In my last blog, I discussed the disturbing results of a new research study that found one in five American teenagers already has some degree of hearing loss----a startling 31 percent increase since the late 1980s. The study results were recently published in the Journal of the American Medical Association, and showed that the number of teens with impaired hearing in at least one ear rose to 20 percent from 15 percent.

Your child needn’t be included in these statistics. The National Institute on Deafness and Other Communication Disorders (NIDCD) sponsors an excellent website called It's a Noisy Planet. Protect Their Hearing. This national public education campaign is designed to increase awareness among parents of children about the causes and prevention of noise-induced hearing loss (NIHL). With this information, parents and other adults can encourage children to adopt healthy hearing habits before and during the time that they develop listening, leisure, and working habits. NIDCD is one our government’s National Institutes of Health.

This site includes a wealth of resources, including tips for protecting your child’s hearing, ways to talk to your child about hearing loss and hearing protection, podcasts featuring NIDCD personnel and much more. You can check out this valuable resource by logging on to www.noisyplanet.nidcd.nih.gov

A new research study has found that one in five American teenagers already has some degree of hearing loss----a startling 31 percent increase since the late 1980s.

Researchers at Brigham and Women's Hospital in Boston used government survey data to compare rates of hearing loss among 12- to 19-year-olds during 1988 to 1994, with the period 2005 to 2006. They based their findings on records of and interviews with nearly 4,700 kids ages 12-19 in a study led by the Centers for Disease Control and Prevention.

The results showed that the number of teens with impaired hearing in at least one ear rose to 20 percent from 15 percent. The study results were recently published in the Journal of the American Medical Association. In most cases, the hearing loss was slight. However, hearing loss is usually permanent and potentially progressive. Even mild degrees of hearing loss in children can negatively affect their educational performance and their social interactions.

The reason for the dramatic increase in hearing loss isn't clear, but many parents contend with kids who play their video games and portable music players too loud. Long-term exposure to very loud noises, including music, can cause permanent hearing loss. A case in point: a recent study of children in Australia found a 70 percent increased risk of hearing loss with the use of personal stereo devices.

If you notice changes in your child's hearing -- especially in the ability to hear when there's background noise – you should consider taking your child for a hearing test. And check back for my next blog, which will offer ways parents can protect their children's hearing.

By Joni Doherty, MD, PhD

Some of my patients prefer to sleep wearing earplugs, for a variety of reasons. A snoring spouse, ambient noises like crickets or birds chirping, or loud neighbors can sometimes make wearing earplugs the only way to get a good night’s sleep. But can wearing them night after night be harmful?

According to a study published in May 2010 in the journal Pediatrics, hearing loss in one ear is enough to cause language problems for kids. Researchers at Washington University in St. Louis, Missouri tested 74 pairs of school-age siblings. Half the children had hearing loss in one ear, while their siblings had normal hearing.

The study found that the impaired kids scored lower on both comprehension and speech tests and were more likely to be receiving speech therapy than their siblings; but up to one in 20 kids with such hearing loss often don't receive the help they need, such as a front seat in class, hearing aids or special education.

"Unlike children with hearing loss in both ears, who are routinely fitted with hearing aids and receive accommodations for disability, children with hearing loss in one ear may not be considered to have a 'significant hearing loss,'" the researchers wrote. “Our results suggest that children with hearing loss in one ear should be eligible for the same accommodations as children with hearing loss in both ears."

The key idea of study, according to its authors, is that we don't want to ignore children with hearing loss in one ear.
 
Click here to review the study.

According to research conducted by otolaryngologists at Henry Ford Hospital in Detroit, roller coasters can give you more than a quick shot of adrenaline. They have linked the force of acceleration in roller coasters to ear barotrauma, which in extreme cases can lead to temporary hearing loss, dizziness, ear pain or the sensation of ear popping.

Ear barotrauma occurs when there is a relatively quick change in pressure outside the ear drum and the pressure in the middle ear space. This common condition is most often occurs during air travel and scuba diving, and most recently to the use of improvised explosive devices in Iraq and Afghanistan.

Today's roller coasters have higher speeds and sharper turns, which are more likely to result in ear injury. In the case studied, a 24-year-old man turned his head during a roller coaster ride, causing his right ear to be exposed to about 0.6 PSI (pounds per square inch) when the roller coaster accelerated. The researchers estimated the ride he was on reached a maximum speed of 120 mph within 4 seconds.  The pressure caused barotrauma to the ear, resulting in pain, swelling of the ear canal, and an inflamed ear drum. Study results were presented April 30 at the Triological Society's 113th annual meeting in Las Vegas.

Although the risk of experiencing barotrauma when riding a roller coaster is low, it is most likely to occur if passengers do not remain facing forward during the ride. To minimize your risk, always remain facing forward during the ride to help prevent the full impact of acceleration hitting your ear.

A study conducted by researchers from Harvard University, Brigham and Women’s Hospital, Vanderbilt University and the Massachusetts Eye and Ear Infirmary found that regular use of pain killers such as aspirin, acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of hearing loss in men below 60.
 
Investigators compiled responses from participants in the Health Professionals Follow-up Study, which tracked over 26,000 men every two years for 18 years. A questionnaire inquired about analgesic use, hearing loss and a variety of physiological, medical and demographic factors. The data showed that men below 60 were a third more likely to have hearing problems if they regularly took aspirin. However there was no greater risk in those over 60, the findings suggest. Non-steroidal anti-inflammatory drugs (NSAIDs), which include Ibuprofen, were found to increase the risk by 61 per cent for those under 50, 32 per cent for those in their 50s and 16 per cent for those aged 60 and over. The results were published in the American Journal of Medicine.

One of the authors of the study, Dr Sharon Curhan from the Department of Medicine at Brigham and Women's Hospital in Boston, noted that "Regular use of (these drugs) might increase the risk of adult hearing loss, particularly in younger individuals.  Given the high prevalence of regular analgesic use and health and social implications of hearing impairment, this represents an important public health issue."

As always, consult your physician if you have questions about the risks of using any prescription or over-the-counter medication.

October is National Protect Your Hearing Month, providing a perfect opportunity to remind my readers about the importance of guarding their ears against potentially damaging, high decibel noises. The harmful effect of loud sounds is well documented, as anyone who has served in the military knows all too well. However, a recent news story on “sound cannons” underscores just how crippling sound can be.

A device called a long range acoustic device (LRAD) was used in late September by Pittsburgh police as "sound cannons" to blast the ears of protesters near the Group of 20 meeting of world economic leaders. The police used the device as a means of crowd control that delivers an "unmistakable warning," according to the manufacturer of the instruments. Its shrill warning tones can be heard at least 1,600 feet (500 meters) away and depending on the model of LRAD, it can blast a maximum sound of 145 to 151 decibels — equal to a gunshot — within a 3-foot (one meter) range. That easily approaches the noise generated by a jet engine, which emits a deafening 140 to 180 decibels of sound. Permanent hearing loss can result from sounds at about 110 to 120 decibels in short bursts or even just 75 decibels if exposure lasts for long periods, according to the National Institutes of Health (NIH). You can read the full story here.

A helpful guide for measuring the safety of various sounds can be found on the website of the American Academy of Audiology by clicking here.

Remember, even seemingly harmless devices like MP3 players can cause damage if played loud enough. Protecting your hearing is critical because once it is damaged, it is not reversible.

Shingles, also known as Herpes zoster, is a painful condition that is caused by the same virus that causes chicken pox. Shingles involves the nerve pathways in the area affected, and is characterized by skin blisters in the early stages of the infection. Some people also subsequently experience strange nerve sensations such as burning, itching, stabbing, numbness or tingling. And while the typical course of a shingles infection lasts two to three weeks, some people may develop Post-Herpetic Neuralgia, nerve pain that lasts long after the blisters have disappeared.

Shingles usually occurs on the chest, face, back, leg or rear. A less common occurence is Herpes zoster oticus, or shingles in the ear. Known as Ramsay Hunt Syndrome, the condition is characterized by intense ear pain, a rash around the ear, mouth, face, neck, and scalp, and paralysis of facial nerves. Other symptoms may include hearing loss, vertigo, and tinnitus. The tongue may lose taste sensation; dry mouth and eyes may also occur.

Unfortunately, some people experience long-term complications from Herpes zoster oticus. They may suffer a permanent hearing loss or facial paralysis. Vertigo may last for days or even weeks. Treatment may include medications such as antiviral drugs or corticosteroids.

More than 66% of the people who develop herpes zoster are over the age of fifty; about five percent of the cases occur in children under the age of 15. Over a half of a million Americans will develop herpes zoster this year. Fortunately, there are precautions you can take to avoid developing shingles. The Centers for Disease Control (CDC) recommends that people 60 years old be vaccinated with Zostavax to prevent shingles. This is a one-time vaccination. In a clinical trial involving thousands of adults 60 years old or older, Zostavax reduced the risk of shingles by about half (51%) and the risk of post-herpetic neuralgia by 67%. While the vaccine was most effective in people 60-69 years old it also provided some protection for older groups.

Misophonia, or hatred of sound, was first identified in 2000 when Pawel Jastreboff, a neuroscientist at Emory University School of Medicine in Atlanta, found that some people had strong, negative reactions to specific sounds. Misophonia sufferers tend to focus on certain sounds to which they have a decreased tolerance, such as noises associated with eating, sniffling, or scratching. The offending sounds create a high level of anxiety and perturb the sufferer to the point of extreme avoidance.

While the exact cause of misophonia is unknown, there is some speculation that the cause may be the brain processing sound information incorrectly. Instead of processing sounds normally, the brain processes the sounds with increased intensity, or as a danger signal instead of a harmless noise. It is common for misophonia to be accompanied by hyperacusis, or sensitivity to sound, leading researchers to theorize that misophonia is caused by a neurological hearing condition.

Misophonia can have an extremely detrimental impact on patients’ lives. It can prevent sufferers from working and interacting socially, or from enjoying common activities of daily living. In extreme cases, decreased sound tolerance can totally control a patient’s life. In these instances, patients do not leave their homes. Their lives, and those of their families, are totally subjugated to the need to avoid the offending sound.

Because misophonia is a relatively unknown ear condition, it often goes undiagnosed. A diagnosis typically involves evaluating the patient's feelings when exposed to sounds. The best treatment approach is one that includes both a hearing specialist and a psychiatrist. The hearing specialist treats the patient with tinnitus retraining therapy, using sound instruments that help desensitize the person to the sounds that aggravate them. An audiologist can also help reprogram the auditory processing center of the brain to associate the sounds with pleasant feelings. A psychiatrist treats any underlying psychological conditions like Obsessive Compulsive Disorder or anxiety by helping the sufferer develop coping mechanisms to use when bothered by sounds. Treatment for misophonia can last anywhere from six months to eighteen months.

If you suspect someone you love has misophonia, help is available. The first step is a correct diagnosis of this hearing condition. Call your ear care professional for an appointment today, and you could start living a more normal life soon.

An interesting article in the Los Angeles Times reports that more children who are born deaf are receiving cochlear implants, with great success.

In a front-page article in the 8/3/09 edition of the Los Angeles Times, reporter Shari Roan writes that "studies published in the last two years have delivered what many experts say is ironclad evidence that" cochlear implants "are safe in babies and toddlers and allow most children to develop spoken language without extensive occupational therapy." The implant "consists of a headset that is removable and a piece that is surgically implanted. A microphone-speech processor the size of a hearing aid is hooked over the ear to process sounds, which are then sent to a transmitter the size of a quarter that adheres to the head." Inside the skull, "a receiver...picks up signals and sends messages to electrodes inserted inside the ear," and "the message moves on the brain." Data indicate that an estimated "40 percent of" children who are "born profoundly deaf" receive "a cochlear implant, up from about 25 percent five years ago," and that number "is projected to rise still further."

The article does a wonderful job of telling the story of one family's journey through a child's deafness and emergence into a world of hearing. It is a story I personally have witnessed on many occasion, but I never fail to marvel at this minor miracle. To read the entire story, click here:

Los Angeles Times