Better Hearing & Speech Month

Every month could be Better Hearing & Speech Month...and we wanted to take this time to encourage anyone to take the first step with us and get a baseline hearing evaluation if there are concerns for hearing loss.  Hearing loss is one of the most common chronic conditions and on average people wait 7 to 10 years to take action!  With various interventions and treatment options to improve hearing and communication, there's no time like the present to take charge of your hearing!

What is Hearing Loss? 

Hearing loss refers to being unable to hear either partially or fully.  Hearing loss can be present at birth, occur gradually over time, occur suddenly, and/or be a result of acquired medical disorders/conditions related to the ear.

Signs & Symptoms of Hearing Loss May Include:

More frequent REQUESTS FOR REPETITION

Difficulty understanding speech in various settings (ie. church, family gatherings, groups/meetings, women & children, telephone, busy restaurants)

Describing others as "MUMBLING" or "SOFT SPOKEN"

Increasing the VOLUME ON THE TV to a higher level than normal

TINNITUS (ringing in your ears) [Check out our article on Tinnitus!]

AVOIDING SOCIAL GATHERINGS due difficulties hearing

If Hearing Loss is Suspected… You should consider a referral to a Licensed Audiologist and ENT!

by Author

Some Statistics on Hearing Loss 

1. Congenital hearing loss affects 2 to 3 infants per 1,000 live births. (1)
2. 5 out of 6 children will have at least one ear infection by 3 years of age. (7)
3. Approximately 15% of American adults (37.5 million) 18+ report trouble hearing. (2)
4. Age is the strongest predictor of hearing loss among adults ages 20-69, with the greatest amount of hearing loss in the 60 to 69 age group. (3)
5. Men are almost 2x as likely as women to have hearing loss among adults aged 20-69. (3)
6. Approximately 0.5% of adults ages 20-29 have hearing loss. Adults ages 40-49, 6.5% have hearing loss and approximately 81.5% of adults age 80 or older have hearing loss. (9)
7. About 28.8 million U.S. adults could benefit from using hearing aids. (5)

Understanding Your Hearing Loss

​Types of Hearing Loss

Sensorineural Hearing Loss can occur when there is damage to cells inside of the inner ear (cochlea) or to the nerve pathways connecting the inner ear to the brain. This is the most common type of permanent hearing loss.

Causes can include: 

1. Presbycusis (Aging)
2. Family History of Hearing Loss
3. Noise Exposure (sudden loud noises, concerts, firearms, explosions, power tools)
4. Trauma to the Head [See Our TBI/Head Injury Blog Post]
5. Sudden Viral attack/infection [See our post on Sudden Sensorineural Hearing Loss]
6. Ototoxic medications (certain cancer medications or everyday prescriptions can be damaging to cells inside our organ of hearing)
7.  Autoimmune disease of the inner ear
8. Genetic causes

 Conductive Hearing Loss can occur when sound cannot get through the outer/middle ear system.

Causes can include:

1. Wax build up (cerumen impaction)
2. Swimmer's ear (ear infections in the ear canal)
3. Middle ear infections (fluid / inflammation behind the eardrum
4.  A hole or perforation in the eardrum
5. Damage to middle ear bones (ossicles) from trauma to eardrum
6. Otosclerosis - fusion of middle ear bones
   
7. Absence/malformation of the outer ear, ear canal, or middle ear (typically present from birth)
8. Bony lesions (non-cancerous growths of bone in the ear canal)
9. Cholesteotoma (growth of skin cells behind eardrum)

​Mixed Hearing Loss occurs when there is damage to the outer or middle ear and the inner ear or nerve pathway to the brain.

Causes include a mixture of components from conductive hearing loss and sensorineural hearing loss (see above).  Example: if you work around loud sounds consistently without hearing protection (causing permanent damage) and have fluid in your middle ear (temporarily worsening how sound is conducted through the hearing system). 

Depending on the suspected cause of your hearing loss, our ENTs may refer you for further testing and evaluation.

by Author

Degree of Hearing Loss (Severity)

​Other Descriptors for Hearing Loss

• BILATERAL (both ears) 
• UNILATERAL (one ear)
• CONFIGURATION (shape of hearing loss on your hearing test example. sloping vs. flat)
• SYMMETRICAL (degree/configuration of hearing loss is the same in each ear) 
• ASYMMETRICAL (degree/configuration of hearing loss are different in each ear)
• PROGRESSIVE (hearing loss that becomes worse over time) 
• SUDDEN (hearing loss that happens quickly, which is a medical emergency!)
• FLUCTUATING (hearing changes over time) 
• STABLE (hearing does not change/remains the same)
• CONGENITAL hearing loss (present at birth) 
• ACQUIRED hearing loss (somehow developed)

Diagnosis

Our Audiologists focus first on providing accurate diagnostic hearing evaluations.  Our patient is always best served in an environment that prioritizes a comprehensive health care approach. That goal is more attainable at a full-service ENT location, with the ability to leverage expertise from both our dedicated doctors of audiology, as well as our partnering physicians.  

Your baseline hearing evaluation will include:

Otoscopy: A look in your ears to assess for any abnormalities. 

Tympanometry & acoustic reflexes: To determine how well your eardrum is moving and to measure the reflexive responses of the middle ear muscles.

Pure-tone audiometry: Listening for the softest tones at different frequencies and intensities (volume).  This gives your audiologist information about the severity and configuration of your hearing loss.

Speech audiometry: Using recorded or live speech to find the softest words that you can hear and understand.  Word Recognition testing will measure your ability to understand speech at a comfortable listening level. Our Audiologists can also use speech sounds to determine your most comfortable listening level and the upper limits of comfort for listening.

Speech in noise and words in noise tests:  Most of our patients complain about how they hear in noisy environments—not quiet sound-treated rooms! Common tests we use to evaluate hearing ability include the Speech in Noise test (SIN or Quick SIN) and the Hearing in Noise Test (HINT). 

Testing for auditory processing disorder: Some patients can have normal hearing evaluations and still feel like they aren't hearing well.  For these patients, we always consider referral for an auditory processing evaluation so we can see what your brain is doing with the message you hear.  

Hearing Health is More than Just a Hearing Test..

• Tinnitus (Up to 90% of people with tinnitus have some degree of hearing loss)
• Diabetes (Hearing loss is 2x as common in people with diabetes)
• High Blood Pressure (Can be an accelerating factor of hearing loss in adults)
• Heart / Vascular Disease (50% more likely to have  hearing impairment)
• Sleep Apnea (30% higher odds of Any hearing impairment)
• Kidney Disease (Of those with chronic kidney disease, 54+% reported hearing loss)
• Autoimmune Diseases (Cogan's syndrome, Relapsing polychondritis, Systemic lupus erythematosus, Wegener's granulomatosis, Polyarteritis nodosa, Sjogren's syndrome, and Lyme disease are common autoimmune diseases that can affect hearing)
• Osteoporosis (Can adversely affect the three tiny bones in the middle ear)
• Smoking (Current smokers have a 70% higher risk of having hearing loss than non-smokers)
• Medications (200+ medications including aspirin, certain antibiotics, cancer/chemotherapy drugs are known to be ototoxic/damaging to hearing)

Treating Your Whole Health

• Social Isolation (Every decibel drop in perception in people under 70 increases the odds of becoming severely lonely by 7%)
• Depression (Some studies have shown reductions in depressive symptoms within three months of hearing aid use)⁴
• Anxiety (people with mild hearing loss have 32% higher likelihood of experiencing anxiety, and  moderate or greater hearing loss having 59% higher likelihood of anxiety)
• Cognitive Decline (Adults with hearing loss experience a 30-40% faster decline in cognitive abilities than peers with normal hearing *75 years & older)
• Falls (People with mild hearing loss are 3x more likely to have a history of falling than people with normal hearing)

Prevention & Treatment

Hearing Loss is often permanent, however, scientists  and researchers are working on ways to potentially restore cells damaged inside of the organ of hearing that result in permanent hearing loss.  Research in the areas of gene therapy, antioxidants (for protection of cells), and regenerative studies are all currently being advanced.  

Until the cure for permanent hearing loss can be found our Audiologists always encourage wearing hearing protection with any situations where noise exposure is a risk to protect hearing!  

There are several treatment options available for hearing loss that may include medical intervention and/or hearing devices.  If your treatment plan includes hearing aids, you can feel confident you're in the right place! Not only is it our professional responsibility to maintain current knowledge on all the latest hearing technology and treatment options, but also to counsel you in a comfortable low stress environment! Our educated team of audiologists provide in-depth hearing aid evaluations to be sure that your better hearing health plan has your goals as the center focus.

If you or a loved one are having concerns about hearing loss (no matter the severity), our offices are readily available to provide an evaluation, consultation, and treatment recommendation best suited for you. The first step is reaching out! 

Call our offices at (704) 703-1080 or book an appointment online today!​  

 References:

1. Vohr B. Overview: infants and children with hearing loss—part I. Ment Retard Dev Disabil Res Rev. 2003;9:62–64.
2. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National Health Interview Survey, 2012 (PDF). National Center for Health Statistics. Vital Health Stat 10(260). 2014.
3. Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years. JAMA Otolaryngology – Head & Neck Surgery. December 2016 online.
4. Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. [Letter] Arch Intern Med. 2011 Nov 14; 171(20): 1851-1852.
5. NIDCD Epidemiology and Statistics Program, based on December 2015 Census Bureau estimates of the noninstitutionalized U.S. population, personal communication; May 2016.
6. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989 Jul;160(1):83-94.
7. Ear Infections in Children. (2022, March 16). National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/ear-infections-children#:~:text=Anyone%20can%20get%20an%20ear,infection%20by%20their%20third%20birthday.
8. Quick Statistics About Hearing. (2021, March 25). NIDCD. https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
9. Goman, A. M., & Lin, F. R. (2016). Prevalence of Hearing Loss by Severity in the United States. American journal of public health, 106(10), 1820–1822. 
10. Kochkin, S.(n.d). The Impact of Treated Hearing Loss on Quality of Life - Better Hearing Institute, Washington, DC. Retreived from: www.betterhearing.org/Hearingpedia
11. Lin, F. (2014, January) Hearing Loss Linked to Accelerated Brain Tissue Loss. Johns Hopkins Medicine News Release. | Li-Korotky, H. S. (2012) Age-Related Hearing Loss: Quality of Care for Quality of Life. The Gerontologist, 52(2) 265-271 
12.  Cruickshanks, K. J. Klein, R., Klein, B. E. K., Wiley,T. L., Nondahl, D. M., Tweed, T. S., (1998) Cigarette Smoking and Hearing Loss: The Epidemiology of Hearing Loss Study. JAMA. 1998;279(21):1715-1719. doi:10.1001/jama.279.21.1715 | 
13. Hull, R. H. & Kerschen, S. R. (2010) The influence of cardiovascular health on peripheral and central auditory function in adults: a research review. American Journal of Audiology. 19(1):9-16. doi: 10.1044/1059-0889(2010/08-0040). 
14.  Hypertension As a Factor Associated with Hearing Loss. Braz J Otorhinolaryngol. Jul-Aug;72(4):533-40.
15. Babich, M., Hoffmeister, D. & Doughty, A. (2009). Osteoporosis and Conductive Hearing Loss: A Novel Model of Clinical Correlation. Retrieved from: PHILICA.COM Article number 148. 
16. American Tinnitus Association, ATA.org | www.mayoclinic.com/health/tinnitus/DS00365