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Jeff Lane Au. D.

Maintaining the Sounds of Summer

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Most hearing aids also have Bluetooth built directly into them, allowing you to make calls, or listen to music or podcasts while exercising.

As the temperatures increase and the days stretch out, it is clear that summer is upon us. For most, this means spending more time outside, near water or traveling. It also means increased considerations when it comes to caring for hearing aids. Fortunately, hearing aids are built with these considerations in mind.

Moisture

Hearing aids are essentially tiny computers. Thus, the internal electrical components are susceptible to damage from moisture. While most hearing aids are not considered to be fully waterproof, they are highly water resistant. In fact, they have an IP rating of 68. The IP scale refers to an object’s resistance to penetration by solid objects and liquid. The second number refers to liquids, with 8 being the maximum resistance. Thus, most hearing aids are able to hold up well against rain, sweat and humidity. So, for most people, as long as they are being mindful, moisture should not be too much of a concern, even during the summer months.

However, there are special situations. If you live in a humid environment, or in a place where temperatures get especially high (as I experienced growing up in Phoenix), the aids are going to be constantly subjected to moisture in the form of sweat or condensation. Thus, the risk of water sneaking its way inside the casing increases. In these situations, a dehumidifier is very useful. It wicks out the moisture when the user is not wearing them. Rechargeable hearing aids actually have a dehumidifier built into the charger. You would just need to add the desiccant, which can be found in most stores. For those with regular batteries, a standalone dehumidifier may be purchased. They can be electronic or manual, and are quite affordable.

Now, what about those who want to hit the pool or lake to cool off? Again, most hearing aids are not recommended for these types of activities, as they would be submerged. But not being able to hear in these environments isn’t ideal either. Fortunately, for those looking to try hearing aids or upgrade their current set, Phonak has just released the Audeo Life, which is truly waterproof! You can wear it in all types of moisture, including being submerged up to one and a half feet. Beat the heat while still being connected to the world around you.

Travel

According to estimates, 82% of Americans took part in some form of travel last summer. Hearing aids can help patients enjoy their trip to the fullest. Fortunately, hearing aid chargers are compact, making for easy transport. Most charger cords are USB cables, meaning they can be plugged into a port if an outlet is not readily available. In some cases, you might not even need to plug in the charger. Phonak has an external battery, called a power pack, which can be attached to the bottom of the charger case. Oticon has a separate smart charger, which is designed specifically for travel. Both of these options allow a patient to charge their hearing aids for a week without the need for an outlet. This can be convenient in situations such as camping, when electricity may not be readily available.

One risk of summer travel is losing a hearing aid. Some manufacturers, such as Oticon, have a feature on their app called Find My Hearing Aid. If you were to get home and realize you had misplaced one, you could open the app and it would tell you the general location of where it was left. Note that this is not a universal feature among all manufacturers. Also keep in mind that all hearing aids come with a multi-year warranty. If you lose your hearing aid and are unable to find it, the manufacturer will replace it one time for a small restocking fee. You will need to contact your audiologist to do so.

Fitness

Summer is a wonderful time to take evening walks or exercise outdoors. Newer hearing aids are being developed with health and fitness in mind. Some models are able to track step count, while others can even go as far as monitoring your heart rate. This is still a new frontier, but one that is quickly expanding. Most hearing aids also have Bluetooth built directly into them, allowing you to make calls, or listen to music or podcasts while exercising. And it can all be done in one package, eliminating the need for too many accessories on the body.

As always, your audiologist will be able to guide you toward the model that best suits your needs. QCBN

Jeff Lane, Au. D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

What Happens When Hearing Loss Occurs in One Ear?

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Our auditory systems are highly tuned to these slight discrepancies.

Hearing loss presents itself in a unique manner in each individual. Barring hereditary losses, each occurrence will be slightly varied. Some people will have a sensory loss, while others are conductive. Some will occur at birth, while others do not appear until late in life. One aspect that is sometimes glossed over is whether the hearing loss is bilateral or unilateral. Bilateral means the loss occurs in both ears, whereas unilateral is just one ear. Since the majority of hearing losses are bilateral, this tends to be the default assumption. But unilateral hearing losses can occur and present their own unique challenges and treatment options.

Causes and Symptoms

An estimated 7% of adults in the United States have a unilateral hearing loss. The causes can include anatomical abnormalities, acoustic or physical trauma, chronic ear infections and viral infections. Similar to bilateral losses, they can be sensorineural or conductive, and can have different degrees of severity. That second part is important, as it will influence the language that is used. A unilateral hearing loss, as mentioned, is a loss that occurs in one ear, but wherein some degree of useable hearing remains. The term single-sided deafness refers specifically to a profound hearing loss in one ear and normal hearing in the other. That is, the affected ear is dead.

All hearing losses affect quality of life and communication ability. Unilateral losses unfortunately add even more challenges. Namely, they reduce the capacity to hear in background noise and localize sounds. When we hear normally, our brains are able to filter out the noise we don’t want to hear and focus our attention on a specific talker. This is called the cocktail party effect. It’s not that our ears don’t hear all the other commotion; our brains are just able to ignore it all so that we can carry on a conversation.

Localization refers to the ability to know where sounds are coming from in relation to your position (e.g., behind, to the left). To do this, our brains take advantage of something called the head shadow effect. If a sound is coming from the right, it will arrive slightly sooner and louder to our right ear than our left because our heads create a barrier around which the soundwave must travel. Our auditory systems are highly tuned to these slight discrepancies. They compare and contrast the signals from each ear to determine the origin of the sound. However, this system relies on the signals on each side being even, which is obviously not the case if one ear has a hearing loss. The lopsided signal throws us off, making it significantly harder to know where sounds are coming from. The same is true for hearing in noise. In short, there is auditory chaos.

Managing Unilateral Hearing Loss

Fortunately, there are ways to help manage unilateral hearing losses. One, of course, is to put a hearing aid on the affected ear. This will improve sound awareness on that particular side and balance out the ears, which will benefit hearing in noise and localization. However, this is not always an option. In such cases, we look to specialty devices.

CROS

If the hearing loss is too significant, or speech understanding it too poor, putting a hearing aid on the affected ear won’t help. In this case, a CROS could be used. A CROS looks like a normal hearing aid, but instead of delivering the sound to the bad ear, it transfers it to the good ear. That way, the good ear does all the listening, but the user still gets the benefit of improved sound awareness on the bad side.

Baha

A Baha, or bone-anchored hearing aid, is a surgical implant that vibrates the skull. The sound then travels across the head and stimulates the good ear. A Baha is typically used in cases where a hearing aid is not possible, such as an undeveloped ear or chronic infections. It also can be used in cases of single-sided deafness, but again, this would require the bad ear to be completely dead.

Cochlear Implant

A cochlear implant as also surgically inserted and works by skipping past the ear altogether and stimulating the auditory nerve directly. They were recently approved by the FDA for cases of single-sided deafness. Cochlear implants have the most prerequisites, but are a wonderful option for those who qualify.

Unilateral hearing can be frustrating and disorientating, but there is always hope. Reach out to your local audiologist to start your journey toward better communication. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

COVID-19 and the Ear

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Current statistics show that about 13% of COVID-19 patients report hearing or balance symptoms lasting up to two months.

For the past two years, the world has been battling the COVID-19 pandemic. While great progress has been made, there is no denying that it is still a global health crisis. Because of its novelty, questions remain about the long-term effects on those who have contracted the virus. This includes the virus’s impact on the auditory and balance systems. Fortunately, research is beginning to appear. To be clear, it is still in the early stages, but it does provide an idea of what to expect.

Hearing Sensitivity

In recent months, I have had patients who felt that their hearing changed after recovering for COVID-19. Did the virus affect their hearing, or was any possible change coincidental? COVID-19 affecting the ear is certainly possible. Other viruses or severe medical conditions have been known to affect the ear, and more significant cases of COVID-19 appear to affect much of the body.

There are multiple ways the virus could affect a person’s hearing. First, it could cause inflammation of the cochlea or auditory nerve. The cochlea in particular is a very delicate organ, which means any slight disturbance could pose a threat. Cardiovascular disturbances associated with the virus could also restrict blood and oxygen flow to the cochlea.

So, what does the science say? It is still not entirely clear. For one, other coronaviruses (e.g., SARS) have not been seen to impact the ear. However, each virus is unique. Current statistics show that about 13% of COVID-19 patients report hearing or balance symptoms lasting up to two months. A systematic review examining studies related to COVID-19 and hearing loss was published in March. It included both case studies (individual patients) and cross-sectional studies. About half of the case studies reported some form of hearing loss as a symptom of COVID-19. Twelve of the cross-sectional also reported hearing loss as a symptom. The authors estimated the prevalence of hearing loss as a result of COVID-19 to be 7.6%.

While the evidence does seem compelling, two considerations should be noted. First, the majority of the studies were deemed to be of Fair, not Good, quality. Second, three of the studies included in the cross-sectional study performed a full test battery on both positive and negative participants. Two of these studies did not find a significant difference in hearing sensitivity between COVID-19 patients and the control group. Thus, more research needs to be done before hearing loss can be definitively listed as a possible symptom of COVID-19.

Tinnitus

Tinnitus is any sound that a person hears that does not originate form a source in their environment. It is often experienced in conjunction with hearing loss, but they can exist independently. The systematic review mentioned previously estimated a prevalence of about 14.8% in COVID-19 patients. However, it was unclear whether the virus caused the tinnitus, or had simply made it worse. It is also possible that the stress of suffering through COVID-19 might be exacerbating the tinnitus. Studies do show that when a person is under more stress, they tend to rate their tinnitus as being more severe or bothersome.

There is a possible physiologic link between the virus and tinnitus. Sensory cells in the cochlea are referred to as hair cells, because of their appearance. There are inner hair cells and outer hair cells. Outer hair cell damage has been shown to have a positive correlation with tinnitus. We can measure outer hair cell status with otoacoustic emissions (OAEs). One study showed that COVID-19 patients had significantly reduced OAEs. Again, this was only one study, but it is worth noting.

Balance

Vertigo and dizziness have also been reported by those with COVID-19. The March study gave a prevalence range of 3.4% to 7.2%. However, the studies do not seem to acknowledge a mechanism for the dizziness. Based on what we know about the balance system in general, it could be a result of the virus attacking the vestibular nerve. Or, it could be simple dehydration or exhaustion. No matter the cause, it does seem to be a possible symptom.

As stated before, more research needs to be done to determine the possible effects of COVID-19 on the audiovestibular system and the likelihood of developing such symptoms. But it does seem something to bear in mind. If you or a loved one develops symptoms following COVID-19, let your audiologist know to help aid understanding and receive the appropriate care. QCBN

By Jeff Lane, Au. D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.

Hearing Mythbusters

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With the internet being ubiquitous, information is easier to access than ever. However, that does not mean that the information is necessarily correct. This sentiment is especially relevant when it comes to health advice. One might read that carrots help improve eyesight; in actuality, this was wartime propaganda to disguise radar technology.

Given the daily onslaught of information, it can be difficult to determine what is factual.

Cleaning Your Ears

Earwax is not innately bad. In fact, it offers multiple benefits! It can serve to keep bugs out of your ear canal and studies have shown it possesses antibacterial and antifungal properties. Of course, too much of a good thing can begin to cause issues. Impacted earwax (i.e. filling the entire canal) can cause hearing difficulty and discomfort. Realistically, though, the majority of people are not at risk of impacted earwax. The skin in the ear canal grows outward, carrying excess wax with it. However, people with stiff or curvy canals, or those who naturally produce a lot of wax, may find that it starts to build up. What are the options for someone in the latter category?

Odds are Q-tips spring to mind. After all, who doesn’t love scrubbing their ear canals after a nice shower? But Q-tips do pose some risk. First, the wax may be inadvertently pushed further down the canal. More concerning, the Q-tip may be inserted too deeply and cause pain or harm. If use cannot be resisted, hold the Q-tip near the end and clean only the outer portion of the canal.

Another common home remedy is an ear candle. In theory, a hollow candle is placed into the ear canal and the opposite end is lit, creating a pressure which removes debris. However, no scientific evidence supports the efficacy of ear candling. Quite the opposite is true. The literature states that ear candling has at best a neutral effect, and can actually pose some risks. There have been reports of burns, infections and even candle wax and ash deposits in the canal.

The best way to prevent buildup is to keep the earwax moist. If the wax is dry and hard, it cannot flow out of the canal as easily. Debrox is the name of popular and safe over-the-counter drops designed to clean the ears. Mineral oil is another reliable, natural preventative measure. Olive oil should be avoided, as it is too thick.

Of course, medical professionals can remove the wax as well. Audiologists regularly have standing appointments every few months to clean out patients’ ears.

Treating Tinnitus

Tinnitus is a condition in which a person hears a sound despite there being no external stimulus to produce said sound. It may sound like ringing or cicadas, although it differs for everyone. At the time of writing, there is no known cure for tinnitus. Unfortunately, there are many medications hawked as treatments. The majority tend to contain a supplement called ginkgo balboa. No studies to date have shown that ginkgo balboa or any other supplements have any effect on tinnitus. There is no inherent danger from these medications, but any perceived benefit is likely a placebo effect.

While tinnitus cannot yet be cured, there are daily strategies that can help manage the severity. First, stress should be minimized as much as possible. Studies show that when people are under more stress, tinnitus tends to be rated as more severe or bothersome. Diet has also been shown to play a role. Caffeine, salt, sugar, alcohol and nicotine play the biggest role in causing tinnitus to flare, but different individuals can be affected by certain foods. Reducing intake of any of the above may offer some relief. Another strategy, although not always simple, is to not focus on the tinnitus. Focusing on the noise will cause stress, which can exacerbate the noise.

Many people find that having background noise, such as television or a white noise machine, can help to mask the noise they hear in their ears. If someone needs consistent noise, hearing aids have the capacity to play customized masking sounds. Additionally, the literature shows that simply wearing hearing aids can offer significant relief for many people. Please note that counseling options are also available for more severe cases.

If you are unsure if a piece of information is accurate, ask your hearing care provider. Extensive schooling and continuing education ensure their knowledge remains current. Accurate information is the greatest tool in remaining healthy. QCBN

By Jeff Lane, Au. D.

Dr. Jeff Lane is an audiologist at Trinity Hearing Center, located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Dr. Lane has a passion for improving the lives of others and may be reached at 928-522-0500 or at audio@trinityhearing.net.

 

Understanding Your Audiology Results

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The first step on any hearing health journey is undergoing an examination. This exam provides you and the audiologist an understanding of your current state of hearing and allows for proper recommendations to be made. The findings are presented in a report called an audiogram. An audiogram contains both a written section and a graph. While the audiologist does review the audiogram during the appointment, it can sometimes be difficult to remember or fully grasp how to interpret your results. Proper interpretation is imperative, as it empowers you to be an equal part in treatment.

Hearing Thresholds

Hearing thresholds are presented graphically on the audiogram. The x-axis of the graph (left to right) represents frequency. Frequency is interpreted by humans as pitch, with increasing frequency corresponding with increasing pitch. Pitch increases from left to right along the x-axis. Thus, the left half of the audiogram would represent bass, while the right half would be treble. An average exam will test frequencies between 250 and 8,000 Hz. While human hearing can detect frequencies above and below this range, these are the most important for daily communication.

The y-axis (top to bottom) represents intensity as measured in decibels hearing level (dB HL). On this scale, 0 dB HL does not represent the absence of sound, but rather the quietest sound that the average adult can hear. Intensity is interpreted by humans as loudness. A higher decibel level corresponds to a louder sound. Quiet sounds are at the top of the graph, while very loud sounds are at the bottom of the graph.

Your ears function both as combined and independent systems. As such, the audiologist will want to test the respective performance of each ear. The hearing thresholds for the right ear are represented by circles or triangles, while the left ear thresholds are Xs or squares. Hearing thresholds are the quietest sound you can hear at a given frequency. For example, the right ear threshold at 1k Hz may be 20 dB HL. This would mean that at that specific frequency, the right ear can hear the sound when it is 20 dB HL or louder, but not below that level. This will hold true for the threshold of each respective frequency. For normal hearing, 20 dB HL is considered to be the cut-off, with 21 dB HL and higher representing increasing degrees of hearing loss.

Speech Understanding

Another main component of a hearing exam is speech testing. Speech test results may be found in numerical form in a box typically located at the bottom of the page. Two main speech tests are typically performed. The first is the speech recognition threshold (SRT). It represents the quietest level at which you can understand speech 50% of the time. The SRT mainly functions as a way to verify accuracy within the test battery. A measurement which is more relevant to daily communication performance is the word recognition score (WRS). Your WRS represents how well your brain can interpret speech sounds and is reported as the percentage of words repeated correctly. When measuring the WRS, the words are presented at a loudness level that is easy for the patient to hear. A high WRS means you can understand words well, while a lower WRS means that the brain has difficulty interpreting the speech sound because of distortion in the auditory system.

Relationship Between Thresholds and Speech Understanding

One important concept to understand is that your hearing thresholds and ability to understand speech are not necessarily correlated. Better hearing thresholds do not always mean a better WRS, nor do worse thresholds always mean a worse WRS. Indeed, two individuals may have the exact same hearing thresholds, yet drastically different abilities to understand what is being said. What then, influences your WRS? It all has to do with the frequency filters in your ears. Each speech sound has a different fundamental frequency. Sounds like “shh” have a higher frequency than “oo” would. When sound is picked up by your ears, it is sent through specially designed filters to help separate out all the speech sounds. As more damage occurs to the auditory system, those filters become less precise and overlap with each other. Thus, “shh” and “oo” may appear to your brain to be coming from the same filter and it has difficulty distinguishing them.

While many factors are taken into account when deciding treatment, test results are a main one. By possessing a greater understanding of your results, you can feel confident in the decisions being made. QCBN

By Jeff Lane, Au. D.

Dr. Jeff Lane is an audiologist at Trinity Hearing Center, located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.