Nina Kraus: Musical Experience Related to Auditory Processing

From time to time, I'd like to share the amazing work being done in the field of hearing.

Nina Kraus, Ph.D., is a scientist, inventor, musician, and professor at Northwestern University who studies the biology of auditory learning.   Her work is fascinating. 

She studies how our brains make sense of sound, and the influences in our lives that may enhance the exquisite processing capacity of our auditory brains.

Sounds are fleeting and constantly changing.  No other sensory system (including vision) can process stimuli as quickly.  Take speech: a single syllable word such as "drink" can have 5 phonemes within it, and if any one of them changes, so does the meaning of the word.  All along the auditory pathway from the ear through the brainstem and up into the higher cortical areas, there are steps of processing involving tuning in, filtering out, and attention.

Dr. Kraus has done studies both in the laboratory and in the community that explore some  powerful influences on auditory processing.  A major area of research looked at how musical experience "primes" the brain for more accurate processing.

One study, called the Harmony Project, looked at what happens when underserved children in Los Angeles, ages 6-9, were provided with musical training.  In summary, the results found that:

• Community music programs may spark neuroplasticity (brain changes) in children.
• It takes time to change the brain.  One year of training did not result in demonstrable brain change, but after two years biological sound processing and everyday listening skills were strengthened.
• Making music matters. Neuroplasicity was demonstrated only in children who actively played music; listening was not enough.

Another study involved high school students.  Results found that:

• Musical training as late as high school still had the potential to improve sound processing in the brain.
• Auditory enrichment such as music could be useful for children with developmental delays.
• The research suggests that musical training may counter some developmental problems.  It supports music as a community-based intervention to enrich sound processing and everyday communication.

Dr. Kraus's work studies neuro-biologic functions with great precision. Her work goes from the lab out into the world.  Using the principles of neuroscience to improve human communication, she advocates for best practices in education, health, and social policy.

Dementia: Can You Decrease the Risk?

A new study suggests that a number of factors,
including mid-life hearing loss, could contribute
to some types of dementia.

There are no guarantees against dementia, but a major international study just published in the esteemed journal Lancet, reports it is possible that one in three cases of dementia could be prevented if more people looked at their brain health throughout life.

According to the researchers, there are life style factors that may make the brain more vulnerable to problems with memory and thinking as we age. Dementia is diagnosed later in life, but changes in the brain begin to develop many years earlier.

Here are 9 factors that contribute to the risk of some types of dementia:

• mid-life hearing loss (9%)
• failing to complete secondary education (8%)
• smoking (5%)
• failing to seek treatment for depression (4%)
• physical inactivity (3%)
• social isolation (2%)
• high blood pressure (2%)
• obesity (1%)
• Type 2 diabetes (1%)

While I have been aware of each of these, I was surprised by the degree (9%!) to which hearing loss factored in. There is much that is still unknown about just how hearing loss is connected to cognitive decline. Maybe hearing loss adds to the cognitive burden of a vulnerable brain, or leads to social disengagement or depression, or is related to systemic age-related microvascular changes.

It's also not proven for sure if use of hearing aids eliminates hearing loss as a risk factor. However, it is likely that if amplification fosters social connection and reduces the effort needed to listen, that addressing hearing loss proactively is a big plus. (And, it makes life better, for sure!)

The take home message is the number of people with dementia is increasing globally, although it is decreasing in some countries. Quoting the Lancet: "Be ambitious about prevention. We recommend active treatment of hypertension in middle age and older people without dementia to reduce dementia incidence. Interventions for other risk factors including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes and obesity might have the potential to delay or prevent a third of dementia cases."

It is a hopeful message: although we cannot totally control our future, there are modifiable risk factors that make an enormous difference, and these addressing them proactively are good for overall health, making good choices a win-win situation.

McGuire’s Volunteers Bring Gift of Hearing & Unexpected Family Reunion to Peruvian Family

1,700 People Fit with Hearing Aids During Starkey Hearing Foundation Mission

David Carr with Juan, Miguel and Danielle Gilewski

Arequipa, PERU – To give the gift of hearing to those who would never have the means or access to hearing aids, David Carr and Danielle Gilewski of McGuire’s Hearing Aids and Audiology Services, recently volunteered to join a mission sponsored by the Starkey Hearing Foundation.

Carr, the owner and operator of McGuire’s and The Hearing Centers, and Gilewski, the general manager of the nine locations on Long Island, Westchester, and the Bronx, not only provided the gift of hearing to a man named Juan, but they facilitated an unexpected family reunion.

The surprise came when Miguel, a volunteer from Peru was serving as a translator for the Starkey Mission as they fit 1,700 patients a day for hearing aids in Arequipa. Little did Miguel know he would be helping translate for his deceased father’s cousin. When Juan sat in his chair to be fitted, he noticed he and Miguel shared the same last name. The two soon made the connection and learned that Juan is the cousin of Miguel's father.

Juan and Miguel had never met, so they were excited to make the family connection. They exchanged contact information so they could stay in touch despite living four hours apart. Through the gift of hearing, they will be able to stay connected.

“Someday a person we have helped might make a decision of kindness or trust because they were helped by an American,” said Carr. “And this time, it came with an added bonus of connecting family.”

The Starkey Hearing Foundation’s mission is to give the gift of hearing to those in need, empowering them to achieve their potential. The Foundation made a commitment in 2010 to the Clinton Global Initiative to provide 1 million hearing aids this decade. Aided by volunteers, such as Carr and Gilewski, they continue to travel the globe helping people in need. To date, they have given the gift of hearing in more than 100 countries.

About McGuire's Hearing and Audiological Services

McGuire's Hearing Aids and Audiology Services was established in 1970 and is owned and operated by third generation McGuire's family member, David Carr. Like his parents before him, Dave's business philosophy of "patients come first" is most evident when he cares for patients as a New York State licensed hearing specialist. In fact, all McGuire employees recognize that patient commitment is the company's primary responsibility. Guided by this philosophy, staff members devote themselves to optimal patient care and exceed state and federal requirements for continuing education. Find McGuire’s on the web at mcguireshearing.com.

About The Hearing Center

The Hearing Center at Pelham, Montefiore, MedAlliance, and Yorktown are part of the family of hearing practices of McGuire’s Hearing Services of New York. McGuire’s Hearing Services is a family owned and operated practice located on Long Island, with over 45 years’ experience serving the hearing community.

The Hearing Centers have provided the highest level of audiological evaluations and hearing aid services. They offer the latest hearing aid technology. They strive to build long-term relationships with patients and families based on trust, comfort and respect.

Our newest Bronx location is the Hearing Center at Medalliance, located near the N.Y. Botanical Gardens and Fordham University.   Medalliance is a multi-service, multi-specialty medical practice that has provided services to the Bronx community for over 23 years.  The HC at Medalliance is an independent free-standing audiology and hearing aid practice with our own entrance on East Fordham Road.  We are able to provide all hearing services with appointments available quickly.

The Hearing Center at Yorktown Heights is our northernmost office, serving people in Westchester, Putnam and Dutchess counties. This office was an established practice that joined our group in 2015, and now shares in the resources offered by a large multi-office practice.

The Hearing Centers serve patients of all ages, from newborn babies through centenarians, with the goal to empower patients to lead happier, more engaged, and more comfortable lives. They treat their patients as they would hope to be, and would want their own family members to be treated. Find the Hearing Center on the web at hearingcenterny.com.

About the Starkey Hearing Foundation

As a young man, William F. Austin, the founder of the Starkey Hearing Foundation, realized his true calling in life was helping people hear, and that by doing so, he could have a lasting impact on the world. For more than 50 years, Austin has been providing the gift of hearing to people in need, and to formalize the philanthropic efforts of Starkey Hearing Technologies, he officially founded the Starkey Hearing Foundation in 1984.  Austin built the organization on his vision — “So the World May Hear.” Over the last three decades, he has expanded the Foundation’s reach from Minnesota, to across the United States and around the world, with the help of thousands of volunteers and supporters.  Find the Starkey Hearing Foundation website.

Summer is prime time for music festivals and concerts.  Sharing music outdoors with friends is a blast (oops).  But, when you pack that picnic dinner remember to take along some hearing protection!  Ear plugs work.

Researchers published a study that was done in the Netherlands (JAMA, Otolaryngology  Head -Neck Surgery online).  A group of people who attended outdoor music concerts were recruited for an experiment through social media. Half were randomly assigned to use ear protectors, and the other half did not use any.  Hearing was checked for "temporary threshold shifts" following exposure.  Bottom line: there was a big difference between the two groups. Temporary hearing loss occured in 8% or the protected group, but 42% in the "naked-ear" group.  The researchers concluded:  "Therefore, the use of earplugs should be actively promoted and encouraged to avoid noise-induced hearing loss."

Here are some suggestions to make concert enjoyment safe for your ears.

Pick you seats carefully. Try to avoid being too close to the stage and the array of loudspeakers.

Keep the children home.  Children's ears are especially vulnerable to loud sound levels, and a really loud concert can cause damage.

Use hearing protection.  There are many options: we sell good quality soft foam ear plugs in all of our offices.  We also make custom ear protectors in a variety of materials and colors for personalized comfort and appearance.  Some are specifically geared for musicians. Also consider noise-cancelling headphones. Generally the volume levels are so high that you will enjoy the music even with hearing protection.

Check the levels.  There are phone Apps that allow you to check volume levels at concerts. If the level is over 90dB, consider moving to a quieter area.

Take a break.  If the music is loud and you don't have hearing protection, then try to limit your exposure, and take one minute breaks for the action from time to time.  Some "time-outs" give your ears a rest and may help keep your ears healthy.

Keep those ears hearing fully...after all, if you love music, you will want to enjoy outdoor concerts for many summers to come.

You May Have Hearing Loss and Not Even Know it

You may think your hearing is just fine...and it may be. But, a study performed by the Centers for Disease Control and Prevention  (CDC) recently found that about a quarter of people between the ages of 20 and 69 who think their hearing is good or excellent are in actuality showing signs of hearing loss.

Hearing loss is often attributed to noisy work environments or to aging.  It is true - these are prime reasons that people's hearing becomes less acute.  In fact, the CDC attributes about 24% of hearing loss to loud workplaces.  However acting director Dr. Ann Schuchat was surpised to learn that many people with evidence of noise-induced hearing loss don't have noisy jobs, and may have damaged their ears from their home or community environments.  “Older people are more likely to have hearing loss, but this study finds some young adults are already losing some hearing, so this is a concern for all age groups,” Dr. Schuchat said. “Asking patients about their hearing, and providing tips for reducing exposure to loud noises, can help our patients  preserve their hearing longer."

Loud noises, such as from sirens to lawnmowers and rock concerts to sporting events can damage hearing. Noise induced hearing loss accumulates over time, and once the damage is done it does not come back.

Hearing loss may start early in life. The survey found that 20% of Americans in their 20's have some loss of hearing for the softest sounds, and especially so for men. The point of this report that struck me it that a quarter of the folks in this survey did not know they were losing their hearing.  The CDC recommends that it is a good investment to avoid cacophony when you can, and use ear protection (earplugs, ear muffs, noise-cancelling headphones) when you can't. Remember to lower the volume on your TV or music.

I would also recommend a "baseline" evaluation so you know your current hearing status.  We can guide you about the state of your ears so they serve you well for years and years!

The World's First "Hearable"

The Bragi Dash Pro tailored by Starkey
is a computer if your ear.

I am really excited about this!

You may have heard of "wearables" - wireless techonologies that you wear such as a smart watch or exercise monitor. A "hearable" is the same idea, but offers both an enhanced listening experience (it is worn in your ear) and biometric data to track your exercise performance.  Let me explain:

Starkey has partnered with a company called Bragi to launch the Dash Pro tailored by Starkey Hearing Technologies.  It is a wireless earphone fit and tailored for the consumer.  It features  a custom shell and enhanced sound so that it fits each specific user.

These are earphones you can walk, run, swim, and bike with.  The custom made shells assure that they fit in you ears comfortably and securely.  You can listen to music through your smartphone with no wires at all.  You can also stream your phone calls. And, you can track your workouts and collect fitness data such as heartbeat, steps and duration while running, cadence while cycling, and breaths while swimming.  Data is picked up by sensors in your ear - how  cool is that!  Since they are waterproof, you can use them for all sports indoors and out.

Here is what you do: make an appointment with us - only your Starkey/Audibel provider can order your custom Dash Pro. We will make custom impressions of your ears, and they will be scanned electronically at Starkey to create 3-D printed shells with the Bragi earphones imbedded. We will fit them to you in our office, and you can be on your way.

Audio quality features full bass and clarity in the treble. The Dash is actually a computer in your ear.  Tailored to you - you can listen to music, track your fitness data, and communicate by smartphone.  I don't have mine yet...they will be released in a few weeks, but I can't wait to try these out.

Exercise

Listen!  Here's one more reason to get moving.  We all know the benefits of exercise: working out helps us manage our weight, boost our energy, stay heart-healthy, and enhance our mood.  And now, research at the University of Florida is suggesting that exercise may help prevent age-related hearing loss, so far, at least in mice.

The researchers divided mice into two groups: the mice in one group each had an exercise wheel, but the other mice did not.  They found that the sedentary mice lost important structures in the auditory system at a much higher rate than their exercising counterparts. According to their results published in the Journal of Neuroscience this resulted in a 20% hearing loss in the sedentary mice but only a 5% hearing loss in the active mice - that's huge!

Age-related hearing loss affects about 70% of adults age 70 and over, and is associated with loss of hair cells, capillaries and spiral ganglion in the cochlear (inner ear) system. These are the structures that sense sound, feed the hearing system with oxygen, and send the sound from the ear up to the brain.

The inner ear is a highly metabolic organ - it is always "on" and processing sound. It needs a lot of energy molecules.  To generate energy molecules the system must be well-fed with oxygen.  Researchers compared the running mice with the non-running mice to test how exercise affects the inner ear structures.  While it's fun to visualize tiny Fit-Bits, they researchers  monitored the exercise wheels to see how far the mice ran.

It's thought that age-related inflammation damages the capillaries and sensory hair cells, and that exercise protects against inflammation.  They found that the runner mice had about half the markers of inflammation than the couch potato mice.  We already know that there is a link between exercise and hearing loss, but this is the first study to show that regular exercise can actually prevent age-related hearing loss in mice.

This is likely to translate to people.  New studies are beginning to look for molecules that are released by exercise that protect biologic function in humans.  According to Dr. Christiaan Leeuwenburgh, a co-author of the UF study exercise likely releases some growth factors yet  to be discovered that maintain capillary. Exercise may also attenuate negative factors such as inflammation.

So, tie up your sneakers, put on some music, and move it!

Cognitive Ability and Hearing Loss May Go Hand in Hand

Did you know that there are links between untreated hearing loss and a decline in cognitive skills? Studies have shown that adults with untreated hearing loss experience a 30-40% faster decline in cognitive abilities compared to peers with aided hearing. 

Cognitive abilities are brain-based skills required to accomplish any task from the simplest to the most complex.  Basically, cognitive abilities affect how a person understands the world and interacts in it. Core aspects of cognition are visual and spatial processing, language, motor skills, memory, attention and perception.

Scientists believe that extra effort exerted by the brain to listen and comprehend redirects resources from the part of the brain used for memory and decision making. In fact, MRI’s of people with hearing loss have shown the part of the brain responsible for sound and speech shrinks faster than normal, likely due to atrophy from lack of stimulation.

A recent study in the Journal of the American Geriatrics Society compared the trajectory of cognitive decline among older adults who were using hearing aids and those who were not. While the study found no difference in the rate of cognitive decline between a control group with no reported hearing loss and people with hearing loss who used hearing aids, untreated hearing loss was significantly associated with lower baseline scores on the Mini-Mental State Examination.

If you have concerns that yourself or a loved one is experiencing hearing loss leading to a decline in overall health, please reach out to our team at McGuire’s. We provide the highest level of audiological evaluations and hearing aid services in a warm, private setting.

Smart Phones and Hearing Apps

Years ago, before there were Made for iPhone hearing aids, I kidded that one day our professional jobs would be taken over by our smartphones. I was kidding, but little did I realize the role that technology would assume in helping us with our amplification.

The Hearing Center audiologist Chris Herget explains, "Yesterday’s hearing aids needed constant tweaking and handling from professional clinicians, to make everyday noises sound natural. Today’s hearing aids are the opposite. Most modern hearing aids do the adjustments automatically based on your environment (reducing distracting noise around you to help you speech better, decrease wind noise while outside), and allow you to even make adjustments on the fly with a smartphone. Imagine yourself listening to your loved ones at a loud party but can’t quite make out what they are saying. In an instant, you can make the noise around you quieter and hear your family more clearly. This is not to say that professional clinicians don’t need to set the default settings and monitor your hearing but today’s hearing aids definitely are patient focused. From smartphone apps, to automatic settings, to noise reduction and environmental identification, modern hearing aids are the future of hearing healthcare."

Every hearing aid manufacturer is now offering an array of apps - some apps allow the listener to enhance the listening experience by working directly with the hearing aids.  For example Audibel's Trulink app answers calls and streams phone calls and music directly through your hearing aids. You can personalize and geotag hearing aid settings to best suit your environment. You can control volume and memory settings with your iPhone.  You can have as much or as little control as you like.

Other apps have specific functions, such as the Relax app for tinnitus management.  The listener may browse among a selection of "relief" sounds and select the most helpful for his individual preferences, and then stream the sounds to his wireless hearing aids.  We have learned that tinnitus is best managed by a comprehensive program of tinnitus education and sound therapy.  

McGuire's hearing aid dispenser Michael Burke has a patient who has used hearing aids with tinnitus masking for many years, but found that these instruments allowed little control over the tinnitus stimulus available to him.  But with his latest hearing aids and Relax app, he has blossomed into a "techie" and through the app he now decides whether he wants a (virtual) walk through the woods, along a sandy beach, or to sit and listen to birdsong all through the magic of his Relax iPhone app!

Another type of app is the listening exercise exemplified by Hear Coach or LACE. These programs allow the user to train their listening systems (ear to brain) to practice discerning speech in a variety of challenging listening environments.  As we tell our patients, better hearing is not just about making things louder, but also about filtering the sounds that we don't need and home in in on the ones with the information we want.  These games may be thought of as Physical Therapy for the ears!

Study States Fibromyalgia Patients Have Higher Risk of Hearing Loss

According to a recent study done by Norwegian researchers (published by Fibromyalgia News Today), patients suffering from fibromyalgia are 4.5 times more likely to suffer from hearing loss.  Fibromylagia, a musculoskeletal pain disorder that causes chronic pain, affects the central nervous system and may be associated with an overall dysregulation of the nerves. 

Hearing loss appears to be more common for those afflicted with fibromyalgia, and other musculoskeletal disorders, for a long period of time. The loss is attributed to the damage to the inner ear auditory nerve pathways to the brain. The prevailing theory is that all fibromyalgia-related symptoms result from an alteration in the central neural processing of perceptive stimuli.

Fibromyalgia is frequently associated with feelings of “ear fullness,” earache, and tinnitus.  

Our team at McGuire’s specializes in treatment of these symptoms, so please contact us today so we can help you recover any loss or relieve discomfort.

Listening: A Work in Progress

Our listening system is quite amazing.

Imagine you are at a party and there is a group of people chatting. You may be talking to one person for a while, and then you may shift your focus to another. You're still standing in the same spot, but you are able to home in on one conversation at a time. While listening in noise may be tough, we are able to tune in to one speaker while the other becomes part of the background sound.  We have known about this for a long time - it's called the "cocktail party effect" and it's one of the cool things about our amazing hearing system.

A similar process is being studied at the University of California at Berkeley. We've all had this experience, too: initially someone's thick accent seems indecipherable, or you can't make out the lyrics of a song.  You listen again and again, and voila!  The meaning of garbled words pops out.

Recent work suggests that the brain is actually retuning itself to perceive speech information. The UC Berkeley neuroscientist have seen this process in action by recording activity from the surface of a person's brain as the words of a previously unintelligible sentence suddenly pops out. The retuning happens in less than a second!

The researcher Chris Holdgraf says "We believe that this tuning shift is what helps you 'hear'  the speech in that noisy signal. The speech actually pops out from the signal." Co-author Frederik Theunissen adds "Something is changing in the auditory cortex to emphasize anything that might be speech-like, and increasing gain for those features," making the speech more audible in noise.

Another co-author Robert Knight adds "It is unbelievable how fast and plastic the brain is. In seconds or less, the electrical activity in the brain changes its response properties to pull out linguistic information."

Hearing in noise is a challenge for all, and especially for those with hearing loss. But, it is exciting to know that our brains do work to direct our attention and facilitate pulling the message out of the noise. And as we continue to listen, a signal that initially unintelligible may well become clear. Listening is literally a work in progress. If you have hearing aids to help catch more sound, be sure to wear them on a full time basis, and keep listening.

We are Learning More about “Hidden Hearing Loss.”

It may happen once or twice a week:  Someone comes into the office saying they are having difficulty hearing at times when the people with them are not having problems. They may miss the punchline of a joke, or struggle to follow a conversation at a noisy restaurant.  They are not sure if they have normal hearing or not.   We do our testing, and find that the audiogram – the gold standard test of hearing sensitivity – is normal.

Researchers from Massachusetts Eye and Ear have, for the first time, linked difficulty with speech understanding in noisy settings with evidence of a condition known as “hidden hearing loss” in people with normal hearing sensitivity. 

Hidden hearing loss refers to damage to the connections between the auditory nerve fibers and the sensory cells in the cochlea.  This damage precedes the loss of the sensory cells themselves.  Reduced connections likely contribute to problems understanding speech in noisy or reverberant environments, even when the audiogram indicates “normal” hearing.  Lost connections may also play a part in the onset of tinnitus (ringing in the ear) or hyperacusis (sensitivity to loud sounds).

We know that these difficulties do not show up on our routine tests. The researchers at Mass Eye and Ear set out to develop better measures to test for cochlear synaptopathy, that is, damage to the sensory-neural connections.

Diagnostic tests for hidden hearing loss are important to fully assess damage to the inner ear, especially damage induced by noise exposure.  This would give us a more comprehensive understanding of the basis of the problems our patients are reporting.  We can then discuss preventive strategies going forward, and offer assistive technology options such as remote microphones.  Better diagnostic tools are also important is developing future therapies to repair inner ear nerve damage. Research is being done on animals that offer hope that one day connections between sensory cells and auditory nerve fibers can be successfully restored!

This is a work in progress.  Researchers are looking at whether Speech-in-Noise testing or auditory nerve tests can pick up early inner ear damage even before there are audiometric changes.   Clear definitive answers are not here yet, but this is an exciting direction that may lead to better understanding and future solutions.

Meanwhile, protect your ears from excessive sound levels, as we are sure that noise is in part the culprit for inner ear damage, and stay tuned as we learn more.

Dr. Kathleen Campbell: A Career Dedicated to Protecting Ears

When I first read about Dr. Kathleen Campbell's work about 15 years ago, I was blown away. She was testing the use of an anti-oxidant called D-methionine (D-met) in protecting the inner ear from the damaging effects of needed but toxic chemotherapy agents. So often our patients ask if there is a pill to take away their tinnitus or repair their hearing loss, and most of the time the answer is no. There is no FDA approved drug to prevent or treat hearing loss or tinnitus. Dr. Campbell has made her life's work studying ototoxicity (poisoning of the hearing and balance mechanism) and the potential of pharmaceuticals in preventing and managing hearing loss.

Soldiers are exposed to a barrage of potentially damaging noises, and so hearing loss and tinnitus are among the most common injuries sustained in military service.

Ototoxicity has many sources, including chemotherapy medications such as cisplatin, IV aminoglycoside antibiotics and excessive levels of noise. What if we could provide "ear armor" ahead of time to protect against the damaging agents? What if we could treat the ear immediately following exposure and "rescue" the ear from permanent damage?

Imagine the people that might be helped!

• How wonderful it would be if cancer patients could be protected from potential treatment side effects of hearing loss or balance problems, at a time they so need to be able to communicate.
• Do no harm! But sometimes treatments do unavoidable harm. It would be amazing if the heavy-duty IV antibiotics used to treat tuberculosis and cystic fibrosis could be stopped from doing collateral damage to the ear.
• Exposure to intense noise is ototoxic. Soldiers are exposed to a barrage of potentially damaging noises, and so hearing loss and tinnitus are among the most common injuries sustained in military service.

Bringing oto-protective medication to market is a work in progress. Dr. Campbell has been testing protocols and collecting data for many years. Studies thus far show that D-met can provide almost complete protection for cisplatin-induced hearing loss. Important to note, it shows no anti-tumor interference with the cancer therapy. The idea is that oto-protection must protect normal cells, but not cancer cells.

Noise-induced hearing loss is an enormous problem in the military. The Department of Defense and Veterans Affairs spend somewhere between $2 and 4 billion a year on noise related hearing injury. Soldiers with hearing loss have trouble locating where the enemy is coming from and communicating in high background-noise levels. It's the most common disability in the military. It is not surprising that the DoD has funded Dr. Campbell's clinical trials to assess the safety and efficacy of D-met in protecting ears from long term hearing damage.

At this time we cannot walk into our pharmacy with a prescription for oto-protective medication. But it is exciting to know what's in the works, and will soon help patients in treatment, soldiers protecting us, and even ordinary citizens exposed to high levels of sound.

Dr. Campbell has dedicated her career to protecting ears – it is exciting and incredibly useful work.