Hearing Loss Help  

by Neil Bauman, Ph.D.
 

Autoimmune Inner Ear Disease (AIED) is a baffling condition to treat. Sometimes it occurs as the result of untreated allergies. One man explained,

After undergoing steroids and all sorts of medical treatment with no results, I finally heard about allergies being a cause of AIED. After being tested, I found I have terrible environmental and food allergies. Allergy shots have really helped and I am improving now. I also found that in my case, MSG (monosodium glutamate) and various food additives cause attacks of hearing loss and tinnitus. These substances can cause immune system dysfunction. The more you stay away from such things, the better you feel. Your body doesn’t turn on itself for no good reason–it has a little help! Please pass this information along to other people who suffer this horrible agony.

If you have been diagnosed with AIED, make such you see a good allergist and have yourself checked out for allergies that might be the underlying cause. If so, treating your allergies may bring your AIED under control without any other treatment needed.

To learn more about AIED, read my article “Autoimmune Inner Ear Disease (AIED)“.

by Neil Bauman, Ph.D.

 In December of 2006 I wrote about smoking and hearing loss and pointed out that smoking in the presence of loud noise makes your ears even more susceptible to hearing loss than either smoking or loud noise alone.

Now, researchers have published the results of a study on workers in one manufacturing plant showing just how severely noise combined with smoking can affect hearing loss. Here are the shocking results. Workers who were exposed to noise above 85 dB and who smoked had an incidence of significant hearing loss 442% greater than those who worked in the same noisy environment but didn’t smoke.

The researchers next compared the incidence of workers who had hearing loss greater than 30 dB between 4000 Hz and 10,000 Hz in both ears. The incidence of hearing loss was only 11.2% in non-smokers, but was a whopping 49.5% in smokers.

When looking at these same workers, but just considering hearing loss greater than 25 dB at 4,000 Hz in their better ear, the results were even more pronounced. Non-smokers had an incidence of hearing loss of 18.4%, but that figure sky-rocketed to 63.6% in smokers.¹

Therefore, if you value your hearing, you need to do two things. First, if you smoke, stop smoking. Second, wear ear protectors when around noise louder than about 80 dB for extended periods.

Note: smoking isn’t the only agent that has this synergistic effect when combined with loud noise. A number of drugs, chemicals (particularly the organic solvents) and heavy metals also have this property. “Ototoxic Drugs Exposed” (chapters 8 and 14) explains this in much more detail and lists the specific drugs, chemicals and heavy metals that have this nasty property.

¹ Extracted from “Interaction of smoking and occupational noise exposure on hearing loss: a cross-sectional study” Gholamreza Pouryaghoub, et. al. Dept of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran published in BMC Public Health 2007, 7:137. http://www.biomedcentral.com/1471-2458/7/137.

 

by Neil Bauman, Ph.D.

A man had trouble hearing using his hearing aid’s t-coils. I suggested that he go to his audiologist and have the volume set to a level equal to that of his hearing aids’ microphones. When that is done, switching from microphone mode to t-coil mode would produce sounds at the same volume.

He wrote:

I made an appointment with my audiologist to have the t-coil volume increased. Well, my audiologist did her computer magic and VIOLA!!! In fact, she also increased the volume on my right aid. Now, when I use the telephone, I actually have to turn down the volume of the phone a little bit!

To test my t-coils for proper volume and balance, my audiologist took me into her waiting room which is “looped” and I was able to tell her which aid needed to be adjusted up or down. As well as the loop being a convenience to waiting patients, it is also a “tool” she is able to use in cases like mine. I was beyond impressed at the magic she was able to perform. However, she cautioned me that not all hearing aid t-coils volume can be adjusted. She listed some factors such as must be programmable, digital, certain manufacturers, etc.

The good news is that this audiologist was able to set the t- coils to the proper volume for this man. Also, I heartily commend her for looping her waiting room.

The bad news is that obviously she didn’t set up the t-coils properly in the first place when she sold the hearing aids to this man. Why ever not? This is just plain shoddy fitting practice, and shows disrespect towards hard of hearing people. We deserve better. I’m not the only one who thinks this.

For example, in response, Audiologist Brad Ingrao, Au.D. (an audiologist I truly respect for his knowledge of what hard of hearing people really need) wrote:

 I’m happy to hear that your audiologist was able to solve your problem, however as an audiologist, I feel the need to dispel the concept that what she did was magic. What she did was called verification. I am glad to hear that she did it, but the fact of the matter is that, it should have been done initially!

Verifying that hearing aids are performing to the needs of the patient in all modes should be standard practice. Unfortunately, too many audiologists and dispensers trust the computer screens created by manufacturers and then ‘fine tune’ until they (hopefully) get it right.

There are several studies demonstrating that the computer screens are wrong. An even more disturbing fact is that even though we all know that independent verification (i.e. ‘Real Ear’ testing) improves the accuracy of fittings, less than 20% of hearing care professionals do it on a regular basis.

Therefore before you go to an audiologist or hearing aid dispenser, ask them two simple questions.

1. Do you do real ear testing to verify your set up of each person’s hearing aids?

2. Do you have a loop system (either a room loop or something as simple as a PockeTalker and neckloop) that you use to check your set up of the t-coils on each person’s hearing aids?

If the answer to either of these questions is “no,” run the other way. Keep looking for a professional that does those two simple things. Just doing those two simple things can make all the difference to how well you like your new hearing aids.

by Neil Bauman, Ph.D.

A man explained:

I have felt very fortunate during my 81 years in having the ability to play the piano “by ear.” Recently, I found that the notes starting with the “F” in the octave above the middle “C” octave sounded bad enough to me to cause me to stop enjoying the playing. Having the piano tuned produced minimum improvement as did removing my hearing aids, so it must be my hearing. Do you have any comments or is there any information that might explain or improve this situation?

Playing music by ear is not something I could ever do because of my hearing loss—nor could my late mother (hard of hearing all her life also—but who still taught piano to a few students. Nor can my hard of hearing daughter play by ear. However, my other daughter with normal hearing seems to effortlessly play by ear. It’s just not fair, is it?

I’m not surprised that you are having trouble hearing the higher notes on the piano, or that they now sound distorted to you.

Typically, hearing loss begins in the very high frequencies and works its way down the scale. Thus, as a rule, you hear the lower-frequency notes just fine, but as your hearing deteriorates, somewhere on the right side of keyboard an octave or more above middle C you find that the notes just don’t sound the same any more.

My first suggestion is to go to an audiologist and get your hearing checked. Then have your audiologist determine whether your current hearing aids are giving you the needed amplification in the frequencies you are having difficulty hearing properly. It may be that all you need is to have your hearing aids re-adjusted for your current hearing loss.

If your old hearing aids aren’t strong enough now, you may need new, more powerful hearing aids.

However, if your hearing is basically now non-existent in the high frequencies, amplifying sounds you can’t hear won’t help you (and will just cause your hearing aids to squeal—which you won’t hear either). If this is the case, there isn’t much you can do, except to transpose the pieces you like to a lower key where you still hear reasonably well.

It’s one of the “joys” of having a hearing loss. You certainly are not alone. Others have similar problems. For example, my wife hears different keys in each ear so doesn’t know which ear to pitch her voice to.

 by Neil Bauman, Ph.D.

A man wrote:

Your site (http://www.hearinglosshelp.com) is extremely informative. I do have a question. I am a member of ANA (Acoustic Neuroma Association) and there was one member a long time ago that experienced sympathetic hearing loss following AN surgery. Recently, there are others reporting AIED (Autoimmune Inner Ear Disease) following radiation and just watching the tumor. I was wondering if treatments for acoustic neuroma cause AIED, or is it that some people are just destined to acquire this no matter what the situation? Is sympathetic hearing loss and AIED the same thing?

Good questions. Strange as it may seem, sympathetic hearing loss is where you lose hearing in one ear from some cause, then later, your remaining ear loses its hearing—seemingly in sympathy for the first ear.

Now to answer your questions. Is sympathetic hearing loss and AIED the same thing? The answer is technically no—although they may be related at times. This is because if you had AIED in one ear, it could result in sympathetic hearing loss in the other ear according to one theory. Here’s how they think it works.

Some doctors think that the ear may be only partially “immune privileged.” This means that your body may not know about all the antigens in your inner ear. Therefore, when/if they are released into the rest of your body (perhaps following surgery or an infection) your body may think they are foreign agents, and thus wrongly attack these “foreign” antigens. The result could be hearing loss in your other, formerly good, ear.

Dr. Timothy Hain observed that some patients treated for acoustic neuromas have delayed sympathetic hearing loss in the opposite ear. This can also happen if you are treated for Meniere’s Disease in one ear, or if you are treated with radiation for a tumor in one ear.

Thus, there does seem to be some credibility to this theory, but it certainly isn’t the case in everybody with AIED. Dr. Hain suspects sympathetic hearing only occurs in about 1% of the patients in which inner ear antigens are released into the rest of the body following surgery, or other treatments. (1)

(1) Hain, Timothy. Autoimmune Inner Ear Disease (AIED) http://www.dizziness-and-balance.com/disorders/autoimmune/aied.html

by Neil Bauman, Ph.D.

I recently received a phone call from a man who wanted to know about the ototoxicity of Gabapentin, because his doctor had prescribed it for his tinnitus.

I explained to him that researchers have now concluded that Gabapentin (Neurontin) is no more effective than a placebo for tinnitus relief (1).

Why should we not be surprised? After all, Gabapentin causes tinnitus in a good number of the people that take it. In fact, Gabapentin is quite ototoxic. According to the PDR, it can cause hearing loss, hyperacusis, tinnitus, ataxia, dizziness, vertigo, and ear pain among other things.

This is not the kind of drug you want doctors using to treat your ears, or anywhere in your body for that matter!

Rather interestingly, this above article concludes with the statement, “To date, the US Food and Drug Administration (FDA) has not approved any drug for the treatment of tinnitus.” So if any doctor prescribes any drug for your tinnitus, know that this use is not approved by the FDA for tinnitus. It’s that simple.

Since there are more than 450 drugs known to cause tinnitus, the chances of researchers finding one that stops tinnitus seems pretty slim!

To be safe, you always need to check out the ototoxic side effects of any drugs before you take them. One way to do this is to check them out in “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs known to damage ears (including the 450 known to cause tinnitus). For your copy, click on the above link now.

(1) Reported in the April issue of the Archives of Otolaryngology—Head and Neck Surgery 2007; 133:390-397.

by Neil Bauman, Ph.D.

Air bags save lives—and for that we are definitely thankful. They also destroy hearing—and that is not so nice. Here is Lisa’s story.

Last week I was involved in what should have been a minor car accident. I wasn’t paying attention and “gently” hit the car in front of me stopped for a light.

What happened next was terrifying. The inside of the car seemed to explode in a deafening roar. I had an unimaginable pain in both ears and considerable bleeding from my ear canals. I also had a very loud ringing and was virtually deaf.

I was taken to the hospital where it was quickly determined that my eardrums had ruptured. I was referred to an ENT who said they should heal in 2-3 weeks, but possibly with scar tissue that would affect my ability to hear low sounds. As for the ringing, he said that could be permanent. He also said I had suffered inner ear damage that would affect my high-frequency hearing, although he said it was hard to tell how much. He concluded by saying I would need to face life “hearing impaired” and may need to look at hearing aids.

I have always protected my hearing and never would have thought about going to loud concerts or auto races without effective noise protection. I’m only 22 and I can barely hear conversation in a quiet room. With background noise, I am almost deaf.(1)

Lisa is not alone. Many other people have also experienced tinnitus and/or hearing loss when air bags deploy. In fact, the results of researcher Richard Price’s studies indicates that a whopping 17% of the people exposed to deployed air bags will experience permanent hearing loss. That’s a lot of people—almost 1 in every 5 people exposed to air bags going off!

Here’s another surprising discovery. His data also shows that contrary to what experts previously thought, airbag deployment is more damaging to our ears when we have the windows rolled down.

This is because the higher pressure generated in the closed cabin actually prevents greater damage to the ear. The pressure causes a displacement in the middle ear that stiffens the stapes, a small bone outside the inner ear. This stiffening limits the transmission of energy to the inner ear, where hearing damage takes place. In airbag experiments where the cabin is completely sealed and pressure is even higher, hearing damage is reduced even further.

Incidentally, Price’s study only included cars sold in the United States. American cars have larger, more powerful airbags than cars sold in Europe. Hence, cars with smaller airbags sold in other parts of the world would likely pose less auditory danger when tested under identical circumstances.(2)

The moral of the story, and another good reason to drive carefully and avoid accidents, especially “fender benders,” is that an air bag going off causes just as much damage to your ears whether you are going 15 miles an hour (and serious injuries are unlikely) or 80 miles an hour (where hearing loss may be the least of your worries)!

(1) Hearing Loss Web Forum: Issues: Air bags ruined my life. Accessed online at
www.hearinglossweb.com/discus/messages/12/733.html?FridayJune1020050444pm

(2) As reported in The Hearing Review http://www.hearingreview.com/issues/articles/2007-07_10.asp taken from: Price Richard. Intense impulse noise: hearing conservation’s poison gas. Paper presented at: Annual Conference of the National Hearing Conservation Association, February 16, 2007.