There are several risk factors for hearing loss when an audiologist reviews a patient’s history. Well known factors include exposure to loud noises, family history of hearing loss, ear surgery, infections and diseases. A lesser known aspect of a patient’s history is medications.
There are over 200 known medications that may damage your ears and affect their functions. Some affect hearing, some affect balance, and some both.
Common offenders include chemotherapy drugs containing platinum, such as cisplatin or carboplatin, certain diuretics/water pills, such as furosemide (Lasix), certain classes of antibiotics (including many ending in –mycin), quinine, salicylates such as high-dose aspirin and medications for ED.
The inner ear has hearing and balance organs in close proximity. A change in blood chemistry may affect either or both. Some medications, such as aspirin, have a temporary effect. Others may be permanent and last long after the drug is out of the bloodstream.
If someone you know has been put on a regimen including one of these medications, be aware of possible ear effects. Often there may be substitutes with less risk to the ears. Allow your physician to help you decide if the benefits of the drug may be worth the risk to the ears.
If you believe a medication has harmed your hearing or balance, contact your physician immediately and have your ears evaluated. As always, we wish to keep you on a CLEAR PATH to good hearing and ear health.
People whose work and play put them at risk for ear damage often complain about difficulty hearing and ringing in the ears. Construction workers, machinists, contractors, musicians and others find themselves immersed in loud sounds as a matter of common practice. Add hobbies, such as shooting, power tools or practicing music, and you have a recipe for ear damage at an early age. Hearing loss is not a sign of aging, it’s more indicative of “wear and tear” of the ears.
Along with difficulty hearing soft speech and speech in background noise, many noise-damaged patients complain of incessant ringing or buzzing. These are signs one has done damage to the ears. It is important to note we now have technology to improve these symptoms effectively and discretely.
For most patients, the days of big, squawking hearing aids filling your ears or the big “shrimp” behind the ears are over. Most modern hearing instruments are small and hide behind the top of the ear. Only a barely-visible wire enters the canal with amplified sound. The instruments are tuned to the frequencies of loss. High frequencies are added when the loss is in the highs. The same goes for a low or middle frequency losses.
For tinnitus, the goal is to increase the amount of sound we receive. Silence will only allow tinnitus to become more dominant. This is more a brain phenomenon triggered by ear damage. Many modern hearing instruments can be custom programmed with tinnitus therapy noise. This can help promote long term habituation to tinnitus. Habituation is a powerful brain phenomenon that allows us to ignore familiar stimulation, like clothes on our skin or unappetizing odors. Tinnitus can be come no more noticeable than a watch on your wrist or the rim of your glasses as you look through them.
The latest innovation is technology that pairs many hearing instruments with smart phones. iPhone or Android phones can utilize a tinnitus app specific to the amplification and tinnitus of the patient. We can now control sound into our ears much like we control virtually everything else. We tap a screen on our phone. This is an unprecedented level of control by the wearer. Many people are experiencing improved quality of life though this technology.
Don’t miss out on the sounds of life. Be careful with noise exposure and utilize all the technology that is now available. We want to keep you on a clear path to good hearing and ear health.
Audiologist Ron D’Angelo wrote an article that was published in the January, 2017 edition of the Journal of the International Trumpet Guild. The article concerns the intelligent use of hearing conservation strategies and products for musicians and music teachers. A professional trumpet player when he is not seeing patients at our Greece and Brighton offices, Ron has experience on both sides of the stage. He has seen the results of hearing damage from loud musical situations.
Musicians frequently visit our office for consultations on hearing loss, tinnitus, poor loudness tolerance and hearing conservation products. These include custom high-fidelity musicians’ ear plugs and custom ear impressions for in-ear monitors for use onstage or in the studio. Other strategies include environmental changes, positioning, spacing and rest time for ears. We want you to enjoy your music responsibly for as long as possible.
Naturally, this type of advice goes for anyone whose occupation or hobbies may be……loud. There are excellent strategies and products to extend careers and save ears for many whose vocations or avocations put them at risk for permanent hearing damage. A consultation and diagnostic evaluation of your ears is a great first step. Only then can we guide you confidently in the right direction. As always, we hope to keep you on a clear path to good hearing and ear health.
Clear Choice Hearing and Balance is excited to announce our Brighton office has moved to a new location. A stone’s throw from our current space, the new suite allows us to better serve you in an opulent, spacious environment. The office provides us with two concurrent audio test booths, improved facilities for vestibular assessment and rehabilitation, as well as hearing instrument fittings.
The address is listed below. We are in a dedicated medical building with improved access for patients. The Westfall Surgery Center is adjacent to Clinton Crossings at the end of Senator Keating Boulevard.
We still have the convenience of a known medically-rich location to serve our patients from the south and east sides. We will continue to provide state-of-the-art assessment and rehabilitation of disorders of hearing, tinnitus and vestibular function. Our phone number has not changed.
Westfall Surgery Center
1065 Senator Keating Boulevard Rochester, NY 14618
On Friday October 7th we will be participating in the Day of Hearing at Nazareth College, sponsored by Rochester chapter of the Hearing Loss Association of America (HLAA). Local audiologists will be speaking on various topic related to the ears and hearing. Ron D’Angelo, AuD will be presenting on the topic, “A new spin…vertigo, imbalance and hearing loss” from 10:15-11:00 AM.
This presentation will reflect our focus on various disorders of hearing, imbalance and dizziness and our work with area physicians and other professionals. The talk will be informative and interactive; questions and anecdotes are welcome. Mechanisms of balance will be reviewed, as well as disorders that produce imbalance, dizziness and even changes in hearing.
The workshops are free and open to the public. The York Wellness and Rehabilitation Institute will be the venue. We hope to see some of you there. As always we wish to keep you on a Clear Path to good hearing and ear health.
A relative of one of our staff has recently been experiencing a very disruptive set of symptoms related to the ears. This 45 year-old female experiences extreme episodes of dizziness (usually spinning) following exposure to loud noises or coughing/sneezing/straining experiences. Loud noises also sound distorted, and her own voice sounds louder in her head. Her life has changed drastically, to say the least.
She has been diagnosed with Superior Semicircular Canal Dehiscence (SSCD). This rare condition is caused by a malformation in which bone is missing at the border of one of the semicircular canals. When this happens, the inner ear fluid motion that accompanies loud noises or internal changes in pressure, such as coughing, causes the balance organs near the canal to function incorrectly. The symptoms listed above typically follow. Other common symptoms are low-frequency conductive hearing loss in the affected ear, constant dizziness, inability of the eyes to focus on stationary targets and the illusion of motion in visual targets.
Diagnosis is made based on the symptoms, as well as various diagnostic tools. Audiometry, acoustic reflexes, high-resolution CT imaging and specialized vestibular testing can confirm this condition and guide treatment.
More severe cases require treatment if normal life or common activities are disrupted. Surgery is an option that can relieve symptoms. The missing bone region can be “plugged”, which prevents the fluid and surrounding membrane from bulging during loud sounds or changes in internal pressure. All good outcomes begin with a patient who pays attention to symptoms and seeks help. A careful analysis of symptoms, clinical signs and diagnostic results can result in correct diagnosis and appropriate treatment. Do not wait if you or someone you know is experiencing unusual problems with hearing, balance or dizziness. As always, we want to keep you on a clear path to good hearing and ear health.
Simple strategies to preserve your hearing
Many activities we enjoy or perform while working are known to be dangerous to the organs of hearing. These organs are located in the inner ear (cochlea) and are easily damaged by exposure to noise of sufficient loudness and duration. Countless patients have been diagnosed with hearing loss that is most likely caused by exposure to noise.
Occupational hazards, such as construction work, factory machinery, power tools and the like are commonly noted. Recreational noise, such as motorcycles, tools, music, lawn mowing and firearms are also frequently implicated. These activities can damage a group of inner ear structures known as outer hair cells. When these cells are damaged or destroyed by noise, they impair our ability to hear soft sounds, particularly in the high frequency. Clarity is typically impaired, even when low pitch hearing is spared. Unfortunately, this is a permanent condition. Inner ear structures cannot be regenerated.
With intelligent use of hearing protection strategies, we can reduce the damage and preserve our hearing. Strategies include restructuring of the environment, limiting exposure time and the use of protective products.
Loud devices, such as power tools and musical instruments, should not be used in small spaces, where reverberations can multiply the sound produced. Move to a larger space with absorptive surfaces, such as curtains, drop ceilings or carpet when possible. Always limit headphone use with loud music.
Limiting the time spent in noisy areas will reduce risk as well. OSHA workplace regulations recognize that decreases in sound levels increase allowable exposure time. If a project requires noisy equipment, break up the time into segments, and give your ears a break.
Finally, there is no shortage of hearing protection products. These are often available in hardware, sporting goods and music shops. Plugs can be either custom-molded or generic. Remember to replace foam plugs after every use. Muff-style headsets are highly effective and can even be worn over plugs for maximum protection.
It is neither difficult nor expensive to protect your ears from the hazards of loud sounds and still be productive and enjoy music and other activities. Be wise and always allow us to keep you on a clear path to good hearing and ear health.
Many causes of dizziness
Because we specialize in disorders of hearing, balance and dizziness, we see many patients with a variety of symptoms. Many have difficulty hearing, some are bothered by noises in their ears (tinnitus), some suffer disruptive dizziness, and some report poor balance. Earlier blog articles have explored the ways in which hearing, tinnitus, vertigo and imbalance can be related. This month we examine various causes of dizziness.
“Dizziness” is an inexact term many people use to describe sensations which make them feel unstable, typically in the head. Dizziness may include light-headedness or “wooziness”, with a general dulling of the senses, often for brief spells. This is commonly a feature of orthostatic hypotension (momentary low blood pressure in the head following a change in position), circulatory disorders, side effects of prescriptions or interactions of several drugs.
“Vertigo” more precisely describes an illusion of motion in the head or body. Vertigo is common in disorders of the inner ear balance organs. Positional vertigo (BPPV) is very common. This involves incorrect placement of calcium crystals in the ear. The ear responds inappropriately to head movements when these “ear stones” interfere with normal fluid movement in the semicircular canals. This condition is very treatable and requires no medications or surgery.
The central nervous system (brain, brainstem, cerebellum and other nerve structures) can also produce dizziness and/or imbalance. Certain “red flags” in our VNG test battery can often be uncovered for further investigation. Migraine disorder is also known to often produce vertigo, even if headaches are minimal.
Thyroid and diabetes conditions can also cause similar issues. Needless to say, a complaint of dizziness does not guarantee any specific diagnosis. Our diagnostics take into account history, symptoms, medications, other medical conditions, and our extensive test battery. Only when we discover the root cause(s) of the problem can we recommend the best treatment. As always, we seek to keep you on a clear path to good hearing and ear health.
Born deaf vs acquired hearing loss
Those of us who deal with the ears and hearing impairment often make distinctions based on the onset of a patient’s hearing loss. There are many patients who gradually lose their hearing, due to heredity, noise exposure, aging or other factors. Some lose function more rapidly, as through disease, head trauma or sudden noise trauma. These people have one thing in common: hearing was a primary mode of communication prior to the loss. It is understandable that hearing loss will disrupt social interaction. Listening to speech, music and environmental sounds can no longer be taken for granted. Depression, decreased cognitive function and social isolation frequently result.
There are also many people who were born deaf or lost hearing very early in life. They may not have been able to learn language by listening to their parents. For many deaf children sign language becomes a primary communication tool. Captioning and printed words are also used. Cochlear implants and high-powered hearing aids have made it more possible for a deaf-born child to adapt to the hearing world. The Deaf culture, however, has embraced many modes of communication that do not require hearing.
Many deaf people do not feel they have “lost” their sense of hearing. On the other hand, hearing people who have lost hearing during their lives have definitely lost an important connection to their world. This is why it is so crucial to identify and treat acquired hearing loss as early as possible. Studies have found the average person waits seven years to take action on a suspected hearing loss. Do not separate yourself from the people and sounds you want to hear any longer than necessary. Help is available. As always, we want to keep you on a clear path to good hearing and ear health.
Clear Choice Hearing and Balance wishes you a happy and healthy 2016.
Receiving a diagnosis of cancer is a life-changing experience. Fear and uncertainty are natural reactions, with complex plans for treatment following extensive diagnostic work. Treatments can be highly aggressive, ranging from surgery to radiation to chemotherapy. A patient’s options may produce life-saving results, although many have side effects and risks of their own. A link exists between cancer treatments and hearing loss and other ear damage.
Chemotherapy may utilize many different drugs, depending on the type and location of the tumor or cancerous cells. Platinum plays a key role in several major medications. Drugs like cisplatin and carboplatin are well known for their toxicity to the ears. Several other types of drugs, such as methotrexate and nitrogen mustard, also may be damaging to parts of the ear. When chemicals are introduced to the body through the bloodstream or digestive tract, they cannot necessarily be sent only to the site where they are needed. An agent that can destroy cancer cells may also affect normal tissue. The ears are not immune, and typically both are affected. Hearing loss and/or tinnitus may result.
Radiation therapy of the head or neck may also adversely affect ear function. This may take the form of irreversible inner ear damage (sensory loss of hearing) or Eustachian tube dysfunction, which may be treatable. Radiation may only effect one ear.
Effects of damage from cancer treatments include impaired balance, impaired hearing, increased risk of poor communication and social isolation. Employment may be put at risk from untreated hearing loss. Quality of life suffers greatly with these developing problems. Patients undergoing these therapies should have their hearing and balance function monitored, particularly if they suspect changes in function. Hearing aids, as well as augmentative listening products and strategies, may help these patients with communication. Balance therapy may aid in restoring balance function lost to aggressive treatment.
If you or someone you know is facing these treatments, be aware of possible risks to the ears, and do not hesitate to ask for answers or monitoring. The link between cancer treatments and hearing loss is well established, yet not widely known outside of the hearing healthcare community. Call us for more information. We want to keep you on a Clear Path to good hearing and ear health.