Hearing Loss Help  

by Neil Bauman, Ph.D.

A lady wrote:

I have had tinnitus for the past 4+ yrs. It goes up and down according to stress levels, diet, and so forth. However, I went to the dentist three days ago and I notice that the volume has increased more than usual. I called today and his assistant told me he used Lidocaine as an anesthetic. Could this be the cause of the sound level increase? I do not see Lidocaine in the ototoxic lists I have searched in the Internet. Perhaps this could be a temporary condition and may level out in several more days. Do you have any info on this subject?

Internet lists are not very complete and typically only list the most ototoxic drugs. However, Lidocaine is listed in both the Physicians’ Desk Reference (PDR) (used in the USA) and the Compendium of Pharmaceuticals and Specialties (CPS) (used in Canada) as causing tinnitus. (The CPS also lists Lidocaine as causing hyperacusis.)

It is certainly possible that your tinnitus might have been caused by the Lidocaine. However, Lidocaine may not have been the culprit. Your increased tinnitus could have been caused by the “trauma” of your dental work. For example, dental drills are pretty loud in your ears (and via bone conduction too). Also, your jaw could have been stretched a certain way which could have affected your TMJ, and thus affect your tinnitus. You need to consider these and other possibilities besides the Lidocaine.

In any case, I would expect your tinnitus to drop back to its old level in a few days to a couple of weeks.

by Neil Bauman, Ph.D.

A lady wrote:

I read your article ["Sudden Hearing Loss Is a Medical Emergency"]  as I am suffering a single-ear hearing loss. It started two days ago when I woke up. It felt like something was blocking my left ear. It was not very severe though. But today when I woke up, the hearing loss became intense. I read about how to hum and listen to it. I hear the hum louder in the blocked ear, so it’s not a serious problem (according to your article). But the weird thing is that I do not have cold at the moment, so how come that I have a blocked ear? Any suggestions for me?

Although an ear plugged by a cold is one common cause of hearing loss such as you describe, my first reaction is that your sudden hearing loss was likely caused by excess wax in your ear canals. Probably what happened is that a bunch of it fell off the sides of the ear canal and now has blocked off the whole ear canal causing the hearing loss. I’d suggest you have your doctor check out your ear canals and remove any excess wax if he finds any. Hopefully, that will solve your problem.

A few days later this lady confirmed my suspicions. She wrote: “I went to my doctor and he checked my left ear. He said that it was all wax. He told me to pour some warmed olive oil into my left ear and let it soften the wax inside my ear. I did this three times before coming back again the next day. He then performed a suction to my left ear and finally all the wax came out and I can hear very clearly now. He told me to regularly clean my ears to make sure it does not happen again.”

This incident is an example of where the “hum test” (see the above article link) comes in very useful for separating sudden hearing loss conditions that are true emergencies from those that are not. Although scary, sudden hearing loss does not always have dire consequences attached that require immediate treatment. It can be something as simple as ear wax blocking your ear canal. However, if in doubt, seek professional help immediately.

by Neil Bauman, Ph.D.

One lady asked:

Do you ever hear something and can’t figure out immediately where the sound is coming from?

Another lady replied:

For me, that happens all the time. I have much less hearing in my right ear than in my left. At work when someone calls my name and I am up at the printer, I often turn to the wrong person and say, “What?” only to be told that it was someone else nearby.

Or I hear a repetitive noise, and have to turn my head in different directions to figure out where it is coming from so I can go see what it is.

Worst is when I am in a parking lot and hear a horn or the sound of the motor and don’t know if it is coming from behind me, or beside me, or is nowhere near me.

Similarly, I do not know what direction sirens are coming from when I am driving. It is scary, but also embarrassing at times. Fortunately I don’t have to deal with it very often, but one week I mistook where a police siren was coming from twice.

The first time I was on a ramp getting ready to merge onto a highway from the interstate and heard a siren. I looked carefully at the end of the ramp as I delayed merging into traffic and couldn’t find the source of the siren, and then realized the police car was behind me so I needed to get out of his way!

Then several days later I was driving home and came to an intersection with limited visibility when I heard a siren. I assumed since I was on a side road and the crossroad was a well traveled road, the emergency vehicle was on that road and again looked both ways several times trying to figure out where the siren was coming from. At which point the car across the intersection waved me to come through even though he had gotten there before I did, and I then discovered (again) that the police car had been sitting right behind me.

This goes to show that we hard of hearing people need to always be alert and use our eyes in addition to our ears (not to mention looking in every direction—not just the most likely ones)!

Unfortunately, people with a slow, progressive hearing loss often still act as hearing people, and expect their ears to work normally. Thus, they rely on their (defective) ears instead of using their eyes in addition to their ears.

For myself, I can’t hear the sirens until they are right beside me (much too late to get out of their way), so I always watch for flashing lights. It is the rare emergency vehicle that ever gets close to me without my already having seen its emergency lights and taken appropriate action. This is because I was born with a severe hearing loss and never have been able to rely on my hearing.

by Neil Bauman, Ph.D.

A lady wrote:

I read with interest about the lady who had trouble hearing her own voice when using the neckloop with her cell phone. I, too, had that problem and had 3 of my programs on my Freedom CI switched to M/T mode.

I don’t use the neckloop often but recently went to a convention and used the neckloop with my cell phone to contact my friends inside the convention center. I could hear them well. However, they had difficulty hearing me when I spoke into the neckloop mike. They said my voice sounded “tinny” and “far away”.

My hearing friends got frustrated and just wanted me to hear and speak directly into the cell phone. Is this a normal occurrence when using the neckloop, or does this mean there is something wrong with my neckloop? Other friends have expressed the same difficulty of hearing my voice via the neckloop on other occasions. Please let me know what I can do this solve this problem.

The problem is when you plug a neckloop into the headset jack, then the cell phone’s mic is cut off—so you can’t accommodate your friends by talking into the phone’s microphone even if you wanted to. (That is why the neckloop has the microphone built in.)

I think most of what you are experiencing is an inherent problem with the basic design because the microphone is hanging down on your chest instead of up by your mouth. Obviously, the closer the microphone is to your mouth, the better (and louder) your voice will sound to people listening to you at the other end. Thus a neckloop microphone isn’t the best choice in that respect as it is always so far away from your mouth. Furthermore, the noisier the location, the more noise a distant microphone will pick up. Thus neckloop microphones would sound better in quiet situations.

Now, what can you do to help things along? I can think of two things. First, I wonder if you talk quietly in the first place. That would make it difficult for the more distant neckloop microphone to adequately pick up your voice. So speaking up would almost certainly help.

Second, instead of talking “out”, try talking “down” to your microphone. Aim your voice as best you can at the microphone. This should help too.

Doing both would be even better. Try this and see if it makes any difference.

If all else fails, hold the microphone up closer to your mouth when you talk. This should make a difference by greatly reducing the distance from it to your lips. It might look funny, but it should work.

Finally, there is always a chance that your neckloop isn’t working properly—but I’d try the above first. If the microphone is bad, doing the above shouldn’t make much difference.

by Neil Bauman, Ph.D.

A recent report out of Norway (September 11, 2008) revealed a shocking statistic. “One in six children are affected by kindergarten noise.” One in four employees suffer permanent hearing loss for the same reason.

Figures published by the pre-school teacher’s union and work safety authorities indicate that stress, headaches, tinnitus, learning difficulties and at worst, impaired hearing can affect children in noisy kindergartens, according to daily newspaper Dagbladet.

According to a Labor Inspection Authority report from 2005, 75 percent of kindergarten employees are exposed to harmful levels of noise at work. This means that the kids are also exposed to these same harmful sound levels.

Things are no better over here. Many kindergartens are noisy places. I know. My younger daughter works in one. But this does not have to be. She told me the remarkable difference in noise levels in Montessori schools she has also taught in. Maybe the kindergartens should learn how the Montessori schools control excessive racket and do the same. Reducing this harmful racket will benefit both the kids and the staff.

Aftenposten English Web Desk / NTB

by Neil Bauman, Ph.D.

A man wrote:

Thank you for both your wonderful website (http://www.hearinglosshelp.com ) for the Univox 2A loop system I just installed. I found the system by “googling” for a loop system. Your website is very user friendly and I felt that I could trust the content.

I have a moderate to severe hearing loss. It didn’t become moderate to severe until about 5 years ago. Up until then I was able to enjoy television much like normal hearing people, only missing a little bit here and there. As anyone with my level of hearing loss knows, it became a whole different story with moderate to severe loss.

I invested in an expensive new Bose home stereo with the hopes that the good sound quality would enable me to hear my television. I can tell the sound quality is good, but I still cannot make out speech because the speaker is about 12 feet away.

I think I am like a lot of hearing impaired individuals in that I have begun to feel hopeless, like there is simply no way I will hear things like TV “normally” ever again.

I read the reviews of other users of the Univox 2A, but I was still a little apprehensive. Well, I just hooked it up and I am blown away!

Sound is piping through my hearing aid (with the t-coil program on) and I can hear EVERY WORD, even the commercials, which previously were impossible! I simply cannot believe how good it sounds. I am already a lot less resentful of my hearing loss.

This solution works perfectly, allows me to hear and to keep the TV at a comfortable volume for others, it’s totally hassle free, all I do is put my aid on t-coil and it works.

Thank you so much this gift of hearing that I never thought I would have, even in today’s age of technology innovations. It has far exceeded what I had hoped for. This is truly one of the happiest moments I have had in many years. Hallelujah.

It’s always nice to get letters that reinforce just how wonderfully clear the sound is when using the t-coils on your hearing aids coupled with loop systems. I have enjoyed this beautiful, clear sound for some time, as I looped my house quite a while ago.

If you want to learn more about these wonderful loop systems, read the article “Loop Systems—the Best-Kept Secret in Town!“.

The Univox 2A loop amplifier (mentioned above) is truly a great little home loop amplifier—and it doesn’t cost an arm and a leg either!

by Neil Bauman, Ph.D.

A lady wrote:

I am writing to you as I am trying to find out the reason for my hearing loss. I am 28 (female) with a mild—moderate—severe hearing loss (at low—middle—high frequencies). My hearing loss was first noticeable at age 20. I had my first audiogram at age 26, so do not have any records of the loss before that.

My parents have perfect hearing and we have no record of hearing loss in their generation of the family. We do not have much information about previous generations.

I was infected with Tuberculosis at age 10 and was treated with an 8 months daily course of Isoniazid/Rifampin. The treatment started at age 11. By the time I was 12, I had stopped taking the medications. I can say for sure that I had perfect hearing at least till age 16-17. But sometime after that my hearing started to degrade (was noticeable only at age 19-20).

My question is, “Could the drugs taken at that point of time (age 11-12) trigger an onset of progressive hearing loss which became obvious after 6 to 7 years? Or, does hearing loss due to ototoxicity show up immediately or within a couple of years? Will the loss caused due to ototoxic drugs be progressive?”

I’m sure anything is possible, but I would have expected your hearing loss to show up in the weeks and months after you took these drugs—not years later— if these drugs were responsible for your hearing loss.

Both Isoniazid and Rifampin are ototoxic and have caused hearing loss and tinnitus in some people. They can also cause ataxia (staggering gait), dizziness and vertigo (spinning sensation). However, I don’t know what percentage of the people taking either of these drugs have a resulting hearing loss. Nor am I aware of these drugs being implicated in progressive hearing loss.

If indeed these drugs did cause your hearing loss, my question to you is, “How do you know you had ‘perfect’ hearing until 16?” Is it possible that the drugs had already killed the very high frequencies by that time? Typically, ototoxic drugs begin their damage at the highest frequency you can hear and work their way down the frequency spectrum. I doubt many people would even notice if they had lost hearing above 16,000 Hz for example.

Another factor to consider is whether you had balance problems associated with taking these drugs. If you had ataxia or dizziness or vertigo and now have hearing loss, then I could see that there might be a connection. This is because often drugs that affect hearing also affect balance—so if the drug damages one, often you will also see some damage in the other.

Also, there may have been other medications you have taken over the years, particularly antibiotics, that could have caused your hearing loss. Therefore, from the limited information you have given, there is not enough evidence that the above drugs were responsible for your hearing loss.

You can learn more about such drugs by reading my book “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs known to damage ears (and information on 148 ototoxic chemicals too).

by Neil Bauman, Ph.D.

A man asked:

When the microscopic hair cells are damaged and break off in the cochlea, what happens to them? Are they harmlessly absorbed, or do they float around and impair the action of the remaining hair cells?

Great question. Most people have the misconception that the tiny hairs “break off” from being exposed to loud sounds, or other causes—much like tree branches breaking in a hurricane. This is not the right analogy.

In actual fact, as I understand it, the tiny hairs don’t “break off”. Rather the whole hair cell itself dies—taking with it the bundle of “hairs” numbering between 30 and 300 tiny stereocilia per bundle (what we colloquially call “hairs”) that stick up from each hair cell. These dead cells are then absorbed by the body.

What causes these hair cells to die? One mechanism is being “zapped” by “free radicals” released as a result of loud noise or ototoxic drugs for example. The hair cell either dies from a “direct hit”, or if mortally wounded, programs itself to die through a process called apoptosis.

In addition to dying hair cells, another mechanism is that as we age, the stereocilia seem to slowly disappear—becoming shorter and shorter and finally the whole hair cell is “overrun” by adjacent supporting cells and “disappears”.

In any case, the dead cells are not left to float around and cause havoc with the remaining hearing mechanism.

by Neil Bauman, Ph.D.

A man wrote:

I wear hearing aids. Are there any cell phone attachments so that I can wear my hearing aids and use my cell phone in hands-free mode while I am driving?

If your hearing aids have good t-coils in them, then there are two good possibilities for hands-free cell phone use.

One is to get a cell phone that has the standard 2.5 mm hands-free jack and plug in the T-Links that couples to the t-coils in your hearing aids. If your phone has a proprietary hands-free jack, you can likely get the necessary adapter here.

Second, is to get a cell phone that has bluetooth built in and then use a bluetooth neckloop that also couples to the t-coil in your aids. You can see such a bluetooth neckloop here.

My wife’s cell phone has both the 2.5 mm jack and bluetooth built in so I use either option when I use her cell phone. Both work well for me.

by Neil Bauman, Ph.D.

Kissing causes hearing loss? You’ve got to be kidding!

Actually, it’s true. Not all kissing, mind you, but kissing someone on their ear can be dangerous to their hearing health. Here’s the incident that brought this fact to light.

A mother and her 4-year-old daughter were sitting on the floor watching TV. Impulsively the child hugged her mom and vigorously kissed her. Unfortunately, the kiss landed directly on the opening to the mother’s left ear canal.

This sudden (and considerable) suction applied negative pressure to the ear drum. (1) As the mother related, “While she was doing it, it felt like she was sucking the air out of my head.” (3) “When she finished, I had no hearing in that ear.” In addition to the total hearing loss, “she had a very intense screeching tinnitus. She had a lot of facial twitching, muscular twitching and pain.” (2)

Fortunately, most of her hearing returned a few hours later, but she was left with a permanent 35 dB hearing loss in the lower frequencies, “screeching tinnitus” that later subsided to a permanent soft rushing sound, hyperacusis (normal sounds are now too loud—”any loud sound would jostle her and send her through the roof”) (2), dysacusis (distorted hearing) and facial twitching. (3)

About a year later, she contacted Dr. Levi Reiter, professor and head of the Audiology program, at Hofstra University in New York. Dr. Reiter’s testing revealed that she had no auditory reflex in that ear any more. The auditory reflex is where the tiny stapedius muscle (actually the smallest muscle in the human body) contracts and pulls the tiny stapes (or stirrup) (the smallest bone in the human body) away from the oval window to reduce the volume of sudden loud sounds. (2)

In addition, “she had another interesting symptom, whenever she would turn her head from side to side, it felt like something was loose in her middle ear.” (2)

Further investigation by Dr. Reiter indicated that what likely had happened was that the ligament that fastened the stapedius muscle to the stapes had ripped apart, leaving her with a non-functioning auditory reflex in that ear. Since the auditory reflex could no longer dampen louder sounds, she was left with permanent hyperacusis.

Interestingly enough, this mother only experienced sensorineural hearing loss. There was no conductive loss whatsoever. You would have thought the middle ear bones would have been dislocated causing a conductive loss, but nothing of the sort happened (apart from the ligament on the stapedius muscle being ripped apart—which doesn’t cause hearing loss).

Initially the press reported this event as the “Kiss of Deaf”, but due to Dr. Reiter’s ongoing research in this area, this phenomenon is now going by the moniker of “Reiter’s Ear-Kiss Syndrome” (REKS).

Ever since the first reports came out in the media, Dr. Reiter has been receiving calls and emails from people all over the country who also have experienced hearing loss from a kiss on the ear. (4) Rather than it being a strange and unique occurrence, Dr. Reiter told me that REKS is much more common than it first appeared to be.

He emphasizes that you must never kiss anyone on their ears, or let them kiss you there. (Nibbling on someone’s ears is an entirely different matter!) He writes: “My biggest concern as far as warning the public and getting this out is regarding newborns and infants. Mothers and fathers, and even sisters and brothers and grandparents love to smooch up that little baby—give him a whole kissing frenzy.” (2)

Note that this may be especially true when little children try to kiss a baby sibling. They aren’t discerning where they kiss, and may forcefully kiss them on their ear. (Adults may inadvertently do this too.)

Dr. Reiter continues, “The ear canal of an infant is very small, so that negative pressure you’re applying to the ear canal is going to have a much greater impact than on an adult. I’m afraid there are infants out there who are experiencing this, but they can’t say ‘Mommy, I can’t hear in one ear,’ and the net result is that five years later, when they have a hearing test, no one will know to relate it to this.” (2) Therefore, for the sake of everyone’s ears, confine smooching to other parts of the body.

If you have had any hearing loss or other ear problems resulting from a kiss on your ear, Dr. Reiter would love to hear from you for his ongoing research into this phenomenon. His email address is ears@drreiter.net.
_________

(1) “The Kiss of Deaf”: A Case Study by Levi A. Reiter. The Hearing Journal. August 2008. Vol. 61, No. 8. pp. 32-37.

(2) Interview with Levi Reiter, Ph.D., CCC-A, Professor of Audiology, Hofstra University. Topic: The Kiss That Caused Hearing Loss, or Reiter’s Ear Kiss Syndrome (REKS). 7/28/2008.

(3) Little Girl Gives Mom Kiss Of Deaf. Hearing Review, The Insider. July 31, 2008.

(4) Ear Kiss Causes Rare Syndrome by Dee Naquin Shafer, the ASHA Leader. August 12, 2008.