What is EVA Enlarged Vestibular Aqueduct

What is an Enlarged Vestibular Aqueduct (EVA)?

 The vestibular aqueduct is a bony canal that begins inside the temporal bone and travels

within the inner ear to deep inside the skull

 Running through the aqueduct is a fluid-filled tube called the endolymphatic duct, which

connects the inner ear to the endolymphatic sac

 The role of these two structures is to maintain a normal ion concentration

 Some believe that the vestibular aqueduct is mature at birth, while others believe it

continues to grow postnatally until about age 3-4

A vestibular aqueduct is considered enlarged if it is greater than 1-1.5mm. Usually, when the

aqueduct is enlarged, the endolymphatic duct and sac are large too. This causes the regulation of

cochlear fluid and ion concentration to be disrupted

EVA & HEARING LOSS

 EVA can occur in isolation, but also can co-occur with congenital disorders such as

Pendred syndrome, CHARGE syndrome and Branchiootorenal syndrome

 EVA can lead to both hearing loss (most likely sensorineural) and balance issues

 It can be identified with a CI Scan or an MRI

 There is no “cure” for EVA, but hearing aids are most commonly used to manage hearing

loss associated with it

 Vestibular therapy can be beneficial to those who have balance problems due to EVA

EVA & CONTACT SPORTS

 Those with EVA may be at risk for progressive hearing loss, in which the hearing can

gradually or rapidly decrease or fluctuate over time

 Head injury or barotrauma increase the likelihood of progressive hearing loss

 People with EVA are *strongly advised* to avoid contact sports such as football and

soccer, as well as wear helmets when engaging in activities that put them at risk for head

injury

Contact us for more information on EVA!

What are vestibular disorders

Vestibular Disorders

How does my ear affect my balance?

 The Organ for Balance, or the vestibular system, lies within the inner ear

 It consists of three fluid-filled loops call the semicircular canals

 The fluid within the canals changes in response to head motion

 Our vestibular system, eyes and proprioceptive system help us move our bodies within

space and maintain our balance

Vestibular conditions can be caused by:

 Changes in medication

 Poor circulation of the ear

 Movement of “ear crystals” within the semicircular canals

 Infections

 Debris in the semicircular canals

 Traumatic brain injury

Symptoms of a vestibular disorder:

1. Falling, swaying or tilting

2. Vertigo

3. Floating feeling

4. Feeling off-balance

5. Leaning to one side

How do I test for a vestibular disorder?

An audiologist may perform a videonystagmography (VNG) to test for certain vestibular

conditions. This gives the audiologist information about how the vestibular portion of the inner

ear is functioning. The patient wears goggles to monitor eye movements. The patient will

perform several tasks, including following a moving target on a screen, moving their head and

body in various positions, and having warm and cool air put into the ear canal. During these

tasks, the audiologist monitors eye movements and attempts to simulate dizziness to determine

the potential source of symptoms.

What happens next?

Depending on the results of the testing, an audiologist may refer for vestibular therapy.

Sometimes, the audiologist may refer to a specialist, such as an Ear, Nose and Throat physician

or a neurologist to determine if additional testing is warranted. In certain cases, home exercises

may be recommended to alleviate dizziness symptoms.

Who benefits from using custom musician ear plugs

WE MAKE CUSTOM MUSICIAN MONITORS!!

Q: What are musician monitors?

A: Musician earplugs and in-ear monitors are used for musicians and sound engineers to protect

their ears when performing or when exposed to high levels of sound pressure

Q: How do custom musician plugs differ from conventional ear plugs?

A: Conventional earplugs muffle speech and music; additionally, conventional earplugs reduce

more sound in the high frequencies than low and mid frequencies, which makes speech and

music sound unnatural and distorted. Custom earplugs allows for speech and music to sound

natural, preserving the distinct quality and richness of speech and music, but it is ensured to be at

a safer volume level.

Wearing in-ear monitors allows for musicians to hear themselves play music while still

protecting their hearing.

Musicians are not the only professionals who use musician plugs or in-ear monitors:

Aircraft:

 Crew

 Flight instructors

 Passengers

 Pilots

Athletics:

 Athletes

 Coaches

 People at sporting events

Construction:

 Carpenters

 Equipment operators

 Road builders

 Steel workers

Emergency vehicles:

 EMTs

 Highway patrol

 Firefighters

Industrial:

 Factory workers

 Shop teachers

 Students

 Supervisors

Leisure:

 Concerts

 Nightclubs

 Noisy restaurants

Medical-Dental:

 Dentists

 Hygienists

 Technicians

 Surgeons

Motor Sports:

 Motorcyclists

 Pit crews

 Race car drivers

 Spectators

Music:

 Concerts

 Marching bands

 Musicians

 Night clubs

Others:

 Delivery drivers

 Markey traders

 Night club staff

 Truck drivers

Celebrities with Hearing loss

CELEBRITIES WITH HEARING LOSS

1) Stephen Colbert: Colbert is deaf in his right ear as a result of surgical removal of a tumor

when he was a child. Colbert initially wanted to be a marine biologist, but the damage to

his ear would not allow him to scuba dive.

2) Steve Martin: The actor utilizes hearing aids to manage hearing loss and tinnitus. Martin

reportedly has hearing damage as a result of noise-induced hearing loss after being too

close to a loud gunfire on the set of “The Three Amigos” without wearing hearing

protection.

3) Katie Leclerc: The actress, who played a deaf teenager on the TV show Switched at

Birth, was diagnosed with Meniere’s disease, which causes fluctuating hearing loss,

ringing in the ears, aural fullness, and vertigo.

4) Whoopi Goldberg: The TV personality reportedly has low-frequency hearing loss, which

creates difficulty hearing vowel sounds like “a” and “e” that produce the energy of sound.

Goldberg has attributed her hearing loss to many years of listening to loud music without

hearing protection. She currently wears two hearing aids and is vocal about her hearing

journey.

5) Halle Berry: Berry has stated that she has a significant degree of hearing loss as a result

of a head injury.

6) Lou Ferrigno: The bodybuilder and actor has had profound hearing loss since the age of

three. He wore many hearing aids over the years, but due to his impaired word

understanding, was ultimately a Cochlear Implant recipient. Ferrigno has stated that the

CI has helps him hear “s” sounds and ambient noises that he was previously not able to

hear.

7) Derrick Coleman Jr: The football player has had known hearing loss since the age of

three due to a hereditary condition. He reportedly wears pantyhose underneath his helmet

to keep his hearing aids protected from moisture and prevent feedback!

Protecting your hearing aids in the Summer time

The summer is the riskiest time of year for hearing aids!

Hearing aids can:

• Get lost on days at the beach

• Be forgotten about when jumping into the pool

• Clogged with sand

• Moist from sweat

Here are some tips to protect your hearing aids during these summer months!

1) Keep up with daily cleaning!

 Use the brush to clean hearing aid microphones

 Wipe down the hearing aids using a microfiber cloth

 Change wax filters when necessary

2) Use a drying kit or desiccant to place next to your hearing aids at night

3) Place your hearing aids inside nylon sleeves to protect them from moisture

4) Remember to place your hearing aids in a portable pouch before going in the pool or onto

the sand. Don’t put them in your pocket!

5) Use an otoclip to clip your hearing aids to your shirt while playing sports

6) Visit your provider to have your hearing aids cleaned and checked to make sure they are

working properly for those summer activities!

Enjoy your summer!

Updated hours week of 04/18/2022-04/22/2022

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?

1. Hearing loss is most commonly low frequency, though it can vary

2. Tinnitus is often described as a “roaring” or humming sound, which is also low frequency

3. Aural fullness typically occurs in the ear that is affected, and is most likely a byproduct of hearing loss

4. 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!