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Hearing Aids and Tinnitus: A Comprehensive Approach to Relief
The constant disruption of tinnitus can leave you struggling to focus at work, enjoy quiet moments, or get a good night's sleep. Many people find themselves avoiding social situations, feeling stressed, and experiencing anxiety due to these persistent sounds. The impact on daily life can be profound, but recent advances in hearing aid technology have created promising solutions for managing these challenging symptoms.
Understanding Tinnitus and Hearing Loss
Tinnitus and hearing loss frequently occur together, though one can exist without the other. When hearing loss develops, the brain often becomes more sensitive to internal sounds as it attempts to compensate for reduced auditory input. This increased sensitivity can intensify tinnitus symptoms. By addressing both conditions simultaneously through advanced hearing aids, many patients experience meaningful improvement in their quality of life.
The Science Behind Hearing Aids and Tinnitus Relief
Modern hearing aids work through several mechanisms to reduce tinnitus symptoms:
Sound Masking
By amplifying environmental sounds, hearing aids help mask the internal sounds of tinnitus. This makes the tinnitus less noticeable during daily activities.
Brain Retraining
Increased auditory input from hearing aids helps redirect the brain's attention to external sounds rather than internal tinnitus signals. This neuroplastic adaptation can lead to reduced tinnitus perception over time.
Stress Reduction
When hearing becomes easier, the mental strain of listening decreases. This reduction in cognitive load and stress often leads to less pronounced tinnitus symptoms.
Specialized Programs
Built-in tinnitus management features provide additional tools for symptom relief throughout the day.
Advanced Hearing Aid Options for Tinnitus Management
Our practice offers several cutting-edge hearing aid models with sophisticated tinnitus management capabilities:
Oticon Intent
The Intent's Tinnitus SoundSupport system provides customizable background sounds that can be adjusted to match your comfort level. Its advanced sound processing ensures clear amplification of environmental sounds, creating natural tinnitus masking throughout your day.
ReSound Nexia
The Nexia incorporates comprehensive Tinnitus Therapy features. Users can select and precisely adjust calming sounds to match their specific tinnitus pitch. Built-in connectivity allows direct streaming of soothing sounds from smartphones, expanding your tinnitus management options.
Phonak Infinio
This model's Tinnitus Balance feature includes an adjustable noise generator for sound enrichment. The Infinio's AutoSense OS 6.0 automatically optimizes settings as your listening environment changes, maintaining consistent tinnitus relief throughout the day. This adaptation is particularly beneficial in quiet situations when tinnitus often becomes more noticeable.
Signia IX
The IX model features innovative Notch Therapy technology. This unique approach amplifies sounds except at the specific frequency of your tinnitus, potentially reducing its perceived intensity over time. Traditional sound therapy options complement this targeted approach, providing comprehensive tinnitus management.
Starkey Genesis AI
The Genesis AI combines artificial intelligence with advanced tinnitus management. Its Multiflex Tinnitus Technology offers customizable sound therapy through an intuitive smartphone app. The system learns from your preferences over time, creating an increasingly personalized tinnitus management experience.
Our Comprehensive Treatment Approach
At Southwest Balance, we recognize that effective tinnitus management requires more than just technology. Our process includes:
Detailed Evaluation
We begin with comprehensive hearing testing and tinnitus assessment to understand your specific symptoms and needs. This evaluation helps us identify the most effective treatment approach for your situation.
Precise Fitting
Using Real-Ear Measurements, we verify that your hearing aids provide appropriate amplification across all frequencies. This precise fitting is crucial for both hearing enhancement and tinnitus management.
Personalized Programming
We carefully program your hearing aids to address both hearing and tinnitus needs, ensuring optimal relief. Regular adjustments maintain effectiveness as your needs change.
Ongoing Support
Our team provides continued support and fine-tuning to ensure your tinnitus management strategy remains effective long-term.
Supporting Management Strategies
While hearing aids play a central role in tinnitus management, we often recommend complementary approaches:
Sound Therapy
Additional sound therapy techniques can supplement your hearing aids' built-in features, providing relief in specific situations.
Stress Management
Simple relaxation techniques can enhance the benefits of your hearing aids, particularly during high-stress periods when tinnitus often becomes more noticeable.
Lifestyle Modifications
Small changes in diet, exercise, or sleep habits can support your overall tinnitus management plan.
The Importance of Professional Fitting
While over-the-counter devices offer convenience, they typically lack the specialized features found in prescription hearing aids designed for tinnitus relief. Our audiologists use precise fitting techniques and Real-Ear Measurements to ensure your devices provide optimal benefit for both hearing and tinnitus management.
Common Questions About Tinnitus and Hearing Aids
Will hearing aids increase my tinnitus?
Properly fitted hearing aids should not worsen tinnitus. Most patients experience significant symptom relief.
How long until I notice improvement?
Response times vary. Some patients notice immediate relief, while others may need several weeks to experience significant changes.
What if my hearing test is normal?
Even with normal hearing, the tinnitus management features in modern hearing aids can provide substantial benefit.
Patient Success Stories
Many of our patients have achieved significant tinnitus relief using these advanced devices. One patient using the Phonak Infinio with Tinnitus Balance reported dramatically reduced tinnitus awareness within weeks of fitting. Another found that the Signia IX's Notch Therapy helped minimize tinnitus interference with sleep and daily activities.
The Role of Professional Care
Professional audiological care makes a significant difference in tinnitus management success. Our team stays current with the latest tinnitus research and treatment options, ensuring you receive the most effective care possible. Regular follow-up appointments allow us to fine-tune your devices and adjust your management strategy as needed.
Schedule Your Tinnitus Evaluation
Living with tinnitus doesn't mean you have to accept its impact on your daily life. At Southwest Balance, Dizziness & Ear Institute, our experienced audiologists are ready to help you explore the latest hearing aid technology for tinnitus relief. We'll work with you to develop a personalized management plan using advanced devices and proven techniques. Call our Phoenix office at (602) 265-9000 to schedule your comprehensive tinnitus evaluation.
Latest Articles
How Does a Hearing Loop System Work?
Hearing aids are extremely effective at enhancing a person’s ability to hear, but when worn in a crowded atmosphere they can quickly bombard the listener with unwanted noise. Auditoriums, concert halls, theaters, and places of worship are especially tricky for the hard of hearing. Hearing loop systems offer a straightforward solution to this dilemma, making it very easy for individuals with hearing aids to enjoy movies, sermons, concerts, and other oral presentations without distraction.Hearing loops are a relatively simple bit of technology that works in conjunction with the telecoils that are installed in many modern hearing aids. Originally, the telecoil feature was used primarily to pick up on magnetic signals created by telephones. This allowed the wearer to easily listen to telephone conversations without distraction from background noise. Hearing loop systems use this same concept but on a larger scale, creating magnetic signals that anyone in the area with a telecoil can pick up on.The first part of a hearing loop system is an audio input, often from a PA system or a dedicated microphone feed. This audio signal is fed into a hearing loop amplifier, which drives a current through a cable (or series of cables) looped around the room. Properly installed loops do not have dead zones, which means that anyone with a telecoil who is inside the loop can pick up on the transmitted audio.While newer technology such as FM transmission neck loops are becoming more established among many establishments, hearing loop systems can still offer a number of advantages to the hard of hearing. Their convenience alone makes them a popular choice among venues and patrons alike. Listeners also appreciate their more subtle nature, which allows them to enjoy a concert, presentation, or worship service without the self-consciousness that can accompany wearing a neck loop.Though no hearing technology is perfect, hearing loop systems offer a huge service to many people, giving many listeners a much more enjoyable experience.
Which Type of Ear Plug is Best for You?
Using ear plugs is one of the simplest things you can do to protect your ears from harmful noise levels. When these small devices are inserted into your ear canal, disruptive or dangerous sounds are blocked out. Shopping for ear plugs can be confusing, as there are a large variety of styles available, but with patience and a little bit of know-how you can find the plug for you.Start by assessing the amount of noise dampening you require. Take a look at the noise reduction rating (NRR) on the box to find out how much sound it cancels out: better quality plugs have a rating between 21 and 33. Think about where you plan to use your ear plugs. For example, you will find that plugs with a lower NRR will be sufficient if you plan to use them to block out traffic noise while working or studying. However, if your profession requires you to spend time around loud equipment or music, a higher rating is more appropriate.The composition of your ear plugs is another important factor to consider. Foam ear plugs are made from a type of memory foam that is inserted into the ear canal. The foam is compressed during insertion then expands to plug the canal. Silicone ear plugs differ from foam in that they are molded over the outside of the ear canal. Both foam and silicone ear plugs need to be replaced periodically.Lastly, evaluate whether you’d be better served with non-disposable, custom ear plugs. You can get away with using a simple silicone or foam plug in many situations, but there are specific plugs made for certain environments. Musicians often wear custom-made, non-disposable earplugs to help protect their hearing while they are performing. These plugs are carefully crafted to fit your ear, allowing you to hear what you are playing while blocking out harmful sounds.Many people shop for earplugs to wear while sleeping to block out the sound of their partner’s snoring. Look for specialized plugs that will block out the sound of snoring while still allowing you to hear your alarm clock, fire alarm, and other important sounds. Try out these plugs with your head tilted to the side. This simulates the changes that take place in your ear canal while lying down, helping you determine whether the plugs will be comfortable while you are sleeping.If you take the time to really think about what you need your earplugs for, you should not have any problems finding a pair that suits you.
Are In The Ear Style Hearing Aids Right for You? Explore the Pros and Cons
You’ll probably be exposed to a number of hearing aid styles and features when choosing a device for a loved one or for yourself, and one of the most common is in-the-ear (ITE). In-the-ear hearing aids are a popular choice for individuals with mild to moderate hearing loss. They are custom-made to fit comfortably in the lower portion of the outer ear. What follow is a summary of the advantages and disadvantages of the ITE hearing aid style.Each in-the-ear hearing aid is custom made for the wearer because it must fit the exact shape of your ear. The custom fit is achieved by first creating an ear mold which becomes the template for the device’s shape. By doing so, you will enjoy high quality sound, low feedback, and an extremely comfortable overall experience. Unlike behind-the-ear devices, ITE hearing aids don‚Äôt require any tubes or wires: all the device‚Äôs components are included in a single case. This makes them lightweight and easy to wear.The ITE hearing aid style has certain distinct advantages. It tends to be excellent at handling high-frequency sounds (which is the range where many people have the most significant hearing loss). Unlike a behind-the-ear model, these devices can take advantage of the outer ear‚Äôs ability to collect and focus high frequency sound waves. ITE devices are also recessed far enough into the ear that headsets and telephones can usually be used normally. This type of hearing aid‚ small size can be both an advantage and a disadvantage.Their small size keeps them from being very obvious, making them a great choice for listeners who are a little self-conscious about wearing a device. However, this small size also causes a short battery life and keeps them from having all the features found in some other devices. Handling the device and changing the battery inside requires good finger dexterity and eyesight.As with all the hearing aid styles available, in-the-ear hearing aid has both advantages and disadvantages. A hearing aid specialist can help you evaluate your options and make recommendations based on your needs and preferences.
Charitable Organizations Devoted to Advancing Healthy Hearing
With numerous charitable organizations available to consider, selecting one can feel like an overwhelming task. Selecting which charities to support financial is based on several factors including the cause itself, the reputation of the organization and the intended use of the funds. You can become a part of one of many national and international charity organizations that lend their time and resources to helping those in need of better hearing health.Hearing Health Foundation – Collette Baker Ramsey, a woman who suffered fromhearing loss herself, created Hearing Health Foundation in the 1950s. This organization fosters research to treat and cure hearing loss and promotes the prevention of hearing conditions through public education. Currently, the foundation is researching a cure for tinnitus, which is ringing in your ears that often signals a loss of hearing. There are many ways to help out with this foundation. You can make any cash donations or contribute gifts in the form of stock. You can write and share a personal experience with hearing loss, assist in fundraising, and even name a research grant. For the most up-to-date information of the Foundation’s activities and current needs visit their website at www.hearinghealthfoundation.org.Hearing Loss Association of America – Hearing Loss Association of America (HLAA) prides itself as being the largest national organization for helping people with hearing loss across the U.S. Its mission is to provide resources and support to individuals with hearing loss and their families while educating the public about hearing impairments. HLAA does work on a local, state and national level and part of its mission is to influence legislation that impacts the hearing impaired. You can begin by signing up for their newsletter, becoming a member of the organization, or registering for one of their bi-annual fundraiser walks called Walk4Hearing. Donations are also accepted online at www.hearingloss.org.Starkey Hearing Foundation – As a huge national and global foundation, Starkey Hearing Foundation provides hearing health services in three ways: Hear Now, Listen Carefully, and Hearing Aid Recycling. Anyone can donate new and used hearing aids to the Hearing Aid Recycling program, which gives them to people in need. Hear Now provides financial assistance to U.S. residents in need of hearing aids. The Listen Carefully Program is provides education to youth in schools about the dangers of loud music and headphone use. To get contact details for each organization or to give a monetary gift, visit www.starkeyhearingfoundation.org.
A Look at the Newest Digital Noise Reduction-Enabled Hearing Aids
Noise is a fact of modern life. From packed restaurants to sport stadiums to the train station, noise is all around and may become overwhelming sometimes. People who use hearing aids are particularly sensitive to this problem as it becomes difficult to differentiate between meaningless noise and important sound. Digital noise reduction technology embedded inside hearing aids is one approach to combating this problem. It allows the wearer to block unwanted noise and focus on specific sounds.Hearing aids that utilize digital noise reduction technology are able to pick up on the unique differences between speech and noise. In quiet environments, picking up the sounds of speech is easy because they are the primary sounds in the room. Likewise, if you are listening to someone in a crowded room, your device understands that there noise present. Once your device picks up on sounds that may interfere with your ability to follow a conversation, it automatically lowers the volume in the noisy channels.While no hearing aid can completely eliminate unwanted noise, it can go a long way in reducing the frustration brought about by trying to communicate in loud environments. The general consensus among hearing aid wearers with this technology is that speech sounds better and background noise is less overpowering.Users are most pleased with their results when the device is used to counteract a constant background noise. This means that steady sounds such as an air conditioner or engine running are more effectively blocked than dynamic music or a nearby conversation.To make the most out of the digital noise reduction feature in your hearing aid, you might want to consider taking some common sense steps to reduce the noise around you. For example, if you find yourself in a noisy part of a restaurant, ask to be seated somewhere that isn’t quite as hectic.Digital noise reduction technology is not perfect, but it can go a long way in helping to counteract the unwanted noise you encounter in your day to day life.
Sports-Related Concussions: Call for Hearing Healthcare to Get in the Game
Dr. Dana Day was featured in Heather Lindsey’s article,Sports-Related Concussions: Call for Hearing Healthcare to Get in the Game in the February 2014 Volume of the Hearing Journal, you can access the article online here as well…
Audiologists have a key position to play in managing athletes who sustain a concussion.
Missing the diagnosis of concussion’s audiologic consequences may delay return to play, work, or other daily activities, as well as increase the risk of depression, sleep disturbances, anxiety, and change in mood or behavior, said Dana Day, AuD, managing member of Arizona Balance and Hearing Associates (ABHA) and an audiologist with Banner Concussion Center and the Central Arizona Center for Therapeutic and Imaging Services (CACTIS) Foundation, which is creating a concussion management program in Phoenix.
Unfortunately, awareness and understanding of the auditory and vestibular side effects of concussion, which can include benign paroxysmal positional vertigo, hearing loss, tinnitus, noise sensitivity, and auditory processing problems, is “still in its infancy,” Dr. Day said.
This information gap may not come as a surprise, given that data on sports-related concussions are lacking overall, especially in younger populations, as noted in the Institute of Medicine–National Research Council (IOM–NRC) report on Sports-Related Concussions in Youth: Improving the Science, Changing the Culture released Oct. 30, 2013.
Approximately 1.6 million to 3.8 million “sports- and recreation-related traumatic brain injuries (TBIs), including concussions and other head injuries, occur in the United States each year,” the report authors noted, citing a 2006 article from the Journal of Head Trauma Rehabilitation (21[5]:375-378 https://journals.lww.com/headtraumarehab/pages/articleviewer.aspx?year=2006&issue=09000&article=00001&type=abstract). However, because athletic concussions are likely underreported, these figures may be higher, they added.
Awareness of the issue has increased, though, and is partly behind a rise in the incidence of sports-related concussion over the past decade, according to the report. For example, the reported number of people age 19 and younger treated in U.S. emergency departments for concussions and other nonfatal, sports-, and recreation-related TBIs increased from 150,000 in 2001 to 250,000 in 2009.
Generally, concussions are more frequent among high school athletes than college athletes in football, men’s lacrosse and soccer, and baseball, according to the IOM–NRC report. Concussion is also more common during competition than practice, except when it comes to cheerleading.
Sports with the highest incidence of concussion include football, ice hockey, lacrosse, wrestling, soccer, and women’s basketball. Concussion rates also appear greater for youths with a history of concussions and among female athletes.
LESSONS FROM MILITARY RESEARCH
While data on the auditory side effects associated with sports-related concussion are limited, Dr. Day noted, audiologists can learn a lot from TBI research in military personnel.
Tinnitus and hearing loss are two of the most widely reported audiologic consequences of traumatic brain injury, said Paula Myers, PhD, chief of the Audiology Section at the James A. Haley Veterans’ Hospital in Tampa, FL, whose comments for this article are based on her research of injuries from blasts or motor vehicle accidents.
In a report on veterans of the Iraq and Afghanistan wars who were evaluated for traumatic brain injury, 59 percent experienced sensitivity to noise, and 66 percent reported hearing difficulty (Brain Injury2012;26[10]:1177-1184) https://informahealthcare.com/doi/abs/10.3109/02699052.2012.661914. Another study of military personnel with TBI found that up to 38 percent complained of tinnitus (J Rehabil Res Dev 2007;44[7]:921-928) https://https://www.rehab.research.va.gov/jour/07/44/7/page921.html.
Following TBI, audiologic sequelae may arise from debris, tears, or external bleeding in the ear canal; a ruptured tympanic membrane or ossicular damage in the middle ear; cochlear damage with or without eighth nerve complex injury; disruption of the membranous labyrinth; or vascular compromise in the inner ear, Dr. Myers said. The temporal bones and central auditory nervous system pathways may also be affected.
A standardized approach to audiological management of TBI patients does not exist because peripheral and central function; speech perception abilities in quiet and degraded conditions; cognition; and emotional, behavioral, and physical health all vary greatly in this population, Dr. Myers said.
However, audiological assessment of mild TBI should begin with a comprehensive case history that includes pre- and post-injury information about physical and cognitive functioning, visual ability, dizziness, and hearing, including tinnitus and exposures to loud noise, she recommended.
Information gathering about traumatic brain injury should focus on the nature of the injury, use of protective gear, loss of consciousness at the time of injury, history of prior head injuries, and current medications, she said.
Patients with mild TBI should then receive an audiologic evaluation with otoscopy, pure-tone audiometric thresholds up to 12,000 Hz or the frequency limits of the individual’s hearing, speech recognition testing in quiet and in noise, a complete immittance battery, otoacoustic emission testing, evaluation for central auditory processing disorders, and electrophysiological evaluation with appropriate referrals to otolaryngology, Dr. Myers said.
Reassessing patients with TBI six months post-injury and annually thereafter—sooner if subjective changes are noted—is advisable due to the potential for latent sequelae, she added.
INVISIBLE INJURIES
One of the greatest challenges for audiologists addressing sports-related concussion is that both audiological problems and brain injuries are not readily visible, Dr. Myers said.
Another difficulty is that auditory symptoms are only one of many sensory problems seen in these patients, Dr. Day said. Testing in a well-lighted room may not be possible due to light sensitivity. Additionally, the optokinetic stimulus itself may induce motion intolerance.
“The audiologist must be able to adjust testing on the fly at times to get the diagnostic information needed,” Dr. Day said.
Lack of awareness is another obstacle to care, she added. While audiologists know mild TBI can cause ossicular bone dislocation, they’re not as familiar with the cognitive and oculomotor aspects of concussion. Consequently, they may assume patients are “not giving their best effort” during diagnosis.
In her clinic, Dr. Day most often sees the audiologic sequelae of tinnitus, noise sensitivity, hearing loss, and auditory processing difficulties.
“These complaints are likely explained by damage to the outer hair cells of the cochlea, damage to the ossicular chain, cognitive deficits in the speed at which auditory information is processed, attention to auditory information, and memory,” she said.
Dr. Day also commonly sees dizziness, vertigo, headaches, and sensitivity to light in her patients.
To provide the best possible evaluation and management of sport-related concussion, audiologists should work with a multidisciplinary team, she said.
This approach is especially useful in patients who continue to experience symptoms beyond a three-month follow-up period. Some individuals “do not get better on rest alone,” she said.
MULTIDISCIPLINARY APPROACH
At Banner Concussion Center and the CACTIS Foundation, the multidisciplinary team includes a physician trained in sports-related injuries and concussions; neuropsychologists familiar with neurocognitive testing; professionals experienced in comprehensive neurovestibular assessment and therapy; providers of vision services, including optometric evaluation and treatment; and audiologists who conduct a comprehensive evaluation.
Protocols for working with concussion patients at Arizona Balance and Hearing Associates involve a complete medical history and the performance of tests for high-frequency distortion-product otoacoustic emissions, ultrahigh-frequency (12,000 Hz to 20,000 Hz) hearing thresholds, ipsilateral and contralateral acoustic reflex thresholds, and speech in noise, which, if abnormal, may require full evaluation for a central auditory processing disorder.
The center also conducts videonystagmography (VNG), with a well-defined protocol for ocular motor testing. “Our clinic prefers to utilize water calorics whenever possible to assure the most accurate caloric findings,” Dr. Day said.
She and her colleagues may consider other tests such as ice water calorics, rotary chair testing, computer dynamic posturography, and cervical vestibular-evoked myogenic potential with or without ocular vestibular-evoked myogenic potential.
Video head impulse testing is still being evaluated by the practice for use in patients with a concussion.
“I believe [its] greatest value may come in testing the pediatric patient, but the final verdict is still out,” Dr. Day said.
GETTING A BASELINE
Arizona Balance and Hearing Associates is working with the CACTIS Foundation to offer baseline testing services to its youngest patients and athletes, who are 6 to 14 years old.
“We hope that by gathering this information prior to injury it will offer an objective measure for making the critical return-to-play decision,” Dr. Day said.
At a minimum, an audiogram and VNG need to be conducted to assure a baseline measurement in case tinnitus or dizziness present as late-onset symptoms, meaning three to six months after injury, Dr. Day said.
In addition to testing, audiologists at Arizona Balance and Hearing Associates directly manage several concussion-related sequelae, such as sensorineural and conductive hearing loss and benign paroxysmal positional vertigo, Dr. Day said.
Tinnitus can be the most challenging condition to address because therapy must be personalized to the patient, she said.
Appropriate medical and psychological referrals should be made for tinnitus, Dr. Myers added.
Sudden-onset tinnitus, with or without hearing loss, requires same-day assessment by otolaryngology and audiology, she said. If the condition is causing severe distress or challenges with coping, referrals should also include psychology.
COLLEGE-LEVEL CONCUSSION MANAGEMENT
To provide better care for its student athletes with potential concussion, Lamar University in Beaumont, TX, implemented a program in the fall of 2013 that uses cognitive and vestibular tests to assess students.
“Usually a concussion will show up as a cognitive problem or a balance problem,” said program developer Vickie B. Dionne, AuD, who is also associate professor and program director of audiology at the university.
“We’re worried about the player who comes off the field and says he was hit hard and then, the next day, has a headache, or everything is blurry, or he can’t process what you say. These symptoms don’t show up right away.”
Currently, the Balance Error Scoring System (BESS) is widely used to assess balance deficits indicating concussion, Dr. Dionne said. It requires a trainer to subjectively evaluate a variety of the athlete’s stances to see if the body sways.
“This is a test that a lot of teams are using from middle school up through college,” she said.
In addition to BESS, a pencil-and-paper test for cognition such as the Standardized Assessment of Concussion is commonly used.
“It consists of questions about the day, year, and the athlete’s name; immediate recall; concentration; and delayed recall,” Dr. Dionne said.
However, given that only three versions of the paper test are available and athletes have been taking the tests for years, subjects often have responses memorized. “It’s no longer a true test,” she said.
UPDATED TESTING
After a heavy overhaul of Lamar’s National Collegiate Athletic Association (NCAA) concussion management plan, Dr. Dionne and colleagues studied 400 student athletes using updated concussion assessment technology, including computerized dynamic posturography (CDP). CDP provides vestibular evaluation of concussion through the assessment of balance, postural sway, and weight bearing.
In addition, researchers used the computerized ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Since the test is randomly generated each time it’s given, athletes can’t memorize it, Dr. Dionne said.
She and coinvestigators acquired baseline CDP and ImPACT assessments from athletes before practice or play and then tested them after a head injury was sustained.
“We thought we were going to test athletes within 24 hours of concussion, but we found a lot of symptoms didn’t show up until 48 to 72 hours later,” she said.
Athletes were not allowed to play until both tests were back to baseline. “We benched quite a few players throughout the year for up to two to three weeks,” she said.
Most people recover from concussion within seven to 10 days, said Richard E. Gans, PhD, founder and CEO of the American Institute of Balance, which has eight clinics in the Tampa and Orlando, FL, areas.
When patients don’t recover within that time frame, they may then move into a post-concussion syndrome profile. Vestibular rehabilitation is being used to treat many of these patients, he said.
RAISING AWARENESS
As part of future research, Dr. Dionne would like to conduct hearing evaluations in student athletes with concussion and evaluate how long any identified cognitive or auditory processing disorders take to resolve.
Testing for auditory processing disorder would be a valuable addition to the program because such deficits could mean students are functioning poorly in class.
Further studies comparing different approaches to diagnosing and treating the audiologic consequences of concussion would be welcome, as would registries tracking the results of patients seen for mild TBI, the testing performed, and subsequent outcomes, Dr. Day said.
The audiology community also needs to establish best practices for assessing mild TBI and monitoring recovery.
“We need to continue to increase audiologists’ awareness of the diverse sensory and communication disorders that may result from a TBI so that a team-oriented, patient-centered rehabilitation plan can be formulated and implemented efficiently, thereby enhancing the likelihood of improved outcomes,” Dr. Myers said.
For More Information
The government, the American Speech–Language–Hearing Association (ASHA), and other organizations offer resources on the diagnosis and management of concussion, including the auditory and vestibular side effects.
* Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for Management of Concussion/Mild Traumatic Brain Injury (TBI): https://bit.ly/TBI-CPG.
* Traumatic Brain Injury Veterans Health Initiative: https://bit.ly/TBI-VHI.
* Centers for Disease Control and Prevention on Concussion and Mild TBI: https://bit.ly/TBI-CDC.
* ASHA Gives Current Perspectives on Traumatic Brain Injury:https://bit.ly/TBI-ASHA.
* ASHA on Tinnitus Evaluation and Management Considerations for Persons with Mild Traumatic Brain Injury: https://bit.ly/mTBI-ASHA.
* Brain Injury Association of America: https://www.biausa.org.
© 2014 by Lippincott Williams & Wilkins, Inc.
A Summary of Vestibular Rehabilitation Therapy for Vertigo or Dizziness
Feelings of vertigo, dizziness, and loss of balance are more prevalent than most people realize; 42% of the United States population (ninety million people) experience this at least once during their lifetime, and for many the condition becomes chronic. In the elderly, dizziness is the most common reason that people over seventy five visit a doctor, and for people over sixty five, falls resulting from a loss of balance are the number 1 cause of serious injury and death.Most (75 percent) of these cases are caused by peripheral vestibular disorders in the inner ear; examples of these conditions include Ménière’s disease, labyrinthitis, perilymphatic fistula, benign paroxysmal positional vertigo (BPPV) and vestibular neuritis, acoustic neuroma. These disorders cause abnormalities in the delicate areas of the inner ear that disrupt our ability to maintain and control our sense of balance. Most of the cases of dizziness and vertigo occur in adults, but these conditions can affect children as well, with even greater impact because they are often involved with athletics or playground activities in which a sense of balance is key.These conditions can be treated with surgery and drugs, but there is another treatment methodology that uses physical therapy to stimulate and retrain the vestibular system and provide relief – Vestibular Rehabilitation Therapy (VRT). The Vestibular Rehabilitation Therapy exercises are individually prescribed for each patient’s symptoms and complaints, but in general they consist of head movements, eye exercises and gait training designed to reduce symptoms and improve stability. VRT cites its goals as seeking to improve balance, decrease the experience of dizziness, improve patients’ stability when walking or moving, improve coordination, minimize falls, and reduce anxiety.VRT has been shown to be effective in reducing symptoms for many people suffering from the conditions mentioned above, and for those with other forms of bilateral or unilateral vestibular loss. The effectiveness of VRT in patients suffering from these conditions who did not respond to earlier treatment methodologies has been proven in several clinical trials. It is not as likely to be beneficial if a patient’s symptoms are the result of transient ischemic attacks (TIA), anxiety or depression, low blood pressure or reactions to medications, migraine headaches.Because the specific exercises in a regimen of VRT vary according to the patient’s symptoms and conditions, it is not easy to give an overview of them. But are all taught by trained Vestibular Rehabilitation Therapy therapists, and often involve movements of the head, eyes, and body that enable your brain and body to retrain themselves and regain control over their equilibrium and balance, compensating more effectively for the incorrect information sent to them from their inner ear. If you have experienced long-term symptoms of dizziness or vertigo, consult a balance specialist and ask for more information. You may also want to contact the Vestibular Disorders Association and take advantage of many of their short publications and resource materials.
Caregivers’ Guide to Tinnitus/Ringing-in-the-Ears in Kids
Tinnitus (ringing in the ears) is a well-known problem among adults, but there are no age restrictions associated with this disorder. Many children also experience the symptoms of tinnitus. While adults can usually determine that the sounds they are hearing are abnormal, many children assume the noise is a regular part of life. If your child shows signs of tinnitus it is important to look into it to rule out any underlying condition.Tinnitus is caused by a number of different conditions in both adults and kids. The disorder is linked to wax build-up in the ear canal, problems in the circulatory system, misaligned jaw joints, noise-induced hearing loss, and head and neck trauma. Slow-growing tumors on nerves in the face and ears can also cause tinnitus. Bring your child to your family doctor to rule out any specific ear problems. If there are not any obvious issues, you will likely be referred to an ear, nose, and throat specialist or audiologist for further investigation.If the examination uncovers a specific reason for your child’s tinnitus, the issue can usually be alleviated by addressing the underlying problem. Unfortunately, many incidences of tinnitus are not associated with a specific issue. In this case, there is no way to eradicate the problem, so your focus should shift to helping your child cope with the sounds he or she is hearing.Your child may find that his or her tinnitus makes concentration difficult. Background noise is an effective way to fight back against this problem. Consider playing soft music or running a fan when your child needs to concentrate. Hearing aids can be helpful for kids with hearing loss by helping them filter out distractions and focus on important sounds.Tinnitus can cause some kids to experience psychological distress. In this case it is important to be supportive and reassuring about the condition. Make sure your child understands that tinnitus is a common problem that affects many other children. Ask your audiologist about how you can explain tinnitus to your child in a way that makes sense to them.Some kids find that their tinnitus gets worse when they are under stress, so work with your child to find ways to manage stressful situations.Always keep in mind that many kids outgrow their tinnitus without intervention, so it may cease to be an issue. While it may be a nuisance now, with time your child can overcome it.
Newer Hearing Aids : Examining the Advantages of Directional Microphones
A hearing aid can be an effective way to offset hearing loss. Every year hearing aids become more advanced and offer additional features and functions that were not previously available. The directional microphone is one of these new features. Many of today’s hearing aids incorporate this device, allowing the wearer to enjoy a more natural hearing experience.The traditional standard for hearing aids was the omnidirectional microphone. When this style of microphone is in use, sound is amplified from all directions in equal measure. While this method works well in a quiet setting such as a living room, it is not conducive to noisier environments (such as a restaurant). In order to compensate for this, directional microphones focus closely on sounds emanating from the front. This allows you to hear what is being said in front of you while blocking out unimportant noise from the rest of the room.Because both types of microphones have their own advantages, many hearing aid designers will incorporate both into their devices. Directional microphone usage varies from hearing aid to hearing aid. In some cases users can manually switch back and forth between microphones, usually through a small switch. Other devices can pick up on which microphone is most useful in a given situation and will automatically switch back and forth.A third type of hearing aid microphone is the adaptive directional microphone. This device offers variation in the direction of amplification, automatically picking up on speech signals and focusing in on the direction they are coming from. Adaptive microphones can be troublesome in crowded environments where many speakers are present, but the user can usually switch to a forward only mode in these situations.Hearing aids designed for kids sometimes utilize directional microphones, but caution is needed when using these devices. Because kids develop much of their language skills from listening to the people around them, a directional microphone may cause them to miss out on an important developmental experience. Children may also have difficulty hearing traffic with this type of microphone. Parents should make sure that their child’s hearing aid has an on/off switch for the directional microphone and make sure it is only turned on when appropriate.The advantages of the directional microphone outweigh its flaws, allowing it to dramatically increase its wearer’s ability to hear.
Are CIC Model Hearing Aids a Good Fit for You? Discover the Advantages and Disadvantages
Completely-in-canal (CIC) hearing aids are the smallest of all the hearing aid options and different than other possibilities because they are custom fitted to the inside of your ear canal to amplify sounds in individuals with mild to moderately-severe cases of hearing loss. CIC hearing aids offer several pros for the wearer, as well as a couple of cons that you should be aware of before getting one.Pros:This type of hearing aid is small and comfortable, which provides both cosmetic and listening benefits to the wearer.Because of their small size, it’s difficult for others to notice a CIC without looking for it and it works automatically without extra knobs and buttons to control. The custom fit of the device may make this a more comfortable choice because they are molded to the shape of your inner earYou can wear some completely-in-canal brands around the clock for up to several months at a time, so there is no need to insert and remove it every morning and night. Models that cannot remain in the ear are equipped with a tiny string for easy removal. Because the device is inside the ear, your outer ear keeps away wind noise and allows you to use the telephone with ease. Additionally, the natural anatomy of the ear helps guide sound to the instrument, which improves the directionality of the sound.Cons:Because the completely-in-canal hearing aids are small, they are generally less powerful and go through batteries faster than larger ones. They are generally the more expensive option because they are custom fitted to the wearer’s ear. Additionally, their tiny size doesn’t leave room for extra features, so you won’t be able to adjust the volume or experience directional sound (the sound in front of you appears louder than one that coming from somewhere else). Moreover, CICs are not powerful enough for people with major hearing loss.
Audiologists at Arizona Balance & Hearing Associates in Phoenix Share Advice for Selecting Hearing Aids for Children
Excerpt: “Arizona Balance & Hearing Associates’ Audiologists want to help parents narrow the range of hearing aid options for their children by explaining the pros and cons of various hearing aid styles for kids.”Read full press release at:https://www.prweb.com/releases/phoenix/hearing-aids/prweb11456331.html
Pros and Cons of Open Fit Type Hearing Aids
Finding the hearing aid that’s right for you or your loved one can be overwhelming, especially considering the variety of hearing aid choices available. The next few paragraphs will describe more about one of the most popular hearing aid styles: open fit hearing aids.Open fit hearing aids share many similarities with behind-the-ear devices. This type of hearing aid consists of a plastic case that rests behind the ear and a small tube that connects the case to the ear canal. However, open fit hearing aids are considerably smaller than their behind-the-ear counterparts.Better ventilation to the ear is probably the largest differentiating factor of the open fit hearing aid. The open fit design allows low frequency sounds to enter the ear without being amplified. This offers a more comfortable and natural experience to those with mild to moderate hearing loss that are able to hear low frequency sounds without amplification. It also prevents wearers from hearing their own chewing, coughing, and speaking, reducing distraction and adding further comfort.Another major advantage of open fit hearing aids is their small size. Many users are able to disguise these devices, making them a favorite among listeners who are self-conscious about having to use a hearing aid.Open fit hearing aids do have downsides, particularly for users who have deep hearing loss. At high levels of amplification (required for individuals with severe hearing losses) the open fit devices often suffer from feedback noise. The hearing aid’s small size can also work against it, as people who do not have fine motor skills often find it difficult to operate such a small device. Additionally, this small hearing aid type requires very small batteries that will need to be changed or charged regularly.Open fit hearing aids may have their flaws, but they are still a great choice for many users. Consult with your hearing professional to determine if the open fit type of hearing aid may be the best for your unique hearing needs and lifestyle.
Understanding Conductive Hearing Loss, Its Root Causes as well as the Treatments
Conductive hearing loss sufferers have problems hearing due to a problem with their ear’s capacity to conduct sound waves. This variety of hearing loss arises from a blockage in the ear canal, but it also may be due to a congenital absence or malformation in the ear. In many cases conductive hearing loss can be treated, fully restoring normal hearing ability.Quite a few congenital problems may cause conductive hearing loss. For example, someone may be born with an ear canal that isn’t fully open, or their ear canal may not have developed at all. Deformation of inner ear components can inhibit optimal hearing. A number of these congenital problems can be addressed via surgery. Others may be best addressed with a hearing aid. Congenital problems are among the less frequent reasons behind conductive hearing loss.One of the more common causes of conductive hearing loss is a buildup of fluid or wax in the outer ear. Wax buildup and infections of the ear can lower a person’s hearing ability. Ear infections can be cured with prescription antibiotics while cleansing the ear might be sufficient for eliminating ear wax buildup.Buildup in the middle ear can also result in conductive hearing loss. This issue is most often caused by the accumulation of fluid. Frequently attributable to ear infections, this issue is widespread in kids. Sinus pressure from the common cold or allergies can exert pressure on the middle ear, putting a damper on a person’s ability to hear. A uncommon reason for hearing loss in the middle ear is tumors.Perforated eardrums or foreign bodies in the ear canal are other problems that may be responsible for conductive hearing loss. Conductive hearing loss principally happens on its own, however it can coincide with other forms of hearing loss. Consult with a hearing care specialist right away if you experience any unexplained hearing loss. In many cases complete hearing can be recovered with appropriate treatment.
Watch Out for Hearing Loss from these Everyday Medications – The Ototoxic List
There are countless drug and medication commercials nowadays with seemingly endless lists of negative side effects. Did you know certain medications can cause balance problems or hearing loss? These medications are in wide use, and they’re called ototoxic medications. Ototoxic drugs are over-the-counter (OTC) and doctor-prescribed medications that can damage your hearing and alter your balance. You can find more than 200 recognized ototoxic drugs that are in common use according to the American Speech-Language-Hearing Association (ASLHA). Quite a few of these ototoxic medications are used, and you’ve probably heard of them and might even be using them.
- Loop Diuretics – Loop diuretics are sometimes used in the management of certain kidney conditions, high blood pressure, and heart failure. Loop diuretics have been shown to cause tinnitus and hearing loss, which is sometimes only discovered during a hearing test.
- Salicylates – Salicylates are commonly found in everyday pain relievers such as aspirin and in aspirin-containing medications. Tinnitus and hearing loss are known to be caused by high daily doses (8 or more tablets per day) of medicines containing salicylates. Fortunately, when drugs containing salicylates are discontinued, the ototoxic side effects will go away on their own.
- NSAIDs – Nonsteroidal anti-inflammatory drugs(known as NSAIDs) can result in temporary hearing loss and a ringing in the ears in large quantities.Some easily recognized NSAIDs include ibuprofen and naproxen.
- Aminoglycoside Antibiotics – There are numerous categories of aminoglycoside antibiotics used to treat bacterial infections, including streptomycin, kanamycin, neomycin, gentamicin and amikacin. Complications come up when these medications produce free radicals, which do damage to the inner ear. Expectant mothers should be mindful of possible congenital deafness from using aminoglycosides during pregnancy.
- Chemotherapy Drugs – Cancer treatment drugs, such as bleomycin, carboplatin, cyclophosphamide and cisplatin can cause permanent hearing damage. If you have any hearing or balance changes while taking your chemotherapy drugs, speak to your oncologist.
Increased dosage and/or mixing of these ototoxic medications can increase the risks, but always consult your physician before adjusting or stopping any prescription drugs. To safeguard your ear health, talk to your doctor for alternatives to known ototoxic medications; if they cannot be avoided, make sure you are taking the correct dose precisely as directed.
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Conveniently located near the intersection of 7th Street and Indian School Road.
Southwest Balance, Dizziness & Ear Institute (formerly Arizona Balance & Hearing Aids)
4004 N 7th St.Phoenix, AZ 85014