July 30, 2007 Issue

             HEARING LOSS HELP E-zine
"The premier e-zine for people with hearing loss"

Volume 2, Number 6                July 30, 2007
Publisher: Neil Bauman      neil@hearinglosshelp.com
            http://www.hearinglosshelp.com
    Copyright Center for Hearing Loss Help 2007

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                      "Hearing loss may change your life,
                        but your life need not be any less
                                rewarding and fulfilling
                        because you have a hearing loss."

                                                               — Neil Bauman, Ph.D.

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Please recommend and/or forward this issue of Hearing Loss Help
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In this issue
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1. News Items

2. Beware of (Ototoxic) Drugs That Can Damage Your Ears

3. Answers to Your Questions

4. Subscriber-only Special

5. Coping Strategies

6. Information on Hearing Aids, Cochlear Implants and/or
    Assistive Devices

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1. News Items
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What's the Best Treatment for Sudden Hearing Loss?—The
Surprising Answer

by Neil Bauman, Ph.D.

Sudden hearing loss is a medical emergency. That is not in doubt. What is in doubt is how doctors should best treat sudden hearing loss.

Treatment for sudden hearing loss currently includes steroids, antiviral medications, vasodilators, hyperbaric oxygen, and to a lesser extent, vitamins, minerals and herbs, Some ear specialists choose not to treat Sudden Hearing Loss at all—citing spontaneous recovery rates of between 32% and 70%. However, giving steroids such as Prednisone is by far the most popular treatment.

So what's the problem? The shocking truth is that there is little scientific evidence that supports the use of Prednisone, or any other treatment for that matter, according to an analysis of 21 random studies done on Sudden Hearing Loss over the past 40 years according to researchers Drs. Anne Conlin and Lorne Parnes in Ontario, Canada.

In the studies they analyzed, the doctors found positive results reported for systemic steroids (pills), intratympanic steroids (injected through the eardrum), batroxobin (an anti-clotting agent), magnesium, vitamin E and hyperbaric oxygen. However, they also found serious limitations in each study that had a positive finding, thus throwing these results in doubt.

Drs. Conlin and Parnes wrote: "To our knowledge, no valid randomized controlled trial exists to determine effective treatment of sudden sensorineural hearing loss." In other words, there is no proof that any treatment really works.

For example, after pooling the data that compared steroids with placebos, the results showed no difference between treatment groups, In addition, there was no difference in the results between people treated with antivirals plus steroids vs. those treated with placebos plus steroids. Nor was there any difference in the results between people treated with steroids vs. people treated with any other active treatment.

The authors conclude, "At present, sudden sensorineural hearing loss remains a medical emergency without a scientific understanding of its cause or a rational approach to its treatment."

Therefore, until studies are done which prove what treatments (if any) are effective, you may be just as far ahead to do nothing and let nature take its course. The odds are good that your hearing will come back—at least partially, but if it doesn't, the treatments your doctor would prescribe likely wouldn't help you much either.

The problem is in knowing whether hearing came back because of the medical treatment, or in spite of it. The tendency is to think it was because of the treatment, but this apparently is not a good assumption at all.

However, if you feel you want to take the "shotgun approach" and try any or all the treatments in hopes that one will work for you, go right ahead. That is your prerogative. Just don't expect miracles as there are still far too many unknowns about the effectiveness of any current treatments for Sudden Hearing Loss.

Extracted from the Archives of Otolaryngology: Head & Neck Surgery (Vol. 133, No 6, 573-581 and 582-586).

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Some Children Are Born with Temporary Deafness

by Neil Bauman, Ph.D.

Strange as it may seem, some children are born deaf, but "regain" their hearing a few months later without medical intervention according to Dr. Joseph Attias at the University of Haifa in Israel.

Amir Gilat, in his report "Some children are born with 'temporary deafness' and do not require cochlear implant," explains:

"There are two causes of congenital deafness among children. One is the lack of hair cells that activate the auditory nerve. The second cause is a malfunction of the nerve itself. A child may be born with what appears to be a normal inner ear, but the hair cells do not 'communicate' with the auditory nerve and the child cannot hear."

Typically, doctors recommend that deaf children receive a cochlear implant as soon as possible so language develops normally. However, for those children with this kind of "temporary deafness" a cochlear implant is totally unnecessary as their hearing may return to normal over a period of 17 months or so.

According to Dr. Attias, "Because children typically go through a series of tests and evaluations by different doctors, a process that often takes months, there are cases of children who were initially referred for a cochlear implant who didn't have it done because their hearing comes back." For example, Dr Attias said, "I called parents and found seven cases of children who were diagnosed as deaf, did not have a cochlear implant, and began to hear."

Gilat continues, "Dr. Attias then found five more children who had been referred to him for pre-operative testing who had begun to hear in the meantime. By the end of his clinical research, he had identified a 'window of opportunity' of 17 months during which deaf children may begin to hear."

Dr. Attias cautions, "A child whose deafness is caused by a malfunctioning connection between hair cells and the auditory nerve should NOT have a cochlear implant in the first 17 months of life. Research results show the possibility that at least some of these children undergo the procedure for nothing."

Since a cochlear implant does not give normal hearing, such children would actually end up with worse hearing than if they had not received a cochlear implant. Therefore, the trend to implant children as young as 8 months or so would not give enough time to evaluate whether their hearing might "come back" on its own.

Interestingly enough, some children only develop partial hearing rather than normal hearing. Since they are hard of hearing, these children can be fitted with hearing aids rather than having a cochlear implant. Gilat concludes, "Dr. Attias is now researching 'temporary deafness' among young children, looking to find a way to identify those who will recover and those who will not."

As a result of this research, if you have a child that is diagnosed as deaf at birth, you might want to have hearing testing done for a number of months to see whether any hearing is showing up before you opt for a cochlear implant for your child.

Reference: Eurekalert May 16, 2007
http://www.eurekalert.org/pub_releases/2007-05/uoh-sca051607.php.

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Diabetes and Hearing Loss

by Neil Bauman, Ph.D.

If you have diabetes, you are twice as likely to develop hearing loss as you would be if you'd not had diabetes according to Catherine Cowie, PhD, the director of the diabetes epidemiology program at the National Institutes of Health.

Hearing loss from diabetes affects all speech frequencies, but is more pronounced in the higher frequencies. For example, in her study, Dr. Cowie found that 32% of diabetics had low-frequency hearing loss (15% for non-diabetics), while 57% of diabetics had high-frequency hearing loss (36% for non-diabetics).

This increased hearing loss could be the result of either changes in the circulatory system resulting in less blood flow to the peripheral blood vessels (which includes the tiny arteries in the inner ear), or changes in the nervous system—typically death to some nerve endings (which also includes the hair cells [technically the auditory nerve endings] in the inner ear).

Therefore, if you have diabetes, it sure wouldn't hurt to have regular audiograms done every year or two so you can keep tabs on your hearing. If you are losing significant hearing, then you can get hearing aids before hearing loss sneaks up on you and negatively impacts your life.

(Extracted from: Diabetes and Hearing Impairment: Audiometric Evidence From the National Health and Nutrition Examination Survey, 1999-2004. Abstract 991-P)

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Hearing Loss and Air Bags

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.

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2. Beware of (Ototoxic) Drugs That Can Damage Your Ears
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Gabapentin Does Not Work for Tinnitus

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

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.

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Having trouble hearing on your cell phone because of lack of
volume or interference?

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ears! Click here to learn more.

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3. Answers to Your Questions
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If you have a question, or if something has been puzzling you concerning your ears, email it to mailto:neil@hearinglosshelp.com and put "e-zine question" as the subject. Suitable questions will be answered here.
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Sympathetic Hearing Loss

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

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4. Subscriber-only Special
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As is our custom, with each issue of Hearing Loss Help eZine we bring you a subscriber-only special that is only available to you, our loyal subscribers.

This issue's special is for the eBook version of our book on Musical Ear Syndrome called "Phantom Voices, Ethereal Music & Other Spooky Sounds". When hard of hearing people begin hearing phantom voices or music, they immediately worry they are going crazy. After all, only people with schizophrenia and other mental illnesses hear such sounds, right? Wrong! The truth is, thousands of sane, hard of hearing people experience the spooky phantom voices, music and other sounds associated with Musical Ear syndrome. Learn what these sounds are, what causes them, what you can do to alleviate or eliminate them and how you can regain your peace of mind (176 pages).

This eBook normally sells for $16.99. If you always wanted this book, now is your chance to save 30% off the already low eBook price. For a limited time you can have it for just $11.97. Furthermore, for our overseas friends, because it is an eBook, there is no shipping charge and you can download it immediately— no waiting time. (Note: the eBook version is identical in content to the printed edition.)

Order it now while you are thinking about it because this special will only be available until August 21st at midnight.

To get this special price, you must click on the below link. Do not order from the regular links on the web site or elsewhere or you will be charged the regular price.

To purchase this eBook edition of Phantom Voices, Ethereal Music
& Other Spooky Sounds at this special subscriber price of just $11.97, click on the above link now.

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If you are receiving this issue of Hearing Loss Help e-zine as a forward, you can sign up for your own subscription at http://www.hearinglosshelp.com, or send a blank email to hearingloss-158260@autocontactor.com. Hearing Loss Help e- zine doesn't cost you a cent!

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5. Coping Strategies
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When Your Piano Sounds Bad

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.

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6. Information on Hearing Aids, Cochlear Implants
and/or Assistive Devices
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Adjusting T-Coil Volume and Real Ear Testing on New Hearing
Aids

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.

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                       HEARING LOSS HELP E-zine

Neil Bauman, Publisher               Center for Hearing Loss Help
49 Piston Court                       Stewartstown, PA 17363 USA
Phone: (717) 993-8555                       Fax (717) 993-6661
http://www.hearinglosshelp.com     neil@hearinglosshelp.com

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