Inner Ear Disorder Can Easily Be Treated

BPPV can easily be treated.

Benign Paroxysmal Positional Vertigo (BPPV) is the most common type of dizziness, and happily, the most easily treated. In many patients, it can be cured with a simple series of movements.

BPPV occurs when tiny crystals called otoconia become loosened from their normal location in the inner ear.   They are then free to flow in the semicircular canals, the part of the inner ear that senses movement of the head.

Patients with BPPV may experience dizziness or spinning when they turn over in bed, get in or out of bed, look up to a high shelf or put their head back in the shower. They may become unsteady when they arise. They may even experience nausea and other motion sickness like symptoms.

The onset of BPPV may be abrupt and scary. The usual course of the illness is a gradual improvement over weeks to months.  However, if properly diagnosed and treated, we often facilitate your recovery.

If you are having dizziness when you change position, ask your physician if a VNG is an appropriate part of your assessment.

If the VNG test indicates you have BPPV, an audiologist will guide you through a simple series of movements to return the loose crystals where they belong. The patient follows directions on simple movements, seated, and lying down, and then in a seated position once again. The activity is quick, painless and easy.

Not all patients with dizziness have BPPV. If you are having problems with dizziness, vertigo or balance, ask your physician if a VNG (videonystagmography) may be part of your dizziness workup. VNG is considered the "gold standard" test of inner ear balance function, and if you have BPPV, there's a good chance that a licensed audiologist can help you.

Hearing Aids VS. PSAPs - Do You Know the Difference?

Pardon the pun, but by now many of us have heard about PSAPs, or personal sound amplification products. These devices, which are being touted as the second coming in hearing aid advancement, are becoming evermore popular with their lower prices and ease of purchase over conventional hearing aids.

This popularity is understandable since they appear to offer some of the same advanced technology used in expensive hearing aids…and promise to give you super hearing for pennies on the dollar.

In truth, there is technology in them that enables these PSAPs to amplify sound, which, under certain conditions can be very effective. However, amplify is the key word here. That’s where the differences between PSAPs and actual hearing aids begin to show themselves.

While not being totally disingenuous, companies selling these PSAPs are not completely forthcoming either. What they don’t tell you is that, these are not hearing aids. These are instruments designed for people with no hearing issues. That’s right. If you have low to moderate hearing loss or above, these OTCs (over the counter) products do nothing to address those issues in any clinical manner.

In fact, many fall quite short when it comes to performing even as advertised. Moreover, these are one-size fits all sound amplifiers with volume control and in some instances, noise filters.

What’s Wrong With That as Long as it Makes it Louder?

Nothing, if all you need is more volume. However, many people with a hearing impairment need more than just an instrument that cranks up the volume. One example, depending on your degree of hearing loss, is being unable to discern words, which is a common source of frustration. If words sound foggy or like a wall of sound, turning up the volume is only going to get you a louder wall.

It is Best to Consult a Professional

A professional Audiologist is familiar with all types and degrees of hearing loss. They are trained to know what to look for, to recognize the degree of hearing loss you may suffer (if any) and how best to address any issues moving forward.

Today’s hearing aids are technologically advanced and can be fine-tuned to maximize your ability to hear with the proper volume and clarity, while targeting your specific areas of need. You just can’t get that from an amplifier.

When it comes to your hearing, don’t take chances with a device you can pick up off a convenient store counter. Seek out a professional for proper evaluation and treatment. 

Surprising News about the Link Between Dementia and Hearing Loss

Has hearing loss slowly crept up on you? Many people think of aging-related hearing loss as a minor annoyance, not a serious health issue. But there is evidence that hearing loss could be directly related to the onset of dementia, according to a joint study in 2011 by Johns Hopkins University and the National Institute on Aging. 

Researchers aren’t sure why there’s a connection between hearing loss and dementia. One theory is that the social isolation experienced by people with hearing loss makes them more vulnerable to cognitive problems like dementia. Another possibility is that the onset of dementia is related to the cumulative stress of trying to make sense of garbled sounds. Scientists say that when you’re extremely focused on translating random sounds into an understandable sentence, there’s no brain power left for other functions. The technical term for this struggle is “cognitive load.” 

Meanwhile, it’s clear that proactively guarding your hearing health provides multiple benefits. Good hearing health – and cognitive health —starts with a simple hearing check. If you’ve noticed any difference in your hearing, or if others have pointed out that you may have a hearing problem, experts say that you should make an appointment with an audiologist to assess the situation. And if you already use hearing aids but feel that you may be missing some parts of conversations, it’s a good idea to have your hearing aids reprogrammed or replaced by a specialist.

Did you know that these problems can be caused by hearing loss?

• Isolation and loneliness
• Relationship difficulties
• Fatigue
• Memory and attention lapses
• Depression and anxiety

If your quality of life has diminished because of hearing loss, consider contacting a hearing professional. Your personal hearing solution may be simpler than you think.

Hearing Loss Linked To Falling

Hearing loss has been linked to a wide range of health problems, in addition to social challenges.

Now a new study finds that subjects who have a hearing loss are three times more likely to fall than their peers who reported no hearing loss.

Study investigator Frank Lin, an assistant professor in the Johns Hopkins School of Medicine and the university's Bloomberg School of Public Health, and his colleague Luigi Ferrucci, of the National Institute on Aging, noted a correlation between subjects who reported at least a "mild hearing loss" of up to 25 decibels, and the frequency of falls.

Lin and Ferrucci found that people with a mild hearing loss were nearly three times more likely to have a history of falling. Every additional 10 decibels of hearing loss increased the chances of falling by 1.4-fold. The study's finding still held true even when investigators accounted for factors linked with falling, including age, sex, race, cardiovascular disease and vestibular function. Even excluding participants with moderate to severe hearing loss from the analysis didn't change the results.

The study utilized data from the 2001 to 2004 cycles of the National Health and Nutrition Examination Survey. This research program has periodically gathered health data from thousands of Americans since its inception in 1971.

The researchers' findings are published in the Archives of Internal Medicine.

Lin suggests that the reason for the strong correlation may be the fact that individuals with hearing loss could have a compromised sense of awareness in their overall environment, making tripping and falling more likely. Another reason hearing loss might increase the risk of falls, Lin says, is cognitive load, in which the brain is overwhelmed with demands on its limited resources.

"Gait and balance are things most people take for granted, but they are actually very cognitively demanding," Lin said. "If hearing loss imposes a cognitive load, there may be fewer cognitive resources to help with maintaining balance and gait."

Dr. Mary Bohr, Director of Audiology at McGuire's Hearing Aids and Audiological Services, agreed with Dr. Lin's assessment. "We recognize the importance of taking a thorough history for each patient we see and of updating that history at least once a year. Information regarding falls and unsteadiness is very important to us. Statistically, at least 50% of visits to the primary care specialist by people over 65 are due to complaints of unsteadiness," she observed.

"This very important research by Dr. Lin reiterates the need to examine the whole person, not just the complaint. We hope that physicians will address the observations Dr. Lin made and treat hearing loss as a significant factor in patient well-being both physically and psychologically," Dr. Bohr concluded.

Hearing Loss and Teens

Last month, the Journal of the American Medical Association stunned America when the publication announced the results of a recent hearing study conducted on teens.

The study showed that one in five teens exhibited a slight loss of hearing, affecting only one ear and involving mostly high-frequency sound. One in twenty teens, however, showed "moderate, progressive" loss.

"It's not a stretch to attribute these losses to the prolific use of loud-playing MP3s, concert attendance and other environmental factors," noted Dr. Mary Bohr, Director of Audiology at McGuire's Hearing Aids and Audiological Services.

"One of the best ways to combat this trend is to educate teens and their parents about healthy hearing habits," she added.

Scientists believe that, depending upon the type of noise, the pure force of vibrations from loud sounds can cause hearing loss. Recent studies also show that exposure to harmful noise levels triggers the formation of molecules inside the ear that contribute to hair cell damage and noise-induced hearing loss, or NIHL. These destructive molecules play an important role in hearing loss in children and adults who listen to loud noise for too long.

NIHL occurs based on three factors the decibel level (loudness) of a sound; the amount of time you are exposed to it; and the distance you are from the source of the sound. In addition, the impact of noise adds up over a lifetime. If you are exposed to loud sounds on a regular basis, your risk for permanent damage adds up as you age.

NIHL is also related to a person's genes. Some people are more likely than others to develop NIHL when they listen to certain sounds. Scientists are working to determine why some people are more at risk for NIHL and why some face less risk. For this reason, it is wise to protect our hearing when we are exposed to loud noise.

Researchers who study hearing loss in the workplace have found that a person who is exposed to noise levels at 85 decibels or higher for a prolonged period of time is at risk for hearing loss. An MP3 player at maximum level is roughly 105 decibels. Scientists recommend no more than 15 minutes of unprotected exposure to sounds that are 100 decibels. In addition, regular exposure to sounds at 110 decibels for more than one minute can result in permanent hearing loss.

Dr. Bohr advises patients to avoid risking NIHL by practicing the following:

• block loud noises by wearing headphones, earplugs or earmuffs
• purchase earbuds that offer a custom fit for you and allow optimal MP3 use without excessive volume . Newly developed earbuds are now available at McGuire's which actually control the loudest sounds from MP3 and IPods so that they never exceed allowable limits.
• avoid the noise by distancing yourself from the source or leaving an area entirely
• cover your ears with your hands if exposed to loud environments temporarily
• turn down the volume of MP3s, stereos, or other devices that emit loud sounds

"If you believe you may have a hearing loss, contact a certified audiologist who offers a free hearing screening with no obligation," Dr. Bohr suggested. "Only a professional hearing practitioner can determine if you have a hearing loss and offer solutions for better hearing," she noted.

Study Links Exposure to HIV in Womb To Later Hearing Loss

Children exposed to HIV in the womb may be more likely to experience hearing loss by age 16 than are their unexposed peers, according to scientists in a National Institutes of Health research network.

The researchers estimated that hearing loss affects 9 to 15 percent of HIV-infected children and 5 to 8 percent of children who did not have HIV at birth but whose mothers had HIV infection during pregnancy. Study participants ranged from 7 to 16 years old.

The researchers defined hearing loss as the level at which sounds could be detected, when averaged over four frequencies important for speech understanding (500, 1000, 2000, and 4000 Hertz), that was 20 decibels or higher than the normal hearing level for adolescents or young adults in either ear.

"Children exposed to HIV before birth are at higher risk for hearing difficulty, and it's important for them—and the health providers who care for them—to be aware of this," said George K. Siberry, M.D., of the Pediatric, Adolescent, and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that leads the research network.

Compared to national averages for other children their age, children with HIV infection were about 200 to 300 percent more likely to have a hearing loss. Children whose mothers had HIV during pregnancy but who themselves were born without HIV were 20 percent more likely than to have hearing loss. The study was published online in The Pediatric Infectious Disease Journal.

"If parents and teachers know the child has a hearing problem, then they may take measures to compensate in various communication settings, such as placement in the front of the classroom or avoiding noisy settings," explained Howard Hoffman, M.A., director of the Epidemiology and Statistics Program at the National Institute on Deafness and Other Communication Disorders (NIDCD), which provides funding to the network for studies related to hearing and language.

Even a mild hearing loss in children can delay the acquisition of language skills. More severe hearing loss may require the use of assistive devices, such as a hearing aid. Information on hearing and deafness is available from NIDCD.

To determine the types of hearing loss the children experienced, the researchers conducted these evaluations:

• Physical examination of the ear canal
• Evaluation of the middle ear function, how sound vibrations are transmitted through the middle ear bones
• Responses to tones presented over earphones

Hearing loss may occur from damage to the bones and structures in the ear canal and inner ear, or from damage to the nerves leading to the brain.

First author Peter Torre III, Ph.D., of San Diego State University, led the study with Hoffman, Siberry and six other coauthors. Collaborators were from the Harvard School of Public Health, Boston; the University of Kansas, Lawrence; and Tulane University School of Medicine, New Orleans.

The research was conducted as part of the Pediatric HIV/AIDS Cohort Study network, led by NICHD in cooperation with and with cofounding from NIDCD and several other NIH institutes, including: the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Heart Lung and Blood Institute, and the National Institute on Alcohol Abuse and Alcoholism.

More than 200 children and teenagers participated. All had been exposed to HIV before birth, and about 60 percent were HIV-positive at the time of the study. Researchers conducted hearing tests on the children if their parents or caregivers had reported hearing problems, they had low scores on a standard test of language or their health care providers detected hearing problems during standard hearing screenings.

The researchers classified participants who could not hear tones below a certain volume as having hearing loss with difficulties in quiet and noisy settings. The researchers documented a greater proportion of hearing loss cases among HIV-positive children and found that those who had developed AIDS at any point were even more likely to have hearing loss—even if the disease was under control at the time of the study.

Earlier studies have found that children with HIV are susceptible to middle ear infections. Repeated middle ear infections can cause hearing loss. However, in 60 percent of cases in the study, hearing loss was the result of problems with the transmission of sound from the nerves of the ear to the brain, rather than to damage in the middle ear resulting from ear infections.

"Although ear infections are more common among children with HIV, these do not appear to be the reason their hearing is more likely to be compromised," said Torre.

Hearing Aids Reduce "Ringing" In The Ears

A new study recently conducted by the Better Hearing Institute (BHI) has found that nearly thirty million Americans – or ten percent of our population – suffer from chronic tinnitus, or "ringing in the ears."

In fact, tinnitus was recently indicated to be the number one service-connected disability of military personnel returning from service in Afghanistan or Iraq.

Sufferers of tinnitus generally describe the noise as a ringing, a humming, or a buzzing. The sound can be constant or intermittent, and in one or in both ears.

"Persistent, chronic tinnitus is a highly intrusive, increasingly common condition that can interfere with a person's cognition, ability to interact with family and friends, and basic life functions," stated Jennifer Born, study co-author and the Director of Public Affairs at the American Tinnitus Association.

The leading cause of tinnitus is extreme exposure to noise. Those suffering from the condition almost always have hearing loss in conjunction with tinnitus. Yet, the researchers involved the study were surprised by the number of respondents who initially reported that they had tinnitus, but no hearing loss. After testing them, however, the study authors discovered that the majority of the respondents did, indeed, have hearing loss.

"It's very likely that these individuals were aware of their tinnitus but not their hearing loss – which would indicate that the population with hearing loss is much larger than previously believed," noted study co-author Dr. Sergei Kochkin.

"People suffering with tinnitus should seek the counsel of an audiologist so that appropriate remedies are explored," said Dr. Mary Bohr, Director of Audiology at McGuire's Hearing Aids and Audiological Services. "It's quite possible that a patient's tinnitus can be helped by hearing devices."