multitude of factors, including bacterial and viral infections, environmental and work-related noise exposure, genetics, medication toxicity and trauma.
Some of these conditions affect the cochlea, which is the inner ear. As the innermost part of the vertebrate ear, this section of the body is responsible for sound detection and balance. If this part of the body is damaged, your ability to hear suffers greatly.
New research at the Indiana University School of Medicine has developed a way to grow inner ear tissue from human stem cells. The researchers’ findings may lead to better methods of treating hearing loss. Find out how they were able to achieve this success and what it means for the those with hearing impairments.
Research Into the Inner Ear
“The inner ear is only one of few organs with which biopsy is not performed and because of this, human inner ear tissues are scarce for research purposes,” said Eri Hashino, Ph.D., Ruth C. Holton Professor of Otolaryngology at IU School of Medicine. “Dish-grown human inner ear tissues offer unprecedented opportunities to develop and test new therapies for various inner ear disorders.”
In the past, researchers have had difficulties growing inner ear tissue. Traditionally, scientists cultivate human stem cells in a flat layer on a culture dish. However, this method proved unsuccessful in producing viable tissue. Research leads, Karl R. Koehler and Dr. Hashino, instead tested a different culturing technique called three-dimensional culture.
The three-dimensional culture is a technique that grows stem cells in a floating ball-shaped aggregate. This method allows the cells to grow more naturally. They incubate in an environment similar to the body. Through expert guidance, the scientists were able to create structures called “organoids.” These structures contain sensory and supporting cells akin to the ones in the inner ear.
What Does This Research Mean for the Future?
“This is essentially a recipe for how to make human inner ears from stem cells,” said Dr. Koehler, lead author of the study and whose research lab works on modeling human development. “After tweaking our recipe for about a year, we were shocked to discover that we could make multiple inner ear organoids in each pea-sized cell aggregate.”
“We also found neurons, like those that transmit signals from the ear to the brain, forming connections with sensory cells,” Dr. Koehler said. “This is an exciting feature of these organoids because both cell types are critical for proper hearing and balance.”
Dr. Hashino and his colleagues hope to use this new knowledge to study diseases and disorders that affect hearing. In addition to learning more about the ear, the scientists hope to develop new therapies and drugs.
“We hope to discover new drugs capable of helping regenerate the sound – sending hair cells in the inner ear of those who have severe hearing problems,” Dr. Hashino said. If successful, then this is another step towards healing people with hearing impairments.
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.
Sometimes, hearing loss occurs because of damage to the tiny hair cells within the inner ear. Using a cochlear implant device allows deaf patients to bypass the effects of inner ear damage, giving them the ability to hear some form of sound. A cochlear implantation requires drilling a hole behind the ear, through the skull bone, and to the inner ear. Researchers may have found another way to perform this procedure.
Using Robotics for Cochlear Implantation
During a cochlear implantation, the hole is drilled to allow the device access to the inner ear. To improve the drilling procedure, scientists at the University of Bern turned to robotics. They developed a high-precision surgical robot to create the entryway for the cochlear device. Their hope is that it provides better hearing outcomes.
The surgical robot would make the hole about 2.5mm in diameter. In order to perform a task of such magnitude, the robot has the do the surgery by itself and without any hands-on interaction or visual from a surgeon. This obviously presents concerns. Surgeons need to be able to track the drill’s progress to make sure in is on track and just in case there is an error.
The researchers built the robot with interlocking safety components. This allows the drill to avoid damaging key areas like the nerves and inner ears.
Prof Weber of the University of Bern, explains: “The robot relies on a number of sensors which are a high-accuracy, optical tracking system, a sensor for resistance that can “feel” the texture of the bone while drilling, and a radar-like nerve stimulation probe that sends small electric pulses into the bone from which the robot can compute whether or not it is on the preplanned track.”
This may be the next major development in cochlear implantation. It has proven effective for one patient and hopefully, it will prove helpful for future patients.
It’s amazing how technological advancements have made life better for so many people, especially in the world of medicine. Scientists often research this type of technology to see how well they work. With this research, they access the technology’s effectiveness and make improvements. Recently, researchers looked into the hearing aid, hoping to find out if it had lasting effects.
The Purpose of a Hearing Aid
It is common for older adults to lose their hearing. That is why hearing aids were created. They are a solution to a problem that affects plenty of adults. Sounds become louder, speech skills increase, and cognitive understanding improves.
Many who need this hearing technology do not use it. In fact, less than 30 percent of adults over 70 years old use hearing aids. If you expand the age range from 20 to 69, only 16 percent of people who need hearing aids use them.
Testing Different Hearing Aids
The objective of the research was to prove that hearing aids do provide a benefit, no matter what kind. There are generally two types of hearing aids that people buy. The first is customized and created after a consultation with a doctor. The other is cheaper, pre-programmed hearing aid.
Scientists gathered 154 adults, ages 55-79, with hearing loss. They separated them into three groups:
- Customized group
- Pre-programmed group
- Placebo group
People in the placebo group were given aids that provided no hearing benefits. After testing, they found that both the customized and pre-programmed hearing aids were effective. However, people in the customized group were more likely to buy their hearing aids.
Overall, people liked the quality of the customized hearing aid better. When offered the customized hearing aid, the pre-programmed and placebo group were more impressed by its quality. Hopefully, patients with hearing loss will see that hearing aids help, no matter what kind.
If you often hear a sound that isn’t there, then you may have tinnitus. This condition affects millions of Americans. In fact, the CDC estimates over 50 million Americans are dealing with this troubling health condition. Of those 50 million, 2 million suffer from severe tinnitus. There is no cure, but new technology seems to be helping patients.
The Brain Fitness Program – Tinnitus (BRP-T)
Unfortunately, tinnitus comes with cognitive issues. This causes a decline in reaction times and the ability to pay attention. It can even interfere with a patient’s ability to process and remember certain situations. Researchers believe that the answer to this problem is to strengthen the brain. Through neuroplasticity, they hope to heal the mind by forming new neural connections.
One attempt at “working out” the brain is a training program called the Brain Fitness Program – Tinnitus (BRP-T). Through an online interface, the program uses 11 interactive exercises. It seeks to improve simple acoustic stimuli, continuous speech, and visual stimuli.
Fixing Severe Tinnitus
Through testing a group with severe tinnitus and a control group, researchers at the Washington University School of Medicine in St. Louis were able to find out if the BRP-T actually worked. Randomly selected individuals from both groups used the program an hour every day, five days a week for two months.
As predicted, the tinnitus patients showed improvements. After thorough testing, their perception, memory, attention, and concentration showed better results than those who did not undergo the training.
Researchers say this about the results: “We believe that continued research into the role of cognitive training rehabilitation programs is supported by the findings of this study, and the role of neuroplasticity seems to hold a prominent place in the future treatments for tinnitus,” the researchers write. “On the basis of our broad recruitment and enrollment strategies, we believe the results of this study are applicable to most patients with tinnitus who seek medical attention.”
As we get older, we begin to worry more and more about our bodies. What is ailing us and what will fail next? These are the questions that many of us have. For that very reason, scientists look into how our bodies operate to get not only a better understand but to fix our illnesses. The American Physiological Society performed a recent study examining the causes of age-related hearing loss and difficulties processing speech. Here is what they found.
Processing Speech Deteriorates
Processing speech is important. It helps us communicate effectively with others, especially when the volume changes in an area. Your hearing adapts to understand what someone is saying in noisy or quiet areas. A lot of what controls your hearing has to do with the brain. And when the brain malfunctions, your senses go as well.
The scientists at the American Physiological Society suspected that a decline in midbrain and cortical activity are responsible for hearing loss. So, they tested two groups using an electroencephalogram to measure mid-brain activity, and a magnetoencephalogram to measure the cortical activity. A group of younger adults around the age of 22 and another group of older individuals around the age of 65.
As expected, the older groups experienced difficulties processing speech. The environments noise level did not matter. Whether it was loud or quiet, the older group had trouble while the younger group took less time processing cues and speech. And these results show in the same in their brains.
The activity in the midbrain and cortex was low, showing that the health of these key areas is necessary to function. They help us process speech and understand others effectively. Hopefully, further research can tell us more. Aging can be difficult but it doesn’t have to stop us from living life. Maybe, it will be a sign to older adults to seek alternate options to hear from their physician.