gtag('config', 'AW-807615734');

TINNITUS – THE END OF QUIET MOMENTS?

Tinnitus is the perception of sounds that have no external source. The severity of tinnitus varies from an occasional awareness of ringing, hissing, buzzing, roaring, clicking, or other rough sounds in one or both ears, to an unbearable and incessant noise that drives some people to consider suicide.

Tinnitus isn’t a “phantom sound” or “condition” — it’s a symptom of an underlying medical problem, such as noise trauma, age-related hearing loss, ear injury, or disease of the circulatory system.

Tinnitus is relatively common, but in rare cases it can be a symptom of a serious underlying condition, such as a vascular tumor or a slow growing acoustic neuroma (a generally benign tumor that forms on the vestibular nerve that leads from the inner ear to the brain).

Tinnitus facts: If you have tinnitus you aren’t alone. More than 50 million Americans have tinnitus symptoms. 9 in 10 patients with tinnitus also have hearing loss, and 1 in 5 patients find the symptoms hard to endure. 10-15% of Americans experience chronic troublesome tinnitus, lasting more than 6 months.

Tinnitus is frequently caused by prolonged exposure to loud sounds from industrial, recreational, or military noise, or from a sudden impulsive sound from an explosion, gunshot, etc. Tinnitus can also be caused by ear injuries, cardiovascular disease, age-related hearing loss, wax build-up in the ear canal, medications (aspirin, certain antibiotics, diuretics, chemotherapy), ear or sinus infections, misaligned jaw joints (TMJ), head and neck trauma, and Meniere’s disease.

Auditory Pathways and tinnitus. Sound waves travel through the ear canal to the middle and inner ear, where sensory hair cells in the cochlea help transform the sound waves into electrical signals. (See the figure) The electrical signals then travel through the auditory nerve to the auditory cortex of the brain, where they are processed. When hair cells are damaged (figure inset)  by loud noise or drugs known to cause hearing loss, the brain doesn’t receive the signals it expects. This stimulates abnormal neuron activity, which causes the illusion of sound, or tinnitus.

What are the consequences? Tinnitus causes fatigue, stress, sleep difficulties, trouble concentrating, memory problems, anxiety and irritability, and trouble with both work and family life. The degree to which tinnitus invades a person’s life depends on the volume, frequency, and duration of the perceived noise, and on the emotional reaction provoked by that irritation. Tinnitus is no laughing matter; the fear and depression associated with tinnitus can destroy a person’s well-being.

Tinnitus can’t be cured…but it can be managed! Our Doctors of Audiology have the knowledge and training to help you manage your tinnitus. They will assess the personal impact of your symptoms, and then present options for alleviating those impacts. The initial assessment takes 2 hours, and guides us in determining the best therapy for you.

The goal of tinnitus management is to “train your brain” to ignore tinnitus sounds as unimportant. This process is called habituation, and empowers tinnitus patients to overlook the disturbing emotional trauma of tinnitus, in the same manner that many of us have learned to overlook the disturbing effects of a train whistle at night. Other tinnitus remediation therapies include sound therapy, which can be supplied by smart phone apps through hearing aids.

Tinnitus therapy is highly tailored to account for your perception of symptoms and their disturbing impacts. There is no “one size fits all” therapy! Effective treatment strategies generally focus on counseling, sound therapy, relaxation, and stress-reduction methods. If you have tinnitus AND hearing loss, hearing aids can improve your hearing while relieving the negative impact of your symptoms, and this can help restore your quiet moments!

Dr. Li-Korotky, AuD PhD is a Gold member of the American Tinnitus Association

Pacific Northwest Audiology Celebrated Their Open House in Bend Oregon

The Open House was held on October 20, from 10 am – 2 pm at our new custom hearing center at the Shevlin Health and Wellness Center, located at 2205 NW Shevlin Park Rd. in Bend OR.

Collage FinalAround 70 people came to celebrate with us and to see what has already been heralded as one of the most forward thinking audiology clinics in the United States! 

Pacific Northwest Audiology designed this clinic from the ground up. In addition to diagnostic, clinical, and hearing aid services, we established The Hearing Innovations Center to demonstrate the leading edge of hearing enhancement technologies.

Energized by our new Hearing Innovations Center and staffed with Doctors of Audiology, Pacific Northwest Audiology is uniquely positioned to take advantage of the most remarkable hearing technologies of today …and tomorrow!

The Open House gave us a chance to demonstrate amazing new technology. We offered guided tours of the facility, explained our vision for tomorrow, and shared a tasty lunch.

This was a very satisfying event for everyone. In addition to our good friends, we made many new friends!

Hearing Aids Improve Brain Function

A new study, “The benefit of amplification on auditory working memory function in middle-aged and young-older hearing impaired adults,” by Jamie Desjardins, PhD, an assistant professor in the Speech-Language Pathology Program at The University of Texas at El Paso (UTEP), found that hearing aids improve brain function in mature adults with hearing loss.

Texas study, hearing aids restore cognition

Previous Studies

Previous studies have shown that untreated hearing loss is associated with serious emotional, medical, and social consequences, including unnatural mental decline and dementia. These disabilities often result in reduced job performance, lower income, and a generally diminished quality of life. Declining cognitive function is also associated with a loss of auditory working memory, the ability to pay attention to conversations in noisy environments. Working memory is important because it is critical for understanding speech.

Sustained hearing loss causes problems because the brain must allocate extra resources to the task of understanding speech. When this occurs, other areas of the brain associated with cognitive functions are “starved”.

As Desjardins explained, “If you have some hearing impairment and you’re not using hearing aids, maybe you can figure out what the person has said, but that comes with a cost. You may actually be using the majority of your cognitive resources, your brain power, in order to figure out that message.”

Purpose Of  The UTEP Study

As we age, our thinking and memory skills naturally decline. The purpose of the present study was to assess the effect of hearing aid use on the auditory working memories of middle-aged and young-older adults with mild to moderate sensorineural hearing loss. Sensorineural Hearing loss is caused by damage to the inner ear or the nerve from the ear to the brain, and isn’t typically correctable with surgery. The study included 24 adults in their 50s and 60s with bilateral (involving both ears) hearing loss who had never before used hearing aids. 

Cognitive skill trends can be measured by changes in working memory, the ability to process information during conversations. For the present study, cognitive tests were used to measure the working memory, selective attention, and speech processing speed of study participants before and after wearing hearing aids. 

Study Results: Hearing Aids Improve Cognitive Function

Results from this study indicated significant improvements in the auditory working memory of participants after 6 weeks of hearing aid use. Why is this important? Using hearing aids in the early stages of age-related hearing loss, even mild hearing loss, can have a positive impact on working memory performance. 

According to Desjardins, “Most people will experience hearing loss in their lifetime. Think about somebody who is still working and they’re not wearing hearing aids and they are spending so much of their brainpower just trying to focus on listening. They may not be able to perform their job as well. Or if they can, they’re exhausted because they are working so much harder. They are more tired at the end of the day and it’s a lot more taxing. It affects their quality of life.”

An Allied Study

Another study recently published in the Journal of the American Geriatrics Society by researchers at the French National Institute for Health and Medical Research in Bordeaux France found that “Use of hearing aids attenuates cognitive decline in elderly people with hearing loss”. 

The bottom line of this study? Hearing aids appear to have a positive effect on thinking and memory functions, by restoring communication abilities and promoting social interaction, qualities that are known to reduce isolation and resulting depression.

Final Comments

Hearing impairment is one of the most common health problems in the United States. It affects more than 9 million Americans over the age of 65 and 10 million Americans between 45 and 64, but only 1 in 5 people who need hearing aids actually wear them. That means 4 in 5 people with hearing loss are tossing dice that only allow bad outcomes.

Our take-away from these studies? We have choices and those choices effect the way we live. We urge older adults with hearing loss to seek qualified treatment by a Doctor of Audiology.

Audiologists or Dispensers – Part 2

In Audiologists or Dispensers – Part 1, we introduced corporate and professional business models for hearing health care, and indicated that the level of professional service you receive is linked directly to the business model of the hearing care provider you choose. 

Audiologists or Dispensers – Part 2 details the vastly different academic and knowledge requirements for audiologists vs. hearing aid dispensers, and how these differences dictate the legal responsibilities available to each group. It should be noted that audiologists fit hearing aids just like dispensers, but they can legally do much more for your hearing health, whereas dispensers are fundamentally permitted to sell hearing aids.

Audiologists

Audiologists must earn a Doctor of Audiology (AuD) degree. This requires 4 years of undergraduate study in Communication Sciences (speech and hearing) and an additional 4 years of specialized academic work, including high-level training in the prevention, identification, assessment, and treatment of hearing disorders.

Their extensive academic credentials, professional certifications, and licensure, allow audiologists to legally provide a full range of patient-centered care, a set of professional standards that include a thorough patient assessment, comprehensive diagnostic tests, a consultation to discuss treatment options, highly specialized hearing aid fitting and programming, and a process of post-fitting adjustments and counseling.

Profit is certainly important to independent audiologists, but it doesn’t generally dictate the patient process. Many of the diagnostic and counseling efforts that define professional standards of patient-centered care offer low-profit margins compared to hearing aid sales…but these are critical elements of comprehensive hearing care. Take away any of the links from a patient-centered chain and you also disrupt the process of end-to-end care.

Hearing Aid Dispensers

Hearing aid dispensers, (AKA hearing aid specialists) are limited primarily to hearing aid sales. They can recommend, select, or adapt hearing aids and may alter, adjust or reconstruct hearing aid specifications for functionality, such as taking ear impressions for proper fit, but hearing aid sales keep them in business. Hearing aid dispensers can sell hearing aids in many states if they have a high school diploma or GED Certificate, pass a license exam, complete a brief apprenticeship with a licensed hearing aid specialist, and earn continuing education credits (usually from correspondence courses).

Reduced standards for hearing aid dispensers have caused a rapid spread of clinics with superficially trained staff, whose primary lawful focus is limited to hearing aid sales…not audiological services.

The next and following weeks will provide the truth about dispensers, Big Box corporate culture, hearing aid franchise stores, ENT surgeons,  and Online hearing aid sales. You will come to understand business models and their consequences…and you will discover that discount can be very expensive!

Patient-Centered Hearing-Health Care vs. Sales-Centered Hearing Care

The Bottom Line

The following table compares the professional business model, represented by doctor-level audiologist such as those working at Pacific Northwest Audiology, and the corporate business model, represented by “Big Box”, manufacturing, and franchise retailers.

The bottom line is that when you select a hearing care provider you also accept their business model…and the consequences of that model. You can choose patient-centered hearing-health care by a Doctor of Audiology, or volume sales-centered care by a technician.

Given the increasing evidence linking medical, emotional, and social consequences to hearing loss, we hope the table guides you to your best choice for a hearing provider.

 

AuD vs. Dispenser table 3

Hearing Aids Can Prevent Mental Decline

Hearing Aids prevent cognitive decline

An increasing number of research efforts are linking untreated hearing loss to thinking and memory problems, including dementia and Alzheimer’s Disease. Many of these studies indicate that hearing aids should be used as early as hearing loss symptoms can be verified, but evidence supporting hearing aids as a preventive therapy have been largely theoretical. That has changed recently, with new research just published in the Journal of the American Geriatrics Society by researchers at the French National Institute for Health and Medical Research in Bordeaux France. The study followed 3,670 adults, age 65 and older over a 25-year period.

The main findings of this ground-breaking research indicate that “Use of hearing aids attenuates cognitive decline in elderly people with hearing loss”. The study found that people treated with hearing aids for their hearing loss showed the same rate of cognitive decline as a control group with no prior hearing loss. As a contrast, people with untreated hearing loss scored significantly lower baseline scores on the Mini-Mental State Examination (MMSE), a well-established test for determining cognitive function.

The bottom line? Hearing aids appear to have a positive effect on thinking and memory functions, by restoring communication abilities and promoting social interaction, qualities that are known to reduce isolation and resulting depression.

What does this mean to an aging population? “These results argue in favor of screening and rehabilitation of hearing disorders in elderly people,” said Prof. Amieva, a leading researcher in the Neuropsychology and Epidemiology of Aging at the University of Bordeaux, France. “We now have a set of data that is sufficiently robust to assert that hearing loss induces accelerated cognitive decline in the elderly, and hearing aids can attenuate this decline.”

Dr. Li-Korotky, AuD, PhD, F-AAA , is Board Certified in Audiology, and CEO of Pacific Northwest Audiology.

Hearing Loss Linked to Dementia

A Cautionary Tale

Mounting evidence has established a  strong link between untreated hearing loss and diminished cognitive function, including dementia. Studies also link untreated hearing loss to other medical and emotional problems, including depression.

This is a cautionary tale, but a light shines brightly to guide our passage away from danger: Hearing Loss Can End Badly—but we have options!

First, the bad news. Mounting evidence has established a strong link between untreated hearing loss (HL) and diminished cognitive function, accelerated mental decline, rapid rates of brain tissue loss, and other disabling conditions, such as dementia and Alzheimer’s disease. People who don’t hear well tend to withdraw from social activities, and that can lead to depression and early mortality.

The link between HL and dementia is reinforced by statistical and brain scan studies from hearing and social neuroscience research, and backed by compelling theories for how HL promotes dementia.

Dr. Frank Lin from John Hopkins Medicine has identified three primary pathways to dementia and other bad health outcomes:

  1. HL increases the cognitive load on the brain. Struggling to understand speech causes the brain to focus on sound processing at the expense of memory, thinking, and learning processes. Robbing Peter to pay Paul leads to a cascade of bad consequences, leaving seniors vulnerable to dementia and Alzheimer’s disease.
  2. Even mild HL hastens brain tissue loss, and seniors with untreated hearing problems are much more susceptible to brain tissue loss and other unwanted brain structural changes than seniors with normal hearing. This is significant because the brain tissue loss occurs where memory and sensory integration are processed, causing a negative feedback loop that leaves seniors vulnerable to dementia.
  3. People who can’t hear well tend to avoid social engagement. This puts them at a higher risk for becoming socially isolated, lonely, and depressed—and that exposes them to a perfect storm for developing dementia and early death.

Now the good news: new research just published in the Journal of the American Geriatrics Society by researchers at the French National Institute for Health and Medical Research in Bordeaux, France found that hearing aids reduce the threat of accelerated cognitive decline. The Bordeaux study revealed that elderly people with HL who used hearing aids were spared the augmented levels of cognitive decline suffered by others with HL who didn’t use hearing aids.

Social neuroscience research found similar results

Dr. Cacioppo is the Director of the Center for Cognitive & Social Neuroscience and Chair of the Social Psychology Program at the University of Chicago. Decades of research inform the doctor that we are social by design. That means we are hard wired to connect with others. In fact, our need for social interaction is as fundamental as our need for food and water because the consequent social behaviors helped us survive & reproduce.

Highlights from social neuroscience research:

  • Socially connected people are more likely to have good physical health and psychological well-being.
  • People with strong social networks generally live longer. They also have lower rates of anxiety and depression.
  • Forming strong social bonds creates a positive feedback loop of social, emotional and physical well-being.
  • Conversely, lack of social bonding often contributes to a negative feedback loop of isolation, deep loneliness, and antisocial behavior, often leading to bad health outcomes for aging adults, including depression and dementia!

But you can’t connect with people if you can’t hear them, so it is vitally important that hearing and communication problems aren’t keeping you from a socially rewarding life.The bottom line? Hearing empowers social health and social health empower life!

See our Brochure on Hearing Loss and Dementia, here

 

Breaking News - Hearing Aids prevent Dementia study

 

Noise-induced Hearing Loss

When Noise Hurts

Noise induced hearing loss (NIHL) is irreversible hearing damage resulting from exposure to high levels of noise. NIHL affects an estimated 10 to 15 million people in the USA, making excessive noise exposure the most common cause of hearing loss.

What causes NIHL? Exposure to traumatic noise will cause permanent damage to the sensitive hair cells of the inner ear and possibly the hearing nerve.

NIHL is related to both noise intensity and the duration of exposure. Louder sounds require shorter exposures before damage occurs. Why? Because a 10 dB increase in sound level causes a 10 fold increase in sound intensity.

This means that the sound of an MP3 player set at a volume of 115 dB is about 1000 times more intense than a vacuum cleaner sound volume of 85 dB, and a Rock concert can produce sounds (120 dB) that are 100 times more intense than a lawnmower (100 dB)!

NIHL is Permanent. It can be treated to some extent (depending on the damage), but it can’t be reversed!

See our Brochure on Noise-induced hearing loss, here

Tinnitus: The End of Quiet Moments

Tinnitus is the perception of sounds that have no external source. The severity of tinnitus varies from an occasional awareness of a noise (ringing, hissing, buzzing, roaring, clicking, or rough sounds) in one or both ears, to an unbearable and incessant sound that causes a variety of psychological stresses.

Tinnitus isn’t a “phantom sound” or a single disease, but a symptom that can be associated with many causes and made worse by other factors.

Tinnitus is relatively common, but in rare cases it can be a symptom of serious disease such as vascular tumor or acoustic neuroma (a benign, usually slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear).

Tinnitus facts: If you have tinnitus you aren’t alone. More than 50 million Americans have signs of tinnitus. 9 in 10 patients with tinnitus also have hearing loss, and 1 in 5 patients find the symptoms hard to endure. 10-15% of Americans experience chronic tinnitus, lasting more than 6 months.

See our Brochure on Tinnitus, here

Untreated Hearing Loss

The consequences can be severe but treatment offers hope!

Untreated hearing loss has been linked to disabling medical conditions such as dementia, Alzheimer’s disease, depression, and cardiovascular disease. Studies and observational evidence indicate that untreated hearing loss can damage your physical, emotional, and social health and well being.

Your family, friends, and others will not escape these changes. In a very real sense they will share the unwanted consequences of your hearing loss.

The good news is that the worst effects of hearing loss can be moderated with hearing aids, cochlear implants and post-fitting rehabilitation. When people with mild-to-profound hearing loss use hearing aids, they experience less depression, less anxiety, and less emotional stress… while showing significant improvements in their quality of life and well-being.

Given the undesirable consequences of untreated hearing loss, it would be a good idea to get a hearing exam by a well qualified Audiologist, especially if you suspect that you are developing hearing problems. Being more safe than sorry has real meaning when the consequences of inaction are potentially so severe.

See our Brochure on Untreated Hearing Loss, here