Corvallis Hearing Center

Audiology Clinic and Hearing Aids

Call 541-754-1377

Hearing Difficulty?

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Hearing Difficulty?
It’s Important to Know the Business You Are In
Dr. Ron Leavitt, Audiologist

A noted entrepreneur once said “It is important to know what business you are actually in.” In recent years this quote has taken on new meaning for hearing health care providers.

In the past some audiologists may have thought we were in the hearing aid sales business. Then cochlear implants came along and that view was broadened to include a more encompassing term such as the “hearing improvement business” since hearing aids were no longer the only tool in the toolbox.

Today hearing health care providers are faced with a mountain of data suggesting we are in the cognitive optimization business.

Specifically, it is now known that when hearing loss is untreated or improperly treated, a host of anatomical and physiological changes occur in the brain that result in a phenomenon known as “synaptic pruning and resource reallocation.”

While synaptic pruning is used by the healthy brain to minimize those pathways that are nonessential to existence, when hearing loss is improperly treated synaptic pruning and reorganization takes place in critical areas of the brain associated with higher order reasoning. Such unfavorable reorganization/pruning may be a gateway to dementia whose strong relationship to hearing loss has been well documented.

The obvious question then becomes what should we be doing to prevent such an outcome? First, when friends, family or colleagues start saying you are having hearing problems act immediately to get a comprehensive hearing test. There is likely a point of no return where the brain is too improperly pruned/reallocated to recover (see https://corvallishearing.com/1feb2021 for more in-depth discussion).

Next, every hearing aid and cochlear implant must be programmed so as to provide audibility of the greatest number of speech sounds possible within the limitations of the individual’s hearing loss. Unfortunately, such programming rarely occurs (see https://corvallishearing.com/2feb2021 or https://corvallishearing.com/3feb2021 or https://corvallishearing.com/4feb2021 for more in depth explanation).

Next, you must work to maintain optimized hearing of speech sounds. Such maintenance entails annual hearing and hearing aid/cochlear implant checkups. Hearing rarely gets better over time and some causes of hearing loss result in a fairly rapid degradation of hearing in a relatively short time frame. As such, hearing aid reprogramming may be necessary on an annual basis or sooner.

Additionally, hearing aid and cochlear implant performance may degrade over time, particularly when used in high humidity or dusty/polluted environments or worn with excessive amounts of hair spray.

Finally, we must all take some initiative to stay physically active and eat well as contemporary research has shown both are critical areas of intervention in cognitive optimization for both children and adults (see https://corvallishearing.com/5feb2021 and https://corvallishearing.com/6feb2021 and https://corvallishearing.com/7feb2021 and https://corvallishearing.com/8feb2021 for more info).

For anyone interested in more information on this topic we will be presenting this information at our next “virtual” Better Listening Seminar and on our website in the near future. For more info call (541) 754-1377.

 

Hearing Aids for People with Normal Hearing?

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Much research has focused on patients who self-report listening difficulties, but show normal results on the typical pure tone hearing test where you raise your hand, push a button or say “yes” when you hear the tone.

In fact, it is estimated some 26 million people in the U.S. self-report listening difficulties with normal pure tone results (see https://corvallishearing.com/hearing-difficulties for references ).

This 26 million figure would account for nearly 70% of the 37.5 million people in the U.S. who have suspected listening difficulties per the National Institutes of Health estimate.

The literature notes there are a number of auditory disorders that may not produce hearing loss as measured by pure tone testing.  These disorders include Central Auditory Processing Deficit, Auditory Neuropathy Spectrum Disorder, Cochlear Synaptosis, Hyperacusis and tinnitus to name a few.

It is not surprising then that pure tone testing popularized in the early 1940s does not address these more recently-identified auditory maladies.

In a previous article we noted several other tests are often more diagnostically revealing for the disorders listed above.  However, the question for most patients so afflicted with any of these disorders is “What can be done to treat it.”

Unfortunately, the treatment of these disorders is less clear cut than the diagnostic tests used to identify them.

In a recent article Humes (2020) made the case for use of hearing aids with many such patients who show normal pure tone test results (see https://corvallishearing.com/normal-hearing).

In the case of tinnitus (the perception of ringing, buzzing, whooshing sound or music when no sound is actually present) the hearing aid recommendation is often supported. Research has shown oftentimes the brain is essentially turning up the volume looking for sounds that are no longer as loud as they once were before the individual experienced tinnitus.  Thus, hearing aids can amplify these slightly less loud sounds back to their original volume and the perception of tinnitus in as many as 60% of patients is improved.

 

In the case of Hyperacusis (heightened sensitivity to sound, with aversive or pained reactions to normally-loud environmental sounds) this disorder is thought to result from the brain’s loudness mediating function being set at too low a volume.  As such one recommended treatment is gradual introduction of more sound oftentimes from a very low-volume hearing aid combined with counseling to calm an apprehensive patient who is already concerned about too much sound. (see https://corvallishearing.com/tinnitus for discussion).

By contrast in 260 patients with Auditory Neuropathy Spectrum Disorder, 61% of  patients reported little or no hearing aid benefit (see https://corvallishearing.com/auditory-neuropathy).

In short, successful use of hearing aids among patients self-reporting listening difficulties with normal pure tone results depends heavily on the correct diagnosis.  To quote Ghandi “A correct diagnosis is three-fourths the remedy.” It is then imperative that in-depth testing beyond the conventional pure tone examination be completed before any hearing aid recommendation is made for such patients.

Hearing Loss and the Brain: A Story of Evolution

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At times, medical knowledge moves forward in leaps and bounds. At other times such knowledge moves forward in a more gradual fashion. Such has been the case with our knowledge of the effects of hearing loss on the brain.

Seven years ago, Dr. Frank Lin of Johns Hopkins Medical University reported that hearing loss was highly associated with dementia and accelerated brain shrinkage.  At that time, our medical knowledge on this topic took a giant step forward.

Since that report, our understanding of this relationship has been more evolutionary.  For example, Drs. Glick and Sharma showed that untreated and poorly treated hearing loss results in a scrambling of brain resources.

These researchers showed improperly treated hearing loss results in inappropriate use of the frontal and prefrontal areas of the brain. Typically, these two areas of the brain are associated with memory and reasoning. However, in the case of poorly treated hearing loss, these two brain areas are used for understanding speech, lending credence to Dr. Lin’s hypothesis that hearing loss may overwork the memory and reasoning areas of the brain.

On a positive note, Glick and Sharma showed that properly fit hearing aids may reset the brain so that the auditory area is once again used for listening. Now the frontal and prefrontal brain areas can resume their normal functions.

More recently, it was discovered that hearing loss upsets the normal rhythmic pulses and interconnections the brain uses to communicate among its different functional areas.

Within the last few months, two separate reports out of Boston and Northwestern Universities showed reestablishing appropriate pulse rates among these different areas of the brain results in significant memory improvements in older people.

These studies, when considered together, suggest the possibility that properly treated hearing loss with hearing aids, perhaps combined with brain pulse resetting, may combat the devastating effects hearing loss may have on memory.

Currently, several large-scale studies are under way, examining the potential therapeutic benefit of properly fit hearing aids and brain pulse resetting on memory. In the interim, it appears medically prudent to treat hearing loss sooner rather than later, as the average delay between diagnosis of hearing loss and treatment has recently been reported to be nine years. It is no longer appropriate to view hearing loss as an inconvenience that can be ignored.

At our clinic, we are currently reviewing the records of 51 patients who have normal aided scores on the same speech in noise test shown by Glick and Sharma to signal brain resource preservation in hopes of identifying those therapeutic steps that can properly reset the brain.

Those interested in obtaining further information on this topic are invited to the monthly meeting of the Oregon Association for Better Hearing at Corvallis Good Samaritan Hospital, Conference Room B on the second Thursday of every month from 3:30 to 5:00 p.m.

Click Here for the Upcoming Seminar Information

Researchers Discover Proteins That Could Soon Cure Hearing Loss

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Mouse cochlea with hair cells shown in green and auditory nerves shown in red. Credit: Doetzlhofer lab

Researchers at John Hopkins Medicine have found a pair of proteins that control when hair cells are created in the inner ear. This finding, published on June 12th, may hold the key to curing people with irreversible hearing loss.

Approximately 90% of genetic hearing loss is due to hair cell problems or auditory nerve damage. Hearing loss due to excessive loud noise exposure or viral infections damages these hair cells. Fish, amphibians, reptiles, and birds can regenerate their damaged hair cells. Humans cannot regrow their hair cells. Once our hair cells are damaged hearing loss is permanent.

Click here read more about this incredible new finding!

Corvallis Hearing Center will continue to follow this ongoing research and talk about this new finding at one of our future seminars.

Attend our FREE monthly seminar held at Good Samaritan Regional Medical Center on the second Thursday from 3:30pm – 5:00pm of every month. Click here for this month’s topic and meeting room location.

A Source to Resources!

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Through research, networking and years of experience we have collected a huge amount of resources and put them together for your convenience. We want you to have the help you need at your fingertips. We know life is hectic and full of confusion so we hope that this is one way we can help! We have compiled resources for hearing health and information onto one useful page. Just click our link and you will have them at your fingertips. [Read more…]