Jeff Lane

Hearing Aid Myth Busters

September 3, 2023 By quadcities Leave a Comment

Within the lifespan of the warranty, the manufacturer will replace each hearing aid one time for a small fee.

While millions of people are affected by hearing loss, it remains a disability that does not receive much focus. The general public receives very little education on the effects of hearing loss or how to address it. They must seek out answers on their own. This is reflected in many of the common questions patients ask about hearing loss and hearing aids. A prior article answered the most common ones. Here are a few more frequent inquiries.

How Often Should I Wear My Hearing Aids?

As a rule of thumb, it is recommended to wear the hearing aids as much as possible. Especially during the initial adjustment phase, consistent use helps your brain to adapt more quickly. That is, it will take less time for the signal to sound more natural. When hearing aids are worn sporadically, your brain in excited by the “new” sounds it is noticing every time you use them. Studies also show that wearing hearing aids helps to maintain good memory function.

Of course, there are times when it is recommended that aids not be worn; for example, when sleeping. If you happen to fall asleep while wearing hearing aids, it will not damage the devices or cause the wearer any harm, aside from possible discomfort. In fact, some patients who live alone like to keep one on to feel safer at night. But most people remove them at night. Rechargeable hearing aids require removal, as they need to be charged nightly.

It is also advisable to not wear hearing aids when swimming or bathing, as this can damage the devices. (If you have waterproof hearing aids, this is not a concern.) They should also be removed when around loud sounds like machinery or firearms. Hearing aids are able to differentiate between soft, average and loud sounds and process them differently. However, they do not protect the ears from dangerously loud sounds. Thus, hearing protection should still be worn in such situations. Overall, you will figure out what works best based on your lifestyle.

What Happens if I Lose My Hearing Aids?

First, it should be noted that losing a hearing aid is a fairly rare occurrence. When fit properly, they stay in the ear very securely. But life happens. If a hearing aid does get lost, retrace all your steps and look in every possible crevice. Hearing aids are relatively small and good at hiding. Also check places that seem less likely, such as the clothes hamper. Hearing aids can get pulled off when removing shirts or sweaters. Take a day or two of searching to be entirely certain. Once you have confirmed it is lost to the abyss, call your audiologist.

All hearing aids come with a warranty, usually three years. Part of the warranty covers repairs. The other portion covers loss. Within the lifespan of the warranty, the manufacturer will replace each hearing aid one time for a small fee. The fee will vary from office to office, but is typically pretty nominal compared to the cost of a new hearing aid. You must contact the audiologist, as manufacturers don’t allow the patients to order replacements themselves. If the same hearing aid is lost a second time, you would then be responsible for the cost of a new aid.

It should be noted that some manufacturers do offer the ability to track missing hearing aids, like locating a lost cell phone. The manufacturer’s app must be downloaded and paired to the aids for this feature to work. You can press “Find My Hearing Aids” and the app will provide you with their general location. Oticon is one manufacturer that allows for tracking. Phonak does not. The audiologist will be able to let you know whether this feature comes with your specific model. But, again, it always requires the app to work.

Do I Need to Clean My Hearing Aids?

Fortunately, modern hearing aids are very durable and require only simple maintenance. If you have a receiver-in-the-canal or in-the-ear aid, there is a filter on the end of the wire called a wax trap. It should be changed once a month to ensure that the signal is not being blocked by earwax. A tissue, dry cloth or brush can be used to remove debris from other portions of the aid. If your aid has a tube, the tube should be replaced every six months, as a hard tube can distort sound.

Always feel free to contact your audiologist with any questions that may arise. 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.

Sounds of Summer

July 31, 2023 By quadcities Leave a Comment

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

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 your current set, Phonak has 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 partook is 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 manufactures, 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 multiyear 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 heartrate. 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

By Jeff Lane, Au. D.

Dr. 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.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net.

Understanding the Difference Between an ENT and Audiologist

July 1, 2023 By quadcities Leave a Comment

Ultimately, the goal of both audiologists and ENTs is to help improve the lives of their patients.

Hearing health care can be a steep learning curve for many patients. It’s not something which is commonly discussed until help is required. One common question is the difference between an audiologist and an ear, nose and throat (ENT) physician. In actuality, both of these providers work together closely to holistically treat the patient. But the two are distinct professions with important distinctions.

Scope of Practice

Before delving into the differences, it is important to define the idea of “scope of practice.” Scope of practice refers to the services a licensed individual is legally allowed to provide. If a treatment is outside the scope of practice, the practitioner cannot perform it, regardless of their knowledge. For example, an audiologist may be trained to identify an ear infection, but prescribing antibiotics falls outside their scope of practice. Scope of practice plays a major role in distinguishing audiologists and ENTs.

What Services are Provided by the Ear, Nose and Throat Physician?

An ENT is a physician who has specialized in that area of the body. They have gone to medical school and have a Doctor of Medicine (M.D.) or a similar degree. ENTs are able to prescribe medicines and perform surgeries and other medical procedures. In the case of ear infections, for example, the ENT could take a culture of the bacteria and prescribe an appropriate antibiotic. If the infections are chronic, they could insert pressure equalization (PE) tubes to provide a long-term solution. Surgical implementation of cochlear implants (CI) or bone-anchored hearing aids (baha) would also be performed by an ENT. All of these services fall under their scope of practice, while falling outside that of audiologists.

While it may seem obvious, it is also valuable to remember that ENTs treat conditions beyond the ears. If somebody has sinus issues, an ENT could treat them. Thyroid disease and infected tonsils can also be treated by an ENT. So, their breadth of services is far wider than an audiologist’s. They are also permitted to make referrals to other healthcare providers. Since they cannot perform hearing evaluations, they will refer to an audiologist (provided they don’t have one working at their practice).

What Does the Audiologist Do?

An audiologist is a medical professional specializing in the diagnosis and treatment of hearing loss, tinnitus and dizziness. While they do have a doctorate, they do not attend traditional medical school with other physicians. Rather, they attend a four-year graduate program and receive a clinical doctorate. In other words, they have a doctorate specifically in audiology, rather than being a general physician who chose a specialty. They are also required to take continuing education courses to keep their knowledge current.

If your main concern is gradual hearing loss, it is best to see an audiologist first. They will be the ones to perform a hearing evaluation and diagnose the type and degree of hearing loss. An ENT will always want a hearing evaluation, so if you plan on seeing one, scheduling with the audiologist first will help to facilitate the process. Once hearing loss is diagnosed, the audiologist can counsel on management options. If hearing aids are determined to be the best solution, the audiologist will order them and then program them and provide education. They will also be the ones to maintain and repair the devices. While a surgeon would implant a CI or baha, the audiologist will be the one to perform all the programming.

If the hearing loss is determined to be caused by a medical condition, such as a hole in the eardrum, the audiologist will recommend that the patient see an ENT for intervention. However, the audiologist cannot provide an actual referral, as it is currently outside the scope of practice. A sudden hearing loss would also be a reason to collaborate with an ENT. (Please note, if you do have a sudden hearing loss, see an ENT first and immediately, as the rate of successful treatment is much higher with earlier intervention.) In essence, an ENT treats medical conditions, while an audiologist manages the symptoms and helps to improve quality of life.

An audiologist can also help to manage tinnitus, provide custom hearing protection, and diagnose and treat vertigo. They can also clean out ear canals.

Ultimately, the goal of both audiologists and ENTs is to help improve the lives of their patients. Hopefully this article has provided some insight and guidance on the role of both individuals. However, if any uncertainty remains, call your local audiologist and they can help to guide you to the correct location. QCBN

By Jeff Lane, Au.D.

Leaping Ahead with Lumity

May 26, 2023 By quadcities Leave a Comment

It’s called Lumity, and patients are stating that the improvements are very noticeable.

Hearing aids evolve at an incredible rate, with the ultimate goal of improving sound quality and clarity. The other goal is making the hearing aids as user friendly as possible. Manufacturers consistently survey their customers to determine what types of innovations are most desirable. Phonak recently launched a new technology platform. It’s called Lumity, and patients are stating that the improvements are very noticeable.

Sleeker

The most common concern patients have, even when they love how their hearing aids sound, is how they fit on the ear. While they are no longer the size of bricks, hearing aids still take up a fair amount of real estate behind the ear. This can cause interference for people who wear oxygen. It can also impact people who wear glasses, although to a lesser extent. There is simply not enough room for everything. Hearing aids can thus fall off more easily or cause discomfort. These patients then end up having to opt for in-the-ear hearing aids, even if that is not what they truly desire.

Masks have also been a big burden for hearing aid users these past few years. The hearing aids can become tangled in the straps, making them difficult to remove. Mask loops might even catch the hearing aid wires when being removed, causing the hearing aid to fly off the patient’s ear. This, of course, can be very frustrating for patients. A handful of patients have even told me that they stopped wearing their aids in public, as they were too afraid of losing them. Luckily, a new design has arrived to solve all of these concerns.

On the Lumity platform, there is a specific style called Slim. It fits behind the patient’s ear like other receiver-in-the-canal aids, and is still rechargeable. However, it is much thinner. Imagine the difference a standard shoe heel and a stiletto heel. The Slim is like a stiletto hearing aid. This allows for less interference with items such as glasses because less space is required. There is also a small curve to the hearing aid, which follows the natural contour of the skull. This curve allows the aid to sit flusher against the head. It also curves around the ear, like glasses frames, which decreases visibility. A fringe benefit of the new design is that the charger is much smaller and easier to transport.

Smarter

The Lumity hearing aids also provide a leap forward in technological quality. This is true whether you opt for the Slim or traditional style, as both possess the same computer chip. One major improvement is processing speed. Lumity can perform hundreds of more calculations per second than the prior platform. From a user standpoint, this means that the automatic program can analyze the environment more quickly and accurately, providing for a clearer sound quality. And it works! Patients who have upgraded to the Lumity from their older sets say that they can hear a noticeable difference.

In regard to specific new features, one is called Motion Sensor Hearing. If two people are having a conversation while walking, the dynamics are far different than if they were sitting still. With Motion Sensor Hearing, the aids can actually measure your movement and adjust accordingly. Another new feature (available only in the premium level) is called Speech Enhancer. Speech Enhancer automatically provides an extra boost to quiet voices. No longer will a hearing aid user have to struggle to understand tiny voices.

Another exciting development with Lumity relates to Wind Block. Wind Block is another background feature that tries to reduce wind noise as much as possible. While Wind Block is not a new feature, it was previously relegated to advanced and premium level hearing aids only. With Lumity, Wind Block has been expanded to all technology levels. In other words, it is now a default feature.

Lumity still offers universal compatibility with cell phones through Bluetooth, as well as an array of accessories. It should be noted that Lumity technology is currently only available in receiver-in-the-canal models. However, it should be available in in-the-ear models in the next few months. If Lumity sounds right for you, reach out to your audiologist. They will be able to answer your questions and help find a solution which best fits you. QCBN

By Jeff Lane, Au. D.

Dr. Jeff Lane is an audiologist at the Trinity Hearing Center.

Using VR in Tinnitus Management

February 25, 2023 By quadcities Leave a Comment

Recently, researchers have looked to fractal tones for use in sound therapy.

The second most frequent request I receive from patients, after improved hearing, is to make their tinnitus go away. While tinnitus is not dangerous, it can certainly diminish sufferers’ quality of life. Unfortunately, there is no known cure for tinnitus. Instead, the focus is on mitigating the impact on daily life. Studies show that amplification, sound therapy, dietary modifications and cognitive behavioral therapy (CBT) are all effective forms of tinnitus management. But are there any new tools to add to the arsenal? Perhaps! Researchers are beginning to explore the use of virtual reality (VR) in helping tinnitus patients, and the initial results are promising.

Sound Therapy

Sound therapy refers to the practice of having tinnitus patients listen to relaxing sounds to lessen the perceived annoyance caused by the tinnitus. Common stimuli can include white noise and nature sounds, such as waves. They are often presented through hearing aids. The stimulus sound masks the tinnitus; the brain focuses on the stimuli, rather than the bothersome tinnitus. It’s similar to putting on your headphones while trying to complete an assignment so you are not distracted by the noises around you. Sound therapy also promotes relaxation, which has been shown to reduce the perceived loudness of tinnitus.

Recently, researchers have looked to fractal tones for use in sound therapy. Fractal tones sound like wind chimes or singing bowls, which most people find inherently relaxing. However, their real benefit is their unpredictability. Because they do not follow a predictable pattern, the listener listens more passively, which promotes a more relaxed emotional state. Studies have shown that fractal tones can be as or more effective than other types of sound.

Virtual Reality

When hearing the words virtual reality, most people likely imagine video games or online communities. However, studies have shown it to be useful in the medical field as well. It can be used to help manage acute and chronic pain. It can also help with mental health conditions such as anxiety. Scientists believe the therapeutic benefit stems from VR’s effect on our limbic system, which helps to control emotional states and reactions. Since the limbic system is believed to be involved in our perception of tinnitus, VR offers an intriguing pathway to relief. Indeed, one study showed VR to be as effective as CBT in addressing tinnitus.

Happy Marriage

So, sound therapy and virtual reality have both proven themselves viable options for managing tinnitus. But what happens if the two are combined? Is the benefit even greater? Fortunately, we have an answer. A. K. Deshpande, et al. (2022) performed an experiment to explore this exact hypothesis.

The authors gathered 20 adult participants with tinnitus in one or both ears. They excluded those with head, neck or spinal injuries, or those who already had a tinnitus masker active in their hearing aids. They then had the participants undergo two treatment paradigms. One involved a session using a commercially available sound therapy in isolation. The second involved those same participants undergoing the sound therapy in conjunction with VR. The VR involved wearing goggles which presented different nature scenes. Each session was performed one week apart, with the order of the sessions (VR first or second) being randomized.

After each session, the effects of the therapies were determined using three self-assessments. However, for our purposes, we will focus on two: tinnitus loudness and Tinnitus Functional Index (TFI). Tinnitus loudness is the perceived intensity of the tinnitus. The TFI measures the perceived negative impact of the tinnitus on the person’s daily life. Both paradigms (sound therapy only and sound therapy with VR) were shown to help lower both the tinnitus loudness and TFI scores. However, there was a statistically significant difference between the two, which favored the inclusion of VR. In other words, the authors showed that combining the two therapies did make them more effective.

These results are obviously quite exciting. Audiologists have a possible new tool in the fight against tinnitus! However, anticipation must be tempered. As the authors discuss, their experiment did not study the long-term effects and efficacy of their treatment. Also, the setup was entirely experimental and designed solely for the study. There is no commercially available, self-contained device that you can buy to replicate this specific treatment. But such significant results in early experiments are encouraging. Contact your local audiologist to discuss currently available treatments and keep an eye on the horizon. 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. Dr. 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.

How to Care for a Loved One with Hearing Aids

December 29, 2022 By quadcities Leave a Comment

Hearing care professionals are always willing to repair or clean hearing aids. Even calling with a simple question is always welcome.

According to the Labor of Bureau of Labor Statistics, 16% of the population provided eldercare between 2017 and 2018. Combine that with one in three people over the age of 65 having a hearing loss, and there is a very good chance you are or will be caring for someone with hearing aids. Hearing care professionals will diagnose the hearing loss and fit the devices. But, once fit, a majority of the daily use and maintenance falls to the wearer. Or, by extension, the caregiver. It is therefore prudent to know how to properly care for hearing aids.

Daily Care

First, take comfort in knowing that hearing aids are more durable than they appear. This isn’t to say one should play catch with them, but, given the proper respect, the aids will hold up just fine to daily life. Perhaps the most important thing is to not get them wet. Modern hearing aids have the highest IP ratings (resistance to dirt and water). This means they can withstand moderate amounts of sweat, rain, and snow. Humidity is also tolerable, although it is recommended that a specially-designed dehumidifier be used. However, if a hearing aid gets soaked (shower, swimming, washing machine), it can cause damage. Bottom line: hearing aids are water resistant, but not waterproof.

It is also important to clean the hearing aids. If the microphones get clogged or there is too much wax on the portion inside the canal, the sound will be diminished. Luckily, cleaning hearing aids is simple. A dry cloth or tissue can be used to wipe off any debris, while a brush can be used to keep the microphone ports clear. Ask the provider if you are unsure of the microphone location. In the case of receiver-in-the-canal (RIC) hearing aids, it is acceptable to clean the domes with soap and water. Just be sure to remove them from the hearing aid first and allow them to try completely before reattaching.

One should also be conscious of pets. Animals, particularly cats and dogs, are attracted to hearing aids. Unfortunately, they are not very gentle and can often cause significant damage. If the aids are not being worn, place them in a container out of reach of any critters.

Putting on Hearing Aids

It is possible that, because of vision or dexterity difficulties, the patient may not be able to put the aids on independently. Here are the best methods for putting hearing aids on somebody else, based on style:

RIC: Hook the aid over the ear. It should sit on top of the ear, between the skull and pinna, with the wire running down the front of the ear. Grab the wire near the dome and gently insert the dome into the canal. Gently push until it settles into place.

Behind-the-ear (BTE): These types of aids will have an earmold, which is custom-molded to the patient. Thus, the mold can be easily inserted and then the hearing aid can be swung over the ear.

In-the ear (ITE): These aids are custom-molded and are contained entirely within the ear. Insert the aid with the battery door facing outward.

Most hearing aids will have indicators to identify the proper ear: red is right and blue is left. If there are no color indicators, the proper ear can usually be determined by holding up the aid and examining the orientation.

Special Considerations

It is possible that the individual being cared for is not always with the caretaker. Perhaps the loved one resides in a nursing home. In this case, the staff can be trained to assist with the hearing aids. Initial training can be done, along with written reminders. When visiting a loved one, the staff can be asked to provide updates on hearing aid use.

Another possibility is that the loved one is sick. If they are admitted to a hospital, it is probably best to hold onto the aids for them, as aids can often become lost in such an environment. The hearing aids can be placed on the patient during visits with family of the doctor, but should be stored at home. If they are transferred to hospice care, it is probably okay to leave the hearing aids with them as a hospice is a less hectic environment.

Caring for a loved one can be challenging. Remember that it does not have to be done alone, even with hearing aids. Hearing care professionals are always willing to repair or clean hearing aids. Even calling with a simple question is always welcome. QCBN

By Jeff Lane, Au. D.

Treating Emotional Disorders with Maskers

July 28, 2022 By quadcities Leave a Comment

Maskers can help by drawing attention away from the chaotic environment around the patient.

Often when discussing hearing aids with a new patient, they’ll ask, “They just make things louder, right?” Yes, hearing aids do amplify auditory signals, but they also offer so much more. In fact, they are like mini-computers for your ears. New models can stream music and count your steps! But perhaps one of the most useful features is the masker. A masker is essentially a customizable static-like noise emitted by the hearing aids. While it can address a variety of conditions, today I want to focus on two: PTSD and misophonia.

Maskers and PTSD

According to the National Institutes of Mental Health, 6.8% of the population will develop PTSD at some point in their lives. Causes of PTSD can vary widely, but the significant impact on the sufferer’s quality of life is consistent. PTSD actually modifies brain volume in the areas regulating stress, impeding the ability to control emotional reactions. In relation to changes in the auditory system, some studies show that physiologic changes decrease a person’s ability to filter out intrusive stimuli and focus on only what they want to hear. Essentially, people with PTSD are more likely to be unable to direct their focus away from environmental sounds. They will be more easily startled by sounds and have stronger emotional reactions.

Maskers can help by drawing attention away from the chaotic environment around the patient. The user will have a steady signal to focus on and sudden sounds will not be as sharp. The masker sound will act to dull the external stimuli to a certain degree. Plus, the masker is totally customizable, meaning it can be programmed exactly as the patient wants. It can also be adjusted over time as needs change.

Studies have also shown that maskers can help manage tinnitus, which has a high comorbidity with PTSD, especially among veterans. Tinnitus in PTSD patients can trigger traumatic memories and is shown to be much more likely to be influenced by external sounds. Plus, tinnitus itself can cause increased levels of stress. Using a masker can decrease the perceived intensity of the tinnitus; thus, lowering stress levels. I want to note that counseling provided by a trained professional is essential to recovery as well, but maskers can be used as part of a multidisciplinary approach.

Maskers and Misophonia

Misophonia is a condition in which certain sounds elicit strong anger and disgust in a person. It is not related to trauma, like the emotional reactions in PTSD sufferers. And it is more severe than the annoyance you might feel when somebody clicks their pen. For those with misophonia, the sound of someone chewing, for example, leads to significant anger that can cause them to lash out at the person making the sound or go out of their way to avoid being near the sound source. Imagine the frustration you feel when planes keep flying overhead, but more intense and for everyday sounds. This is the daily reality for people with misophonia. And, not surprisingly, this can lead to the individual constantly feeling tense and anxious.

For those of you who have misophnoia, there is good news. First, you are not crazy or overreacting. A British study actually performed fMRI on those with misophonia and those without. They were specifically focusing on the anterior insular cortex (AIC), which helps control emotions and integrate bodily sensations, such as hunger or heartbeat. The scans showed that the AIC was far more active in response to certain sounds in those with misophonia than in the control group. In essence, their brains respond disproportionately to trigger sounds, similar to how the immune system overacts for those with allergies.

The second piece of good news is that misophonia can be managed with maskers. Similar to those with PTSD, the masker takes the edge off of the bothersome noises; thus, making the emotional response more manageable. I recently fit a patient with maskers for her misophonia. She reported that she was able to relax more and that the maskers were a great tool for her. Just like with PTSD, counseling services can also be a wonderful treatment. The counselor would work to slowly expose the patient to triggering sounds and reframe their emotional response in a more positive light.

Given that PTSD and misophonia possess emotional components, a team approach with multiple specialties will always provide the best outcome. Ask your audiologist which treatments will best improve your quality of life. QCBN

By Jeff Lane, Au.D.

What Happens When Hearing Loss Occurs in One Ear?

March 30, 2022 By quadcities Leave a Comment

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.

Are You a Cochlear Implant Candidate?

January 28, 2022 By quadcities Leave a Comment

Cochlear implants are a wonderful invention that can vastly improve the quality of life for those who receive them.

Being diagnosed with a hearing loss can cause conflicting emotions. On one hand, the patient now has an answer that validates all of their experiences and struggles. On the other, they must now undergo the process of managing their hearing loss. The sheer number of hearing aid options alone is enough to overwhelm. But another question may complicate matters: Is a cochlear implant appropriate for me? Realistically, for most patients, the answer will be no. But it is important to understand why, and how it works, in order to make the most informed decision.

Who Needs a Cochlear Implant?

The reason that most people don’t need a cochlear implant is that modern hearing aids are very versatile. Hearing aids currently on the market are powerful enough to easily provide proper amplification for severe hearing losses. They are also sophisticated enough to provide a clear signal in most environments. But they do have their limitations. And that is where cochlear implants come into play.

Simply put, hearing aids can only get so loud. If a person’s hearing is beyond the output limit of the hearing aid, they will not benefit. Particularly for those with profound hearing losses, cochlear implants are the best solution. Because of the way cochlear implants function, which will be discussed more in the next section, they are not subject to the same output limits as hearing aids. Thus, they can provide audibility for any degree of loss.

The other factor is clarity. Some people may have a hearing loss that fits within the output range of a hearing aid, but are completely unable to understand speech. For example, a person may have a moderate to severe hearing loss, but only 30% word recognition. So even though the hearing aid makes it easier for them to hear the sound, speech still sounds garbled and unintelligible. It’d be like listening to a loud, fuzzy radio. Again, this type of patient would benefit greatly from a cochlear implant, as studies show it can help to significantly improve speech understanding. Bottom line, if a patient no longer benefits from appropriately fit hearing aids, they become a cochlear implant candidate.

How Does a Cochlear Implant Work?

When a sound wave approaches the ear, it is funneled down the ear canal to the eardrum. The eardrum vibrates in a specific pattern, which moves the bones in the middle ear (ossicles). The ossicles then vibrate the fluid in the cochlea, which is the organ of hearing. The vibrating fluid stimulates the sensory cells in the cochlea, generating an electrical impulse for the auditory nerve. This is how we hear. However, if the sensory cells or nerve are damaged, this prevents the signal from appropriately reaching the brain, which causes hearing loss.

For those with a cochlear implant, the idea is to essentially bypass the ear altogether, as it is too damaged. Instead, an electrode array is inserted into the cochlea, stimulating the auditory nerve directly. A processor connects to the implant via magnet, collecting and modifying the sound, much like a hearing aid would. There is no acoustic signal, so output limit is not a concern. The signal does not have to travel through the ear, so there is not as much distortion. Cochlear implants are also convenient to use, with some being rechargeable and many being Bluetooth enabled. They can also come with accessories, just like hearing aids. An elegant solution for those most in need.

What are the Qualifications?

In contrast to hearing aids, determining cochlear implant candidacy involves many factors. First, of course, is the hearing exam itself. Candidates must have a certain degree of hearing loss and speech recognition ability of 40% or less. Your audiologist will know the specific numbers. But you must also be a good candidate for surgery. While receiving a cochlear implant is a quick outpatient procedure that is safe at any age, the surgeon must still verify that it is safe to perform the surgery and that there are no anatomical anomalies that would prevent placement. The other big factor is social support. You will need somebody to take care of you during the surgery and while recovering. There are also multiple follow-up appointments with the audiologist, which are necessary for successful outcomes.

Cochlear implants are a wonderful invention that can vastly improve the quality of life for those who receive them. Always feel free to discuss the option with your audiologist if you feel it may be right for you. QCBN

By Jeff Lane, Au. D.

Accessorize Your Hearing

October 1, 2021 By quadcities Leave a Comment

To be clear, accessories are not required to use hearing aids. But for those who need or want a bit more assistance, they are worthwhile.

Technology is constantly evolving, often at a rapid pace, with the goal of improving and simplifying the experience for the user. If you buy a new phone, you get a pair of wireless earbuds. Hearing aids are similar. While modern hearing aids can significantly improve a wearer’s quality of life, some situations could still be improved with the addition of an accessory – situations such as listening to someone behind you while hiking or catching all the information at a meeting. Fortunately, there is a wide range of accessories compatible with current hearing aid models.

Remote Microphones

Remote microphones are a wonderful solution for improving communication between individuals. Let’s say that a hearing aid user is going on a tour. The tour guide will likely be at a distance from the user, or often turned away. Obviously, this makes hearing the tour guide much more difficult for the person with hearing loss. Remote microphones eliminate this frustration by delivering the speaker’s voice directly to the hearing aids. The talker can be far away (typically 60 to 80 feet) or even turned away, and the user will still hear them perfectly clear. Plus, it is all done wirelessly! And the microphones are small, meaning they are convenient to wear.

Also, they are fairly versatile. They can be used in the car, while hiking, in a restaurant, or at home with the two individuals in different rooms. They’re also great for loved ones with very soft voices. Typically, remote microphones are designed for listening to a single talker, meaning they are not ideal for group situations. However, this also means that remote microphones are very affordable.

Roger Technology

Before proceeding, it should be noted that Roger technology is specific to Phonak hearing aids. However, it is unique and beneficial enough that I felt it warranted inclusion. Roger technology is similar to a remote microphone, but far more advanced. First, it can be used in virtually any situation. It can be worn by an individual, or it can be placed on a table to hear multiple talkers. When listening to multiple talkers, it can either be automatic or manual. When automatic, it will adjust its directionality to amplify whoever is currently speaking. Or, the user can select which directions it wants the device to focus upon. (If you only want to hear in front and to the left, you can designate that and the device will ignore everything else.)

Another advantage is that Roger technology can actively cancel out background noise and increase the volume of the desired signal. Thus, you would have a much more favorable signal-to-noise ratio than with a regular remote microphone. Studies actually show that individuals with hearing loss can hear better than those with normal hearing in noisy situations when wearing hearing aids and Roger. While it does cost more, it is a wonderful solution for those who struggle to hear in noise.

Television Streamers

One of the first things patients tell me during a hearing test is that they have to blast the TV in order to understand what is being said. Having properly fitting hearing aids will automatically help. But, TV streamers can make it sound even better! Again, because the signal is being beamed straight to the aids, it eliminates the need for the sound to travel over distance and through other aural clutter. Another nice feature is that the actual TV volume isn’t affected, so other people can still hear the TV at a volume that is comfortable for them. Unfortunately, TV streamers can’t improve the sound mixing of a program.

Remote Controls

All hearing aids have buttons that allow you to adjust programs. However, this may not be the best option for some wearers. Those who have arthritis or neuropathy may not be able to press the button. A person with memory loss may not be able to remember where the button is or its purpose. In these situations, a remote control can be very handy. It is easy to handle and very clear on its operation. For those who want to be more discreet, there are applications for the phone that can act as a remote control as well.

To be clear, accessories are not required to use hearing aids. But for those who need or want a bit more assistance, they are worthwhile. As always, let your hearing care professional be your guide. QCBN

By Jeff Lane, Au.D.

Jeff Lane

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