Hear Well – Live Well

Tinnitus is a condition frequently defined as hearing sounds without the presence of external sounds. It is characterized by an intermittent or continuous ringing, swishing, hissing, clicking or similar type noise that appears to originate from the inner ear or head. It can affect either one or both ears and the sound can range from a low hiss to a high pitch squeal or whine. Tinnitus is not actually a disease, but is a symptom of another underlying problem or condition.

There are two types of tinnitus; subjective and objective tinnitus. Subjective tinnitus is the most common type and is a noise that only the patient is able to hear. Subjective tinnitus is most frequently associated with some type of noise-induced hearing loss but can also be caused by the following situations:

• Age-related hearing loss
• Exposure to loud noise
• Ear canal blockage such as from earwax
• Stiffening of the bones in the middle ear (otosclerosis)
• Medications such as antibiotics, cancer medications, diuretics, certain antidepressants and aspirin taken in high doses; in reality tinnitus is listed as a potential side effect for approximately 200 prescription and nonprescription medications
• Medical conditionals such as high blood pressure, cardiovascular disease, circulatory problems, diabetes, hypothyroidism, anemia and certain allergies

Some less common causes are:

• TMJ disorders
• A benign tumor on the cranial nerve leading to the inner ear
• Head or neck trauma
• Meniere’s disease

Objective tinnitus is much rarer, and can actually be heard by a physician during a physical examination. It can originate from muscle spasms that cause clicks or crackling around the middle ear or sometimes a pulsing sound resulting from altered blood flow or increased blood turbulence near the ear.

When seeking treatment for tinnitus, physicians first try and determine the underlying cause of the condition; sometimes it is as simple as removing excessive earwax from the ear or a foreign object, such as a hair that is rubbing against the eardrum. If the physician doesn’t immediately ascertain the underlying problem, they will order additional testing such as a hearing test, MRI scan, CT scan or an ABR (auditory brain stem response) test. If an underlying cause is found, they will treat the problem and the tinnitus will typically be resolved.

Unfortunately however, the underlying cause is frequently undetermined and the condition persists. When this happens, patients often seek alternative treatment to find some relief. Tinnitus retraining therapy is one form of treatment that attempts to retrain the brain to become accustomed to the abnormal sound to the point where it “ignores” the noise. Audiologists and otolaryngologists typically work in conjunction and utilize a combination of counselling and the use of a sound generator.

Hearing aids are also exceptionally useful in providing tinnitus relief, especially if the patient suffers from some form of hearing loss as well. There are several different hearing aid options available and an audiologist can recommend the right one depending on the severity and the particular problem. Untreated tinnitus can have a significant impact on an individual’s quality of life; fatigue, depression, anxiety, irritability, insomnia, lack of concentration and stress are common consequences of tinnitus. Seeking help to reduce or eliminate tinnitus can help to restore quality of life and alleviate any side effects of the condition.

Most of us are familiar with the complications of uncontrolled diabetes; the heart, eyes, kidneys and nerves are all affected by diabetic complications. However, many don’t realize that hearing loss has also been linked to diabetes. According to the American Diabetes Association, a recent study found that hearing loss is twice as common in individuals with diabetes as it is in those who don’t have the disease. Another study suggested that 70 percent of diabetics between the ages of 50 and 69 years old have high-frequency hearing loss and a much as one third experience low or mid-frequency hearing loss.

While scientists and doctors are now aware that a correlation exists between diabetes and hearing loss, they are still unable to pinpoint the exact cause. While we know that diabetes affects other nerves in the body, it is possible that there is also a nerve breakdown in the ears as well; the same kind of nerve damage that causes tingling and other sensations in the body’s extremities could also affect the nerves in the ear. Another theory is that due to the blood being much thicker when blood sugar is elevated, it is possible that the tiny capillaries of the cochlea are damaged.

The American Speech-Language-Hearing Association reported that autopsied diabetic patients showed signs of sclerosis of the internal auditory artery, thicker vessel walls, demyelination of the cochlear nerve and atrophy of the spiral ganglion. It was also noted that these patients also had loss of the outer hair cells or cilia. Poor sugar control damages blood vessels and nerves throughout the body so it makes sense that the ears would not escape unscathed.

Dr. Kathleen Yaremchuk of Henry Ford Hospital in Detroit said that while no diabetic complication is desirable, hearing loss can be particularly insidious. Individuals who suffer from hearing loss can become isolated and withdrawn from friends and family and depression can soon follow. Other research suggests that hearing loss can also increase the risk for dementia; our brains require daily stimulus in order to remain healthy and when individuals are not receiving that stimulus from their environment, it has the potential to lead to dementia.

The best way to protect your hearing, if you are one of the 29 million Americans that suffer from diabetes, is to maintain good control of your blood sugar. Taking all prescribed medications, eating a healthy diet and making exercise a part of your daily routine all aid in managing your blood sugar more effectively. If you think that your diabetes has already affected your hearing however, don’t wait to see an audiologist. The sooner you begin treatment for hearing loss, the better.

We are all about preserving an individual’s hearing, as well as treating hearing loss  or a hearing impairment if it occurs, but what about preventing it before it ever becomes a problem?  Of course our hearing can diminish as we get older, and our environment can be a huge contributing factor, but recently a study was conducted which conclusively determined that smoking is also directly linked to hearing loss.

The study, led by Dr. Piers Dawes from the University of Manchester in the UK, concluded that smokers were 15.1% more likely to develop hearing loss when compared to passive smokers and non-smokers.  Interestingly, passive smokers were 28% more likely to develop hearing loss than non-smokers.  Dr. Dawes said that “we are not sure if toxins in tobacco smoke affect hearing directly, or whether smoking-related cardiovascular disease causes microvascular changes that impact hearing, or both.”

Research also suggests that there may be a few other reasons why smoking leads to hearing loss.  First, there is the condition of hypoxia, or lack of oxygen.  We know that nicotine and carbon monoxide deplete oxygen levels in the body which can cause tissue damage; the cochlea is not immune to this type of tissue damage and when it occurs, and hearing loss can be the result.

Another problem with nicotine is that it can interfere with the neurotransmitters in the auditory nerve.  Since neurotransmitters are the chemical messengers to the brain, if they become damaged or blocked by the nicotine, they would not be able to communicate effectively to the brain what is occurring along the auditory nerve, thus resulting in hearing loss.

Adolescent smoking has also been attributed to smoking related hearing loss.  The mechanisms of the auditory nerve continue to develop well into adolescence, which make them extremely susceptible to damage.  If the nerve pathways are exposed to environmental toxins such as nicotine, they may not develop properly which could then lead to some form of hearing impairment.

We stress so often about the dangers of noise induced hearing loss,  and ways to prevent it, but we cannot forget about this new threat to our hearing.  According to the CDC, smoking harms nearly every organ of the body, and our ears are not immune to its destructive properties.  There are approximately 42 million Americans who continue to smoke, or about 18%, and that number increases to nearly 60% in other countries.  We need to continue bringing awareness to the harmful effects of smoking, our lives are precious – and so is our hearing!

Whether you are unsure if you are suffering from some level of hearing loss or are unaware of how much more advanced today’s hearing aids are, too many people among our workplaces are living with hearing loss which is affecting their performance and apparently the way their bosses see their work. Employee Wellness Month this June is the perfect time to reduce hearing loss discrimination in the workplace, but at the same time help those who may have hearing loss improve it enough to do a better job at the workplace and at home.

According to the EPIC “Listen Hear!” survey, most people don’t realize that hearing aids have come a long way; nor do they realize that hearing aids are eligible expenses for flexible savings accounts FSAs and health savings accounts HSAs. Today’s hearing aids allow the user to hear from all directions, in a variety of sound environments and some even work underwater. These and the other benefits are something our audiologists are happy to discuss with you as well. Some hearing aids are so advanced that they are digital, wireless, can connect directly to your smartphone or television, and can be as discreet or as visible as you like. A new rechargeable feature on some newly designed hearing aids even allows you to recharge your hearing aids every night, so there’s no more need for small batteries.

Until you make the choice to do something about your hearing loss, however, it can affect both an employer and an employee. Research shows that people who are hard of hearing often get passed over for promotions, make mistakes because they don’t hear the instructions right, are afraid to express their really good ideas for fear that they’ll say the wrong thing at the wrong time because they have trouble following conversations. There was one situation where a female employee was even reprimanded for not being a team player because she couldn’t participate in conversations very well – not because she chose to not participate, but because she simply couldn’t follow the conversation well enough to contribute effectively.

Hearing loss can be tempting to keep as a secret for a number of reasons. Some people keep it inside for fear of feeling embarrassed and others are nervous about losing their job. The truth is that untreated hearing loss creates more problems for all parties involved than would action and openness. Employee wellness is important to employers. We encourage you to discuss this and your other concerns with one of our experienced audiologists and learn how our hearing services could have you feeling more confident and hearing better in the workplace and in life in general.