Promising Research Into Regenerating Inner Ear Hair Cells

May 23, 2013 By Leave a Comment

Many of the problems that cause hearing problems in our patients cannot be reversed which can be quite frustrating for our hearing professionals. One of the main reasons for hearing loss, for example, is damage to the tiny hair cells in our inner ears that vibrate in reaction to sound waves. These vibrations are interpreted by the brain into what we call hearing.

The sensitivity of these tiny hair cells enables them to vibrate in such a manner, and thus makes it possible for us to hear, but their very sensitivity makes them extremely fragile, and at risk of damage. This damage may occur as the result of aging, certain medications, infections, and by extended exposure to high-volume noises, resulting in noise-induced hearing loss. In humans, once these hair cells are damaged or destroyed, they cannot be regenerated or “fixed.” Since we cannot reverse the damage, hearing professionals and audiologists turn to technology instead. We make up for hearing loss due to inner ear hair cell damage with hearing aids and cochlear implants.

This would not be true if humans were more like fish and chickens. Unlike humans, some fish species and birds have the ability to regenerate their damaged inner ear hair cells and regain their lost hearing. Bizarre, but true. Zebra fish and chickens are just 2 examples of species that have the capacity to automatically replicate and replace their damaged inner ear hair cells, thus allowing them to fully recover from hearing loss.

While it is crucial to point out at the outset that the following research is in its beginning stages and that no practical benefits for humans have yet been achieved, sizeable breakthroughs in the treatment of hearing loss may come in the future as the result of the innovative Hearing Restoration Project (HRP). The not-for-profit organization, Hearing Health Foundation, is currently conducting research at laboratories in Canada and the United States Working to isolate the molecules that allow the replication and regeneration in some animals, HRP researchers hope to find some way to stimulate human inner ear hair cells to do the same.

Because there are so many distinct compounds involved in the regeneration process – some that facilitate replication, some that hinder it – the scientists’ work is slow-moving and challenging. But their hope is that if they can identify the molecules that stimulate this regeneration process to happen in avian and fish cochlea, they can find a way to stimulate it to happen in human cochlea. Some of the HRP researchers are pursuing gene therapies as a way to stimulate such regrowth, while others are working on stem cell-based approaches.

Although this work is still in the early stages, our staff wishes them quick success so that their results can be extended to humans. Absolutely nothing would be more satisfying than to be able to offer our hearing loss patients a true cure.

Filed Under: Anatomy and Physiology Tagged With: , , , , ,

Should You Stop Wearing Hearing Aids in Loud Conditions – Could They Further Impair Your Hearing?

May 16, 2013 By Leave a Comment

A standard patient question is whether their hearing aid will increase sounds which can be already too loud, making those sounds louder still. The answer to this common question is very reassuring.

The basic answer is that present day hearing aids won’t increase sounds that are already excessively loud making them even louder, thus potentially harming the wearer’s hearing even further, provided that they’re correctly fitted and adjusted. The phrase in bold type is the critical part, and the reason why you need to seek professional help with choosing and fitting your hearing aids.

The more complex answer has to do with the nature of modern digital hearing aids themselves, and how they work. Digital hearing aids receive sounds through their microphones and turn them into binary information that can then be processed by the hearing aid’s microchip before it is sent to the earphones. These digital hearing aids can be programmed, allowing audiologists to not only set a maximum volume that suits you, but to transform the nature of the sounds you hear. If you have primarily high-frequency hearing loss, for example, we might program the hearing aid to amplify those sounds while reducing the volume of lower-frequency sounds. This preference can be reversed, of course, if you suffer from primarily low-frequency hearing loss.

The newest digital hearing aids can also filter sounds to make them easier for you to understand. For example, if foreground voices are obscured by background noise, the hearing aid can detect the noise and suppress it or lower its volume, amplifying only the voices. The hearing aids can also be adjusted to dynamically compensate for differences in volume; if the speaker or music you are listening to starts softly but then increases and becomes too loud, the hearing aid can compensate for this. This process is aided by directional microphones that can detect where sounds are coming from and thus reduce the volume of background noise coming from behind or to the sides while increasing the volume of sounds coming from in front of you.

An important point to remember is that hearing aids will not protect your ears from loud sounds like earplugs do. Noise-induced hearing loss can still be caused by loud sounds such as chainsaws or overly amplified rock concerts. But in most situations your properly fitted and programmed hearing aid should handle most of the range of sounds you’re likely to encounter.

Filed Under: Choosing a Hearing Aid Tagged With: , ,

How Does the Classification of Hearing Problems Operate?

May 9, 2013 By Leave a Comment

Hearing loss can take many different forms and occur from a number of causes, and to understand them you must understand the way we hear. Along with the eardrum and the ear canal, the outer ear is the portion of the ear on the exterior of the head which collects sounds. The eardrum can also be viewed as part of the middle ear, an area that also includes the 3 tiny bones called ossicles that carry the vibrations of sound and send them to the inner ear. The inner ear has three key parts – the cochlea, the 2 semi-circular canals (important for balance) and the acoustic nerves which send the sound signals to the brain. All of this is incredibly sophisticated and delicate, and a problem in any section can lead to hearing loss. Hearing loss is usually split into four primary classifications.

Conductive hearing loss is due to something hindering the transmission of sound in the outer or middle ear. This form of hearing loss can often be remedied by medication or a surgical procedure; if surgery isn’t a possibility, it can be treated with hearing aids.

Damage to the inner ear, including the cochlea, hair cells lining the inner ear, or the acoustic nerves is called sensorineural hearing loss. Sensorineural hearing loss can usually not be treated using medication or surgery, but its effects can be minimized using hearing aids to allow the person to hear more normally.

The third classification is mixed hearing loss, which is a combination of conductive and sensorineural hearing loss, and which can often be treated using the same combinations of surgery, medication, and hearing aids.

Central hearing loss occurs when sound enters the ear normally, but because of damage either to the inner ear (especially to the cochlea) or to the auditory nerves, it cannot be organized in a way that the brain can understand.

Each of these four main classifications contain several sub-categories, such as the degree of hearing loss, which can be mid-level, moderate, severe, or profound. Additional sub-categories include whether the hearing loss occurs in one ear or both ears (unilateral vs. bilateral), whether it occurs at the same degree in both ears (symmetrical vs. asymmetrical), and whether the hearing loss happened before or after the person learned to speak (pre-lingual vs post-lingual). Additional sub-categories of hearing loss includes whether it is progressive vs. sudden, whether the hearing loss is fluctuating vs. stable, and whether the hearing loss was present at birth (congenital) or developed later in life (acquired). If you suffer from any of these forms of hearing loss, our specialists can help to diagnose it and then to treat it most effectively.

Filed Under: Hearing Loss Tagged With: , , , , , , ,

Picking the Right Cell Phone if You Use a Hearing Aid

April 28, 2013 By Leave a Comment

Hearing aids have not in the past always worked well with cellular phones, because of electronic interference between the 2 devices that caused static, whistling or squealing noises, or lost words. Fortunately, improvements in technology and new government regulations have made the question “Will this phone work with my hearing aid?” simpler to answer. The regulations mandated new labeling requirements and ratings that help you to easily find a mobile phone that works well with your hearing aid.

To understand how this rating system works, you should first understand the two modes that hearing aids work in – M mode (for microphone) and T mode (for telecoil). In M mode, your hearing aid uses its built-in microphone to pick up audible sounds from the environment and amplify them so that you can hear them. In T mode, the hearing aid instead uses an inductive process to pick up electromagnetic signals inside the phone directly, without the need for a microphone. Roughly 60 percent of all mobile phones sold in the US have a telecoil (T) mode.

Under the new regulations, these two modes of operation have ratings that range from 1 (the lowest sensitivity) to 4 (the highest sensitivity). To be sold in the United States as hearing aid compatible (HAC), a mobile phone or cordless handset must have a rating of at least M3 or T3.

In addition, many hearing aids (and cochlear implants) have a similar M and T rating to measure their sensitivity and their resistance to radio frequency interference. When shopping for a phone, to determine its compatibility with your hearing aid, simply add its M and T ratings together with those of the phone to create a combined rating. A sum of 6 or more makes a solid pairing. That hearing aid and mobile phone combination should work well for you. If the combined rating is 5, this combination is considered normal and suitable for most regular phone use. A combined rating of 4 is considered usable for brief calls, but may not be suitable for extended phone use.

If you are shopping for a mobile phone online, you can usually use this combined rating to determine how compatible the phone you are interested in buying will be with your hearing aid. In the end, nothing beats a real world test so you may want to wear your hearing aid to the cell phone shop and test out a few different phone in real conditions.

Filed Under: Hearing Aids Tagged With: , , ,

Why Can I Hear Male Voices Clearly but not Women’s Voices?

April 21, 2013 By Leave a Comment

For anyone who is finding it tougher to hear ladies voices or children’s voices than to hear male voices, it may be a sign that you have suffered some degree of high-frequency hearing loss. Children’s and women’s voices have a higher frequency than men’s voices – 165 to 255 Hertz, as opposed to 85 to 180 Hertz for men. On top of that, the volume of women’s and children’s voice are often less audible because they speak more quietly that men. Although you may suspect that you have suffered a high-frequency hearing loss because you are having trouble hearing these voices, the only way to know for certain is to make an appointment for an exam.

If it turns out to be high-frequency hearing loss, you’re not alone; this is the most common form of hearing loss. High-frequency hearing loss can have many causes: genetics, aging, noise-induced hearing loss (exposure to loud sounds), certain diseases, and certain drugs. The good news is that high-frequency hearing loss can generally be counteracted with technology.

One effective option involves the fitting of digital hearing aids, whose sophisticated electronics can be programmed to respond differently to sounds at different frequencies. For a person suffering from high-frequency hearing loss, for example, a technician could program the digital hearing aid to raise the volume of high-pitched sounds, while not raising the volume of low-pitched sounds as much. Another treatment option is the use of open-fit hearing aids, which leave your ear canal open or partially open, so that low-frequency and mid-frequency sounds enter the ear normally, and only the high-frequency sounds are amplified. A third option for very severe cases of high-frequency hearing loss is a cochlear implant. Because they require minor surgery, cochlear implants are a more serious and more expensive option, but they can provide a solution in extreme cases involving industrial deafness or nerve deafness.

But the first step to finding a solution to your hearing problem is to have an examination, and allow our specialists to determine what the nature of it actually is. In some cases, for example, high-frequency hearing loss has been caused by nothing more than a buildup of ear wax, which can be cleared up without the need for any type of hearing aid. So the best “first step” in dealing with your hearing problem is to make an appointment and allow us to determine the real nature of the problem.

Filed Under: Hearing Loss Tagged With: , , , ,

What Exactly is Tinnitus Retraining Therapy (TRT) and What Types of People Can Benefit from It?

April 14, 2013 By Leave a Comment

Tinnitus is sadly a common condition, affecting approximately 50 million Americans over 50. Those who suffer from tinnitus hear constant sounds that no one around them can hear. These sounds vary from high-pitched ringing sounds, buzzing or roaring, or rapid clicking sounds similar to crickets chirping. Many people “learn to live with” their tinnitus, considering it as an annoyance rather than a condition. However for other people, this constant ringing in the ears leads to additional symptoms of stress and distress, sleep disorders, fatigue, depression, and anxiety.

Some forms of tinnitus respond well to treatment with hearing aids which are programmed to filter and suppress the ringing or buzzing sounds. In this article, we want to introduce you to an alternative tinnitus treatment known as Tinnitus Retraining Therapy (TRT). Using a combination of mechanisms, TRT “retrains” tinnitus sufferers and gives them the ability to reduce their perceptions of the noises they hear, so they no longer react to the sounds negatively, and thus eventually cease being bothered by them.

Discovered in the 1980s by neuroscientist Pawel Jastreboff, TRT challenges the assumptions of many audiologists that tinnitus is a physical disorder due to ear damage that cannot be fixed. Jastreboff has proposed an alternate model for tinnitus based on his background in behavioral neuroscience. Thus freed from the temptation to regard the problem as something that cannot be fixed, he set about developing behavioral modification techniques that could fix it.

According to Jastreboff’s model, tinnitus is not a disease or condition in itself, but a function of hyperacusis – the ability of some people to become aware of normal sounds generated by the auditory system that most people filter out or are unaware of. Jastreboff reasons that the true problem for tinnitus sufferers is the over-reaction and hyper-sensitivity to the ringing or buzzing sounds, not the sounds themselves. Tinnitus Retraining Therapy is a form of individualized counseling perform by people with special training and qualifications. The sessions are very precise to each individual’s needs and aim to teach tinnitus sufferers to mentally curb their reactions to undesirable sounds by focusing on the desirable ones.

Counselors trained in TRT have had remarkable successes helping patient eliminate their negative reactions to the sounds they hear, thereby relieving distress.

Filed Under: Tinnitus Tagged With: ,

The Difference Between Wearing One Hearing Aid or Two

April 7, 2013 By Leave a Comment

Hearing aids are a major investment, so if you have experienced hearing loss in both ears, you naturally think, “Do I actually need two hearing aids, or could I hear equally as well with only one?” Most hearing professionals will state that the benefits of using two hearing aids greatly exceed the additional expense, but to be fair let’s begin with the reasons why some individuals don’t require two.

To start with, if your hearing is fully normal in one ear, you clearly do not need a second hearing aid for that ear. Conversely, if you are totally 100% deaf in one ear, there is no point in having a second hearing aid. If you are prone to recurring ear infections, wearing hearing aids can potentially make the situation worse, so wearing a single aid might be an advantage. Or, if you have a specific form of hearing loss where the speech is heard garbled, a hearing aid in that ear may make your comprehension worse by amplifying the garbled speech. Except for these cases, the arguments for wearing two hearing aids are pretty persuasive, and are validated by surveys of consumer preferences and customer satisfaction – most hearing aid users vastly prefer the binaural sound provided by two hearing aids. Wearing two hearing aids greatly improves your ability to detect the source and direction of the sound. Understanding speech has been proven to be much easier when wearing two hearing aids than when wearing one, especially when the listening environment is noisy.

If you have hearing loss in both ears, wearing two hearing aids will enable you to keep stimulating both ears, whereas wearing only one can allow the other ear to deteriorate further from lack of use. For tinnitus sufferers, two hearing aids are almost always the wisest choice because the hearing aid is used to mask the ringing or buzzing sounds associated with tinnitus. Without the second hearing aid, these sounds continue in the other ear. Not surprisingly, consumer research studies have shown that wearing two hearing aids is less mentally tiring than wearing one.

Collectively, there are numerous reasons why wearing two hearing aids is the better choice and only a few situation where a single one might be recommended. But if you still have your doubts, test it for yourself by making an appointment to see us. You will be able to hear the difference for yourself between one hearing aid and two. Then decide for yourself which provides you with the better hearing experience. We think you’ll decide that two is better than one.

Filed Under: Choosing a Hearing Aid Tagged With: , ,

Quick Analog vs Digital Hearing Aids Comparison

March 31, 2013 By Leave a Comment

When trying to understand the difference between analog and digital hearing aids, it is important to first appreciate the history of analog versus digital, and the alternative ways that they amplify and process sounds. Analog hearing aids came out first, and were the norm in the majority of hearing aids for many years. Then with the introduction of digital signal processing (DSP) technology, digital hearing aids also started to appear. At this point, most (90%) of the hearing aids sold in the US are digital, although analog hearing aids are still sold because they’re often lower priced, and because some people prefer them.

The way that analog hearing aids operate is that they take sound waves from the microphone in the form of electricity and then amplify them, delivering louder versions of the sound waves to the speakers in your ears “as is.” Digital hearing aids take the sound waves from the microphone and convert them to digital binary code, the “bits and bytes” and “zeros and ones” that all digital devices understand. Once the sound is digitized, the micro-chip inside the hearing aid can manipulate the information in complex ways before transforming it back to analog sound and passing it on to your ears.

Remember that analog and digital hearing aids serve the same purpose – they take sounds and boost them so that you can hear them better. Both analog and digital hearing aids can be programmable, which means that they contain microchips which can be customized to alter sound quality to match the user, and to create different configurations for different environments. For example, there might be distinct settings for low-noise locations like libraries, for noisy restaurants, and for outdoor spaces like stadiums.

Digital hearing aids, because of their capacity to manipulate the sounds in digital form, often have more features and flexibility, and are often user-configurable. For example, digital hearing aids may offer multiple channels and memories, permitting them to store more environment-specific profiles. Other capabilities of digital hearing aids include being able to automatically reduce background noise and remove feedback or whistling, or the ability to prefer the sound of human voices over other sounds.

Cost-wise, most analog hearing aids are still less expensive than digital hearing aids, but some reduced-feature digital hearing aids are now in a similar general price range. There is commonly a noticable difference in sound quality, but the question of whether analog or digital is “better” is up to the individual, and the ways that they are used.

Filed Under: Choosing a Hearing Aid Tagged With: , , ,

Central Auditory Processing Disorder Essentials

March 24, 2013 By Leave a Comment

Central Auditory Processing Disorder, or CAPD, is a hearing disorder in which the trouble lies not with the ears, but with the brain. With Central Auditory Processing Disorder, your ears have no problem hearing sounds (especially the sounds associated with speech) properly, but something is affecting the brain’s ability to interpret these sounds. The disorder is thus characterized by a lack of coordination between the ears and the brain.

As many as 2 to 5 percent of school-age children are affected by CAPD including roughly half of all children that have been diagnosed with a learning disability. Children with CAPD often cannot discern the sounds of different words even when the words are spoken loud and clear. This inability to understand words often becomes worse in noisy environments, but is not as present in quiet environments.

CAPD is often difficult to detect, because when children’s hearing is tested in a quiet room, they can clearly hear the pure tones they hear through the testing equipment, and they similarly have no apparent problems hearing and interpreting speech in non-noisy environments. But even though their audiogram results may appear normal, children with CAPD often have difficulty locating where sounds are coming from, difficulty discerning the differences between two similar sounds, difficulty recognizing patterns of repetitive high and low sounds, and difficulty being able to hear more than one person speaking at the same time.

These symptoms may carry over into other areas of life, as the children struggle to cope with not being able to understand people speaking to them. For example, they may become easily distracted by sudden noises, have difficulty following directions, develop reading, spelling, and language difficulties, become disorganized and forgetful, or have trouble following conversations. When given standard hearing tests, these children appear to have normal hearing, so these symptoms are often confused with or mistaken for signs of other problems such as depression or Attention Deficit Hyperactivity Disorder (ADHD). This misdiagnosis is further complicated by the fact that a child may in fact have ADHD or some other learning disorder and also have CAPD.

Properly detecting and diagnosing CAPD as eary in a child’s life as possible is crucial to avoid developmental delays both social and academic. Early diagnosis is key to ensuring that the condition is resolved, which is why it is important, if you have noticed any of the above symptoms in your children, to have their hearing professionally tested.

Filed Under: Anatomy and Physiology Tagged With: , , ,

Addressing the Essential Safety Requirements of Loved Ones with Hearing

March 17, 2013 By Leave a Comment

One component of hearing loss which is seldom discussed is the simple decrease in safety of people who have hearing difficulties. For instance, imagine that a fire starts in your house; if you’re like most people you have smoke alarms to sound an alert so that you and your loved ones can evacuate the house before a fire becomes widespread, and thus deadly. But this time imagine further, and ponder what might happen if your smoke alarm goes off at night after you’ve gone to bed, having removed your hearing aid.

The smoke detectors standard in most homes and those required by city or state governments produce a loud warning sound at a frequency between 3,000 and 4,000 Hz. Although most people can hear these tones without difficulty, these frequencies are among those most impacted by age-related hearing loss and other forms of auditory impairment. So even if you were awake, if you’re among the more than eleven million Americans with hearing loss, there is a possibility that you would not hear the alarm.

Fortunately, there are home safety products that are expressly created for the needs of the hearing impaired. For people with mild to moderate hearing loss, there are smoke alarms that emit a 520 Hz square-wave warning tone that they can generally hear. In case you are completely deaf without your hearing aids or when you turn off your cochlear implants (CIs), there are other alarm systems that use a mix of blinking lights, loud alarms, and vibrating units that shake your bed to wake you up. Several of these systems are intended to be integrated into more extensive home security systems to warn you of burglars or neighbors pounding madly on your doors in the case of an emergency.

Many who have hearing aids or who wear CIs have chosen to boost the performance of these devices by installing induction loops in their houses. These systems are in essence long strands of wire placed in a loop around your living room, kitchen, or bedrooms. These can activate the telecoils inside your hearing aid or CI that raise the volume of sound; this can be very helpful during emergency situations.

And of course there is the humble telephone, which all of us tend to ignore until we need one, but which can become critical in any sort of emergency. Fortunately, a number of contemporary mobile and home phones are now telecoil-compatible, to permit their use by individuals wearing hearing aids or cochlear implants. Moreover, there are telephones specifically designed for the hearing impaired which incorporate speakerphones that operate at high volumes, and which may be voice-activated. These phones allow you to voice-dial for assistance in an emergency situation. Other companies produce vibrating bracelets that communicate with your cellphone to wake you up or advise you if you get a call.

Other safety recommendations are less technical and more practical, such as always keeping the telephone numbers of fire departments, ambulance companies, health care providers, and emergency services handy. We are as serious about your basic safety as we are about your hearing, so if we can be of assistance with any further tips or recommendations, feel free to give us a call.

Filed Under: Hearing Loss Tagged With: , , , ,
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