Hearing 101 Brought to you by 360 Balance & Hearing Presented by: Bridgett Wallace, PT, DPT Physical Therapist and Educator Owner of 360 Balance & Hearing 20+ years specializing in dizziness & balance disorders Provides online and live training for assessment and treatment of dizziness and balance disorders Published journal articles, textbooks, and e-books Brad Melancon, MS, FAAA Audiologist and Educator 48 years (and still counting) of experience Traveled worldwide to train other health care providers in administration and interpretation of vestibular testing Associate Professor at LSU Medical School Starting his 4 th year as Director of Audiology at 360 Balance & Hearing 360 Neuro Health, 2018 1
Describing Hearing Loss Hearing loss is the decreased ability to perceive sound Multiple causes of hearing loss One of most common symptoms reported to physicians ½ billion people world-wide with hearing loss 1:6 Baby Boomers have hearing loss Growing concern of increased occurrence of hearing loss with adolescents Levels of Hearing Loss Based on frequencies where most common speech sounds occur 250 decibels (db) to 6,000 db Normal is anything better than 25 db on a hearing test (audiogram) Mild: 25-40 db hearing loss Moderate: 51-55 db hearing loss Moderately Severe: 56-70 db hearing loss Severe: 71-90 db hearing loss Profound: 90+ db hearing loss 360 Neuro Health, 2018 2
Levels of Hearing Loss Keep in mind, that hearing loss typically happens gradually over time Often not noticed in the earlier phases People often wait 5-7 years before they talk to an audiologist or physician about their hearing loss If hearing loss becomes too severe, it is more difficult to treat Earlier use of hearing aids leads to better outcomes Hearing Loss This picture represents the sounds of daily life and locates those sounds where they typically fall relative to tone pitch and loudness. The blue defines the levels of hearing loss. 360 Neuro Health, 2018 3
Comprehensive Hearing Test (Audiogram) Takes time (45-60 minutes), sound treated room, new digital technology and expert opinion for interpretation Should include: Air-bone conduction studies Tympanometry Reflexes Word recognition scores in both ears Benefits of Comprehensive Audiogram Determines the most appropriate hearing aid(s) Provides valuable information about the types and levels of hearing loss Helps identify possible causes of hearing loss, tinnitus, sensitivity to sound, dizziness and/or balance problems Provides insight to further testing being needed, such as auditory brainstem responses (ABR), electrocochleography (ECoG), and Vestibular Evoked Myogenic Potentials (VEMP) 360 Neuro Health, 2018 4
Brief Definitions of Additional Testing ABR: to measure how sound signals move from the inner ear and along the hearing nerve to the brain as well as other parts of the brain. ECoG: to identify potential hydrodynamic (fluid) problems of the inner ear VEMP: to determine if a specific area of the inner ear and the connections with the brain are functioning normally Types of Hearing Loss Conductive: results from a breakdown of mechanical function of the inner ear Hearing loss BEFORE the inner ear Caused by bony changes, ear wax, middle ear infection, trauma, etc. Sensorineural: results from damage to the nerve endings, hair cells, etc Hearing loss BETWEEN the inner ear and brain Caused by noise exposure, inner ear disorders, trauma, etc. 360 Neuro Health, 2018 5
Additional Types of Hearing Loss Mixed: a combination of conductive and sensorineural hearing loss Central Auditory Processing Disorder: due to a breakdown in how the brain processes hearing Important to assess with learning disorders and post head trauma More on Types of Hearing Loss High Frequency - the most common Associated with age, noise exposure, trauma and benign tumors Mid Range - the least common (rare) May be called a cookie bite pattern and is typically genetic Low Frequency may be conductive or sensorineural If sensorineural, may indicate a fluid problem of the inner ear (Meniere s) and has been associated with low cerebral spinal fluid (CSF) If conductive, may suggest a structural abnormality of the inner ear (Superior Canal Dehiscence), especially if associated with dizziness from loud sounds but tymps and reflexes are normal. Also found in middle ear problems. 360 Neuro Health, 2018 6
Early Signs of Hearing Loss Asking people to repeat what they said Not being able to follow or participate in a conversation, especially in a noisy place Ringing or buzzing (tinnitus) Hear men s voices better than women or children Turning up the TV Benefits of Comprehensive Audiogram Determines the most appropriate hearing aid(s) Provides valuable information about the types and levels of hearing loss Helps identify possible causes of hearing loss, tinnitus, sensitivity to sound, dizziness and/or balance problems Provides insight to further testing being needed, such as auditory brainstem responses (ABR), electrocochleography (ECoG), and Vestibular Evoked Myogenic Potentials (VEMP) 360 Neuro Health, 2018 7
Sample Audiograms High Frequency Hearing Loss Low Frequency Hearing Loss Causes of Hearing Loss Exposure to loud noise Congenital/Hereditary Illnesses Aging Traumatic Ototoxic drugs (especially aminoglycosides and/or cancer treating drugs) 360 Neuro Health, 2018 8
Too Loud??? Remember: If you have to talk louder for people to hear you then that level of noise is potentially causing permanent damage Treatment Options for Hearing Loss Depends on the cause Removing excessive ear wax May benefit from simple over the counter options (NOT Q-TIPS!) or professional removal, depending on the severity Managing middle ear fluid problems (from infections) Medications often help and, in more severe/chronic cases, surgical options may be recommended Hearing Aids Digital technology (last 4 years) is most beneficial 360 Neuro Health, 2018 9
Additional Thoughts on Hearing Aids Newer digital technology allows for faster and better programming to each person s needs If you or a loved one has purchased aids and are not happy then we strongly recommend returning to the audiologist, especially in higher end hearing aids 2 most common causes hearing aids are not working: 1. Not the right hearing aid for the type/level of loss 2. Not properly programmed Newer digital technology helps with background noise Unfortunately, can t turn off background noise because a lot of noises in the background are in same frequencies of speech Hearing Aids and Balance, Memory Will wearing my hearing aid help my balance? A: In a quiet room, most likely, NO. A: In a busier/noisy environment, most likely, YES How we process hearing and balance have shared pathways Hearing loss has been associated with a number of medical conditions (diabetes, heart disease, dementia) and increased fall risk 360 Neuro Health, 2018 10
8 Common Conditions Associated with hearing loss Closing Remarks Hearing vs Listening Hearing: perception of sound Listening: comprehension of sound Comprehensive audiograms are important for properly fitting hearing aids as well as identifying inner ear disorders and/or central processing problems Tinnitus = abnormal sounds in the ear 360 Neuro Health, 2018 11
Closing Remarks Tinnitus Frequently related to hearing loss Also related to stress, anxiety, etc Tinnitus or Sound Therapy can be beneficial may take weeks, months to years Talk to your trusted audiologist and/or physician about tinnitus, sensitivity to sound, and/or hearing loss **With sudden hearing loss, see a physician (ENT) as soon as possible!!! We are so grateful for your participation in Hearing 101. We look forward to your feedback: info@360balance.com Specializing in dizziness, balance and hearing disorders And, don t forget to join us for our Live Q&A on the 3 rd Tuesday of the month: Talk Tuesdays with VEDA https://www.facebook.com/vestibulardisorders Please check out our other e-classes. And, if there is a topic you want us to add, please let us know! Thanks, again!!! 360 Neuro Health, 2018 12