SIGNS AND CONSEQUENCES OF HEARING LOSS

Hearing loss can happen to anyone. It does not discriminate because of age, gender, demographic background or ethnicity. In addition to the noticeable signs of hearing loss, including asking for repetition or saying “What?” there are some warning signs that are not as obvious.  One of the most challenging aspects of hearing loss is the gradual progression in which it appears for some patients. Research shows it takes more than seven years from the time a patient notices they have to....

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AUDIOLOGIST VS. HEARING INSTRUMENT SPECIALISTS

With the addition of hearing aids to chain stores, there are more places than ever to purchase such devices. Making it even more complicated, there are also different levels of hearing health care professionals capable of working with individuals who have hearing loss, including audiologists and hearing instrument specialists. Understanding the key differences between these professionals will allow patients to make more educated decisions regarding their hearing health.

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HEARING AIDS VS. OVER-THE-COUNTER DEVICES

One of the most common questions I get after recommending hearing aid technology to a patient is: Why are they so expensive? This question not only stems from pricing advertised by local hearing healthcare providers, but also over-the-counter (OTC) devices that can be purchased for a fraction of the cost.

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RINGING OR NOISES IN THE EARS?

Tinnitus (pronounced tin- uh-tus) is the perception of sound when no external stimulus is present. The U.S. Centers for Disease Control and Prevention estimates approximately 15 percent of the general public (over 50 million Americans) experience some form of tinnitus. Of that, nearly 20 million individuals struggle with chronic tinnitus that is considered a burden, while 2 million have extreme tinnitus that is often debilitating.


There are two types of tinnitus, subjective and objective. Subjective tinnitus is tinnitus that only the patient perceives. It cannot be heard externally. According to the American Tinnitus Association, more than 99 percent of all reported tinnitus cases are subjective. Objective tinnitus is noises that are audible to many individuals at one time. These sounds can often include hearing circulatory (blood flow) systems. This type of tinnitus occurs in less than 1 percent of all tinnitus cases.


Many people describe tinnitus as a “ringing in the ears,” but there are actually three different ways to describe tinnitus: tonal, pulsatile or musical.


Tonal tinnitus is a type of subjective tinnitus that can be described as a ringing, humming, buzzing, whistling, clicking, swooshing or chirping sound. The volume at which these tonal sounds occur can vary.

Pulsatile tinnitus is a form of objective tinnitus that is described by the pulsing nature of the sound. The pulsing is typically in sync with an individual’s heartbeat. If you experience this type of tinnitus, please contact a physician so they can ensure there is no circulatory cause for it.


Musical tinnitus is the perception of music or singing. This is also known as Musical Ear Syndrome and is quite rare.


THE CAUSES OF TINNITUS

Tinnitus can manifest in one or both ears, occurring intermittently or continually. It is a symptom of an underlying health condition. For most individuals, tinnitus is associated with damage to the ear or auditory system; however, there are roughly 200 different health disorders that can cause tinnitus as a symptom. If there is concern about why an individual has hearing loss, it is pertinent they discuss this with their medical provider to determine the root cause.


HEARING LOSS.

Permanent, sensorineural hearing loss is often associated with tinnitus, specifically age-related hearing loss and noise-induced hearing loss. Age-related hearing loss often starts around age 60 years and tends to affect both

ears, specifically targeting the high frequencies. Noise-induced hearing loss is caused by exposure to loud sounds, including noise from work (farming, construction, heavy machinery), hobbies (motorcycles, woodworking, concerts, shooting range) and/or by accident (traumatic noise).


OBSTRUCTIONS IN THE MIDDLE EAR.

Excessive ear wax, foreign objects or dirt and head congestion can cause the perception of tinnitus due to an imbalance of pressure between different areas of the ear.


TEMPOROMANDIBULAR JOINT DISORDER.

The temporomandibular joint (TMJ), where the lower jaw connects to the skull, is located in front of the ears. Damage to the muscles, ligaments or cartilage in the joint can lead to tinnitus.


TRAUMATIC BRAIN INJURY.

In these cases, the brain’s auditory processing areas are damaged and can generate the symptom of tinnitus. This is a major cause of tinnitus for men and women in the military. Approximately 60 percent of all tinnitus cases diagnosed by the U.S. Veterans Administration are attributable to mild to severe TBIs.


OTOTOXIC DRUGS.

Tinnitus is a side effect to many prescription medications. Often a patient stops experiencing tinnitus once the medication is discontinued. This side effect should be discussed with the prescribing physician. Other medications can cause more permanent tinnitus symptoms, including specific antibiotics, some cancer-treating medications, water pills, diuretics and quinine-based medications. Again, if you are worried your medications are the cause of tinnitus, please speak with the prescribing physician first before discontinuing them.


IMPACT OF TINNITUS ON AN INDIVIDUAL.

Many patients have expressed tinnitus negatively impacts their life. Tinnitus can interfere with the ability to work and socialize and has also been associated with anxiety, sleep disturbances, frustration, lack of concentration, social isolation, depression and mood swings.


TREATMENT.

Researchers are still investigating tinnitus to determine the location of where it occurs in the brain. One common theory is tinnitus is the brain’s way of filling in for missing sounds it no longer receives because of damage. Because this research is still taking place, there is no FDA- approved cure for tinnitus, but there are several treatment options that can ease the perceived burden of tinnitus. Current treatment options include hearing aids, cochlear implants and sound therapy.


If you or someone you know experiences tinnitus, take the first step by contacting an Audiologist for a hearing evaluation and have a detailed conversation about the options that are most appropriate for you or that individual. For further information, visit the American Tinnitus Association’s Web site at www.ata.org.    

DR TIFFANY BREWER

Dr. Tiffany Brewer completed her Doctor of Audiology (Au.D.) at the University of Louisville’s School of Medicine and her undergraduate degree in Speech Pathology and Audiology at Miami University in Oxford, Ohio. She is licensed by the state of Kentucky as an Audiologist and Hearing Instrument Specialist.

more articles by Dr Tiffany Brewer