We will have limited staff and limited hours this week. It may take a bit longer to receive a call back. If there is an urgent issue, please email Dr. Sandler at ES@thcaudiology.com
Hearing Assistive Technology
What is Hearing Assistive Technology?
Many individuals with hearing loss struggle in noisy environments. Hearing aids or cochlear implants alone may not be enough to overcome effects of noise, background conversation, reverberation and distance.
Hearing Assistive Technology (HATS) are devices that connect to hearing aids and/or cochlear implants to allow for a cleaner sound signal and facilitate clearer understanding and communication.
FM System:
An FM system consists of a microphone that is placed close to a speaker, such as a teacher.
The microphone transmits the speech signal directly into the hearing aids, which minimizes effects of distance, noise and reverberation.
An FM system is particularly useful in settings such as a classroom, which can be a challenging environment for children.
Utilizing an FM system has been shown to facilitate language development, reduce listening fatigue and allow a child to have a greater degree of independence at school.
Loop System:
A loop system works with hearing aids or cochlear implants that have a telecoil.
A copper wire is placed within a large room or theater that connects to a loop driver to a public sound system.
The sound is then wirelessly transmitted into the hearing aids or cochlear implant to allow for cleaner and more direct signal.
Remote Microphone:
Remote microphones wirelessly transmit speech signals directly into the hearing aids.
They allow for a direct audio input that helps to overcome effects of distance, noise and reverberation.
Remote mics have been shown to improve speech understanding in the presence of noise.
They can be clipped to a talker’s clothes or placed on a table to pick up a speech signal.
TV Streamer:
This device allows for TV signal to stream directly into hearing aids.
It helps the individual with hearing loss to listen at a volume that is comfortable without disturbing those around them.
The volume can be adjusted on the TV and on the hearing aids independently.
Amplified/Captioned Telephones:
These allow for individual to use captioning in addition to hearing a speaker on the other end of a phone call.
When an individual makes a phone call (either landline or cell phone), the phone connects to a Captioned Telephone Service (CTS), which uses voice recognition to transcribe what the person on the other end of the line is saying.
These captions appear in almost real-time, allowing the individual utilizing closed captions to follow along without falling behind.
For more information about HATS, call our office!
Facts about Meniere's Disease
What is Meniere’s Disease?
Meniere’s Disease is an inner ear disorder than can affect one’s hearing and balance systems
It typically affects one ear but sometimes can affect both
The onset of Meniere’s can be at any age, but most often starts between younger and middle adulthood
What Causes Meniere’s Disease?
Meniere’s is thought to develop as a result of an abnormal amount of endolymph fluid in the inner ear
While its cause is unknown, though it is thought to be due to genetics, viral infection, autoimmune response, or a combination of these
Four Main Symptoms of Meniere’s:
Hearing loss
Tinnitus (ringing in the ears)
Aural fullness (clogged sensation)
Vertigo
The severity of Meniere’s symptoms can fluctuate.
How Do These Symptoms Manifest?
Hearing loss is most commonly low frequency, though it can vary
Tinnitus is often described as a “roaring” or humming sound, which is also low frequency
Aural fullness typically occurs in the ear that is affected, and is most likely a byproduct of hearing loss
Perhaps the most debilitating symptom is vertigo, a spinning sensation that can last for a few hours and may lead to nausea and vomiting
While there is no “cure” for Meniere’s, there are several ways to manage symptoms:
An Ear Nose & Throat physician may recommend a diuretic and/or low sodium and caffeine diet
Motion sickness and anti-nausea medications may be prescribed to reduce effects of a vertigo episode
An Audiologist may recommend a hearing aid if there is hearing loss and tinnitus present
Vestibular rehabilitation may be useful if one has balance difficulties in between episodes of vertigo
Surgical options may be considered in severe cases in which symptoms are not relieved with traditional management strategies for Meniere’s
For more information, contact our office!
Facts about hearing loss
Surprising Facts About Hearing and Hearing Loss
Noise exposure is a common cause of hearing loss
Newborns can have fluid in their ears that can impair their hearing temporarily
Approximately 32 million people with hearing loss are under the age of 15
Sitting close to loudspeakers at a concert can damage someone’s hearing in just 7.5 minutes
Sitting close to loudspeakers at a concert can damage someone’s hearing in just 7.5 minutes
Approximately 25,000 people in the U.S. have cochlear implants; about half of them are children
For people who have hearing loss in both ears, wearing two hearing aids is better than wearing one. Wearing two hearing aids helps the individual localize where sound is coming from
For More Information About Hearing Loss and Hearing Aids, Schedule an Appointment With Us Today!
Single Sided Deafness
Treating Single-Sided Deafness
A Unilateral Hearing Loss (UHL) is when one ear has normal hearing, while the other ear has some reduction in hearing. Hearing loss in the one ear can range in severity from mild to profound. Single Sided Deafness (SSD) is a type of unilateral hearing loss that is so severe that the ear is considered non-functional or deaf. Those with single sided deafness may not benefit from a hearing aid on that ear.
Causes of UHL and SSD may include:
Congenital hearing loss
Trauma or head injury
Acoustic neuroma
Viral or bacterial infections
Vascular insults that damage the auditory pathway
Ototoxicity
Unilateral hearing loss and single sided deafness can have a variety of consequences.
These may consist of: difficulty with speech in noise, being accused of having selective hearing, trouble finding the location of sound in space, a tendency to misconstrue the intended message in group interactions, feelings of rejection/ridicule when an individual cannot follow a conversation, speech and language delays, reduced academic performance, fatigue and appearing disinterested.
There are a number of options to manage single sided deafness:
Contralateral Routing of Signals (CROS) Hearing Aid
This hearing aid device has a microphone placed on the impaired ear and a receiver on the better ear. The signal is wirelessly routed from the microphone on the poorer ear to the receiver on the better ear. CROS devices can lead to clearer conversations, improved speech understanding, and a more comprehensive listening experience.
2. Bone Anchored Hearing Apparatus (BAHA)
This consists of a metal abutment that is implanted into the patient’s skull, and an external piece that snaps on. A BAHA bypasses the outer and middle ear and stimulates both cochleae via bone conduction. A BAHA is beneficial for those with SSD due to outer and middle ear abnormalities.
Soft band BAHAs are an appropriate option for children under the age of 5 or for those who do not wish to undergo the surgical procedure.
Osia Implantable Device
The Osia implantable device is similar to that of a BAHA, as it bypasses the outer and middle portions of the ear to stimulate the cochlea via bone conduction.
With the Osia device, an internal implant is drilled into the mastoid bone, and an external processor connects to the internal piece via magnet to stimulate both cochleae.
Both BAHA and Osia devices have shown to lead to improved understanding of speech listening in both quiet and noise.
Cochlear Implant
Hearing aids make sound louder but do not make sound clearer. When an individual who is fit with a hearing aid continues to struggle with understanding speech, a cochlear implant can be considered.
A cochlear implant is a small electronic device that stimulates the auditory nerve electrically.
An internal component is surgically placed under the skin behind the ear. A thin wire with a magnet and an electrode array is inserted into the cochlea within the inner ear. An external piece sits behind the ear and connects to the internal component via magnet.
The external piece picks up sound with a microphone. The sound is then transmitted along the electrode array, which sends electrical stimulation up to the brain.
For individuals with SSD, cochlear implants are the only devices that can allow for “binaural hearing”.
Contact us to learn more about what device is right for you!
Signs of Hearing Loss
Signs That You Suffer from Hearing Loss
Speech sounds muffled or as though someone has marbles in their mouth
Asking people to repeat themselves, or frequently asking “what did you say?”
Difficulty and frustration when speaking on the phone
Experiencing ringing, buzzing, humming or chirping in one or both of your ears
Finding that you withdraw from social gatherings or participating less because you cannot understand others in noisy surroundings
Feeling that your ears are clogged or full
Struggling to follow conversations in noisy places such as restaurants, theaters, stadiums or lecture halls
Raising the television volume higher, even when others note that the TV is loud
If you feel you may suffer from hearing loss, schedule an appointment with us today!
Hearing Loss from Noise Exposure
Noise Induced Hearing Loss
When an individual is exposed to loud sound, the inner ear can become permanently damaged. This is known as Noise Induced Hearing Loss (NIHL). The longer one is exposed to loud noise, the greater likelihood of permanently damaging one’s hearing. The louder the sound, the less time it takes to cause damage to the inner ear.
Risks for NIHL include but are not limited to:
Working in noisy environments, such as industrial factories, musician venues, warehouses, military bases, or transportation vehicles (trucks, airplanes, ambulances,
Participating in activities such as shooting firearms or attending concerts
Listening to music at an extremely loud volume level for extended periods of time
Signs that may indicate NIHL include:
Gradual or sudden hearing loss
Difficulty understanding people, especially in noisy environments
Sensitivity to noise (hyperacusis)
Ringing/humming in the ears (tinnitus)
Perception that pitch is off
Changes in heart rate
Disturbed sleep
Cognition and learning disorders
How might you prevent NIHL?
Limit exposure to noise! Be sure to wear hearing protection devices such as earmuffs, earplugs or musician plugs. You may also consider using sound-isolating earphones when listening to music to decrease background noise and avoid needing to make the volume louder
A term that has been widely surfacing in the Audiology world is known as Hidden Hearing Loss. This term has been applied to cases in which the patient reports difficulty with speech in noise, tinnitus and hyperacusis, though tests reveal normal hearing. Exposure to loud sounds for extended periods of time can lead to functional deficits before hearing loss is displayed on hearing tests. Even if hearing is normal, these symptoms could be a precursor to hearing loss when exposed to loud sound!
If you think you may suffer from noise induced hearing loss, schedule an appointment with us today!
When should you see an Audiologist?
The Difference Between Ear, Nose & Throat Physicians (ENTs) and Audiologists
Q: What is an ENT?
A: An ENT specializes in medical or surgical treatment of the ear, nose and throat. Some ENTs perform ear surgeries such as PE tube placement, stapedectomies, mastoidectomies and implant devices such as BAHA, Osia, or Cochlear Implants.
Q: What is an Audiologist?
A: An Audiologist is a healthcare professional that specializes in the diagnosis and treatment of auditory (hearing) and vestibular (balance) disorders. An Audiologist uses technological solutions such as hearing aids to manage chronic hearing loss.
Q: When does one need to see an ENT?
A: One should visit an ENT if he or she has medical conditions that may affect the ear, nose or throat.
Q: When does one need to see an Audiologist?
A: One should see an Audiologist if he or she notices increased difficulty with hearing, such as turning the television volume higher or struggling to follow conversations in noisy environments.
Q: Do ENTs and Audiologists work together?
A: Sometimes Audiologists will refer to ENTs to inquire about the underlying cause of a patient’s hearing loss or for medical management of the hearing loss. Similarly, ENTs may refer to Audiologists for management of a patient’s hearing loss when they determine it is not due to an underlying medical condition and can be managed under an Audiologist’s care.
Contact us to learn more about what we do as Audiologists!
Jabra OTC hearing devices
You may be hearing about over the counter hearing devices in the news. There is a lot of excitement about how they will help individuals with hearing loss. We will be offering Jabra Enhance plus as an option in our practice. These are limited self-fitting devices, likely limited to mild to moderate hearing loss. They will be suitable options for some patients, and they are definitely not for everybody. Here is some information about what is included with Jabra devices.
Jabra Enhance $800 for the set
Fitting Formula: Estimation via app
Fitting Range: mild to moderate hearing loss
Follow up service: All via app or Jabra, NOT from TheHearing Center
Warranty terms: 1 year service obtained direct from manufacturer
Streaming Connectivity: Limited to iphone 11 or never with iOS 15 via app and Jabra
Loss and Damage Coverage: None
Expected lifespan: 1 to 2 years
If you think these may be a fit for you, or you would like to better understand the differences between our more traditional hearing aids, and these devices, please contact our office.
Common Questions about Cochlear Implants
Frequently Asked Questions About Cochlear Implants:
Q: What is a cochlear implant?
A: A cochlear implant is a small electronic device that is surgically implanted into the cochlea to stimulate the auditory nerve electrically. An internal component is implanted under the skin behind the ear. A thin wire with a magnet and an electrode array are inserted into the cochlea within the inner ear. An external piece sits behind the ear and connects to the internal component via magnet. The external piece picks up sound with a microphone. The sound is then transmitted along the electrode array, which sends electrical stimulation up to the brain.
Q: Who is a candidate for a cochlear implant?
A: Usually, cochlear implant users are individuals who have significant hearing loss who no longer benefit from hearing aids due to lack of clarity. Recently, the FDA has approved individuals who have single sided deafness to qualify for cochlear implants as well.
We perform extensive testing at The Hearing Center to determine whether an individual qualifies for audiologic cochlear implant candidacy. Once the patient is approved on the audiological front, he or she will be evaluated by an Ear, Nose and Throat physician to determine candidacy on the medical front.
Q: What does the surgical procedure consist of?
A: For a CI surgery, the surgeon makes a small incision behind the ear and drills a tiny hole through a portion of the skull called the mastoid bone. The surgeon then creates an opening within the cochlea (organ for hearing) to thread the electrode array. The electrode array and internal magnet are then inserted into the inner ear. The surgeon then stitches up the incision. In many cases, patients go home the same day of the procedure.
Q: Are there any risks to the surgery?
A: As with any surgical procedure, there are always risks, though they are very rare.
Risks involved in cochlear implant surgery include loss of residual hearing, facial paralysis, dizziness, infection at the incision site and failure of the internal device.
Q: What happens following the procedure?
A: We usually allow approximately four weeks to allow for reduction in swelling and for the incision site to heal. At that time, the patient comes to our office, where we perform a “cochlear implant activation mapping”.
At this appointment, we choose a magnet strength for the external piece and perform a series of tasks with the patient to measure both the softest and most comfortable loudness levels at each electrode. We then “turn on” the cochlear implant.
Many times, patients report that speech initially sounds robotic, cartoon-ish, garbly or unclear. These are all common perceptions that become less dramatic as the brain adjusts to the electrical stimulation over time.
We see the patient frequently following the activation to gradually improve his or her perception of speech. We also provide the patient with aural rehab exercises to practice at home to improve his or her performance.
Q: What does the external piece look like?
A: Cochlear Americas provides two styles of external pieces, also known as “processors”: The Nucleus 7 and the Kanso 2. There is no difference in sound quality; the only difference is the on-ear piece that is attached to the N7 and not the Kanso 2. Patients are allowed to order two processors prior to implantation; we typically recommend one of each style. There is a six-month window to exchange a processor for a different style. The processors come in black, brown, beige, grey and white.
Q: Are there any restrictions when wearing my cochlear implant?
A: The only times we recommend removing the external processor is when sleeping, showering, swimming or participating in vigorous physical activity that may lead the processor to fall off.
Additionally, not all cochlear implants are compatible with MRI. It is important to discuss specifics of the internal component of your cochlear implant with your provider to ensure a safe MRI procedure.
Q: Will a cochlear implant restore normal hearing?
A: A cochlear implant will not restore normal hearing, but if it is being recommended, then it likely is the patient’s best option. Many candidates for CI have extreme difficulty understanding speech, listening to music and hearing environmental sounds out in the world. Cochlear implants not only give access to sound that the patient has been missing, but also makes sound clearer than hearing aids would.
The CI process is taxing and takes time, and it requires motivation on the patient’s and caregiver’s parts. Being motivated to engage with the CI process and wearing the processor consistently will allow for the patient’s best chance at succeeding with it.
STILL HAVE QUESTIONS?
CONTACT US FOR MORE INFORMATION ABOUT COCHLEAR IMPLANTS!