New Video on Newborn Hearing Testing

Given how often we see newborns in need of hearing testing, we have produced a video showing how the two main types of non-verbal hearing tests are performed today: Auditory Brainstem Response (ABR) and Otoacoustic Emission (OAE).

Given newborns can not communicate whether they can hear or not, such hearing tests depend on the ability to detect nerve signals transmitting sound information from the ear all the way to the brain. This type of test is much like an EKG which can detect the electrical activity of the heart.

Watch the video to see how ABR and OAE hearing testing works in infants (as well as adults)!

Human Ear Contains a Built-In “Ear Plug”

According to one Australian researcher, by just chewing a gum or singing/talking loudly, one could be protecting your ears from noise-induced hearing damage. How???

It is not common knowledge that the human ear contains two muscles that attach to the middle ear bones called the stapedius and tensor tympani muscles.

The middle ear bones, composed of the malleus, incus, and stapes, are what transmits sounds from the eardrum to the cochlea which allows a person to hear. The stapedius muscle attaches to the stapes and the tensor tympani to the malleus.

If something prevents the middle ear bones from vibrating, that effectively dampens the sound transmission from the eardrum to the cochlea… just like an ear plug or a bad case or earwax dampens sound transmitted through the ear canal to the eardrum.

SO… if the middle ear muscles tighten which are attached to the middle ear bones preventing them from vibrating, less sound is transmitted to the cochlea… just like an ear plug, except it is built-in.

Just how effectively does this reduce sound?

According to the researcher who has been studying this phenomenon, by about 30 decibels (or 1000x fainter).

That’s about the same as foam earplugs!

How does one “activate” the middle ear muscle contraction?

By chewing a gum or singing/talking loudly!

Some individuals can sense this contraction if they close their eyes and try to “pull the muscles around the ears together”… a fluttering sensation inside the ear may be heard/felt which is the contraction of the middle ear muscles. In rare patients, this contraction may occur involuntarily and continuously.

SO… if you happen to have forgotten your ear plugs and are attending a very loud rock concert, chew gum and/or sing along with the band loudly! This may actually protect your hearing!

Of course, it’s better to wear hearing protection, or better yet, avoid such circumstances altogether.

Read more about this here.

Reference:
How do middle ear muscles protect the cochlea? Reconsideration of the intralabyrinthine pressure theory. Journal of Hearing Science 2011; 1(2): RA 9 – 23

Movie Sets are Dangerous to Ears!

First it was Maggie Q, and now I learn that there are other celebrities with hearing loss due to movie set loud noise exposure.

Leonard Nimoy (Spock of Star Trek fame) suffers from right ear tinnitus due to hearing damage from a special effects explosion during filming of Star Trek episode “Arena”.

Similarly, Steve Martin suffers from tinnitus due to hearing damage sustained during filming of a pistol-shooting scene for “¡Three Amigos!” in 1986.

Here is a full list of celebrities with hearing problems.

Actress Maggie Q Suffers From Hearing Loss

American actress Maggie Q of Mission: Impossible III and TV show Nikita fame suffers from significant hearing loss due to a loud noise exposure from a movie set explosion.

Apparently, during shooting of an explosive stunt, her left eardrum was blown out while her right ear suffered mild hearing loss.

Such an injury could have been prevented with hearing protection.

Earthquake Helps Man Regain Hearing… Perhaps Not!

Fox News reported on Aug 25, 2011 about Robert Valderzak who suffered conductive hearing loss for a few months… until the earthquake shook him and the rest of the East Coast after which he was able to hear.

Though this may sound miraculous, conductive hearing loss is one of those reversible type of hearing loss. It is not permanent. Example of conductive hearing loss include:

• Earwax
• Fluid in the ears
• Ear infection
• Eustachian tube dysfunction
• Problems with the middle ear bones

All these problems can be “fixed” and the hearing loss reversed. Permanent hearing loss is due to nerve damage and a reversal of a nerve type of hearing loss could be considered “miraculous.”

Now how could an earthquake conceivably reverse a conductive hearing loss? Without benefit of having examined Mr. Valderzak, perhaps he had a lot of earwax and the quake “shook” the earwax out or free (kind of like when a person goes swimming and gets some water in the ear that requires head-shaking to get it out).

It could also be coincidence. There are thousands of people who suffer conductive hearing loss every day for one reason or other. Often, this type of conductive hearing loss will spontaneously resolve one day after days or weeks or even months go by even if not aggressively treated medically. That’s why in kids who have fluid in the ears (which causes conductive hearing loss), we sometimes wait 3 months before we put ear tubes in. Quite a number resolve on their own spontaneously.

Now if there are thousands of people with conductive hearing loss and we expect a few to spontaneously recover their hearing each day… and the earthquake was felt by millions throughout the East Coast… I’m surprised that this particular patient is the only one who regained his hearing after the earthquake. I suspect there’s at least a dozen that probably regained their hearing that day that the media has not heard/reported about… as well as the day before and the day after. I also suspect that there’s probably a few hundred that “lost” their hearing during the earthquake due to earwax, fluid buildup in the ears, ear infection, etc.

Read the Fox New article here.

Do Cell Phones Pose a Health Hazard? Do Cell Phone Companies Know About Them?

With all the recent news about increased glucose metabolism in the area of the brain in proximity to cell phone antennas (study abstract here), I thought it worth re-printing this blog article I wrote back in November 2010 regarding the possibility that cell phone makers may know more about health risks associated with cell phone use than they may be letting on. There’s another blog article I wrote regarding what studies ARE already out there regarding risk of developing brain tumors that I felt worth re-printing below as well.

It is true that some people may find this recent research good news for some young people as it may be the only stimulation their brain gets (joking!), but it does bring some additional concerns that may merit limiting cell phone use as well as how it is used.

I quote (myself)…

Recently, there has been much speculation on whether cell phones pose a health risk.

What I find interesting is that the cell phone makers may actually know more about these risks than they are letting on or even have evidence for them.

If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in use or when carrying around. The picture of how the Verizon ad guy is using the cell phone is exactly how you are NOT supposed to use the cell phone (cell phone pressed against the face).

For example, in the iPhone 4 small print booklet that comes in the box with the phone, go to page 5 under the section “Exposure to Radio Frequency Energy.” I quote:

“When using iPhone near your body for voice calls or for wireless data transmission over a cellular network, keep iPhone at least 15 mm (5/8 inch) away from the body, and only use carrying cases, belt clips, or holders that do not have metal parts and that maintain at least 15 mm (5/8 inch) separation between iPhone and the body.”

Now, when I use a phone and answer a call, I have the phone right up against my ear just like the Verizon ad guy. I do not keep it 5/8 inch away from my ear/head.

Now why would a cell phone maker care whether the phone is right up against the ear (so you can hear better) or not unless there is some concern that there may be a danger due to proximity/contact?

Perhaps they are protecting themselves from any possible lawsuit that may occur in the future due to health problems that will occur with phone use over time?

Kind of reminds me of the tobacco industry who for years denied that smoking posed any health risk. Now we know better.

It would be ironic if Paul Marcarelli, the actor of the “Verizon Guy” character, develops a brain tumor due to cell phone use and sues the wireless industry just like the family of David McLean, the actor of the “Malboro Man,” sued the tobacco industry for wrongful death when he developed and died from lung cancer caused by smoking.

Something to think about…

So are there studies out there suggesting that cell phones and wireless phones can lead to brain tumors like astrocytoma, malignant gliomas, and benign acoustic neuromas? Several studies published since 2009 containing long-term (10+ years) follow-up have lent support that it does.

The group at greatest risk for development of brain tumors have the following characteristics:

1) Use of cell/wireless phone younger than age 20 (the younger the age with first use, the worse the risk)
2) Use of cell/wireless phone for more than 10 years
3) The more hours of cellular phone use over time, the higher the risk of developing brain tumors
4) Risk higher with analog cell/wireless phones (instead of digital)
5) Risk higher with increased overall total exposure

By some estimates, subjects who used cell phones for at least 10 years had a 2.4-fold greater risk of developing a brain tumor.

Though unclear how exposure to a phone’s microwave radiation leads to brain tumors, it is known that the cell signal is absorbed up to 2 inches into the adult skull. Even more worrisome is that the depth of penetration is even deeper in children.

The risk is not just to the brain, but even the parotid gland which sits just in front of the ear. In one study published in 2008 revealed an increased risk of parotid gland tumors with cell phone use. Also, contact allergy is another not uncommon risk with cell phone use.

Symptoms that a patient may exhibit that may suggest a brain tumor are subtle and include hearing loss or ringing of the ear on the same side the phone is used on.

It should be noted that all currently published results are based on retrospective studies and ideally, prospective studies will be required to provide more definitive results. However, that will take a long time and perseverance on both the researchers as well as the subjects since ideally, many of the study subjects should be children who are currently using cell phones (which it seems to be nearly all kids nowadays).

In any case, to be on the safe side, it is recommended to talk on speakerphone or use a wired headset (not wireless), or avoid altogether if at all possible, especially in children.

References:
Effects of cell phone radiofrequency signal exposure on brain glucose metabolism. JAMA. 2011 Feb 23;305(8):808-13.

Risk of Brain Tumors From Wireless Phone Use. Journal of Computer Assisted Tomography, 2010; 34 (6): 799 DOI: 10.1097/RCT.0b013e3181ed9b54

Cell phones and brain tumors: a review including the long-term epidemiologic data. Surg Neurol. 2009 Sep;72(3):205-14; discussion 214-5. Epub 2009 Mar 27.

Mobile phones, cordless phones and the risk for brain tumours. Int J Oncol. 2009 Jul;35(1):5-17.

Cell phone use and acoustic neuroma: the need for standardized questionnaires and access to industry data. Surg Neurol. 2009 Sep;72(3):216-22; discussion 222. Epub 2009 Mar 27.

Cellular phone use and risk of benign and malignant parotid gland tumors–a nationwide case-control study. Am J Epidemiol. 2008 Feb 15;167(4):457-67. Epub 2007 Dec 6.

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Fauquier Hearing Aid and Hearing Testing Services Offered at Fauquier ENT

Even though our office has been offering hearing tests and hearing aid services in Fauquier County for over a decade, many people are still surprised when they learn they can get hearing tests, hearing aids, ear plugs, and other ear & hearing services in our office. The additional benefit is having a ENT specialist also present in the same office.

Furthermore, we offer a comprehensive suite of other related services including non-sedated ABR (auditory brainstem response) hearing testing to specialized custom ear plugs for hunters and musicians.

We evaluate all different ages from 1 day old infants to the 99 year old hearing impaired patient.

The full list of Fauquier Hearing services we provide include:

Comprehensive Hearing & Audiometric Evaluations

• Hearing Testing from Birth to Adult
• Newborn Hearing Screening and Follow-up
• Otoacoustic Emmission Testing (OAE)
• Auditory Brainstem Response Testing (ABR)
• Tone Burst Auditory Brainstem Response (TB-ABR)
• Bone Conduction ABR Auditory Brainstem Response (BC-ABR)
• Auditory Steady State Response (ASSR)
• Electrocochleography (ECoG)
• Central Auditory Processing Evaluations (CAPD)

Hearing Aid Services

• Hearing Aid Evaluations and Consultation
• Hearing Aid Dispensing
• Advanced Digital and Wireless Hearing Aid Technology
• Aural Rehabilitation Counseling
• Hearing Aid Service and Repair
• Hearing Aid Accessories and Batteries
• Resources for Parents of Deaf and Hard of Hearing Children

Balance Evaluations

• Electronystagmography (ENG)
• Vestibular Evoked Myogenic Potentials (VEMP) for Meniere’s Disease
• Vestibular Rehabilitation Counseling
• Canalith Repositioning 

Hearing Conservation

• Custom Swim Plugs
• Custom Hearing Protection
• Musicians Filtered Earplugs
• Earplugs for Hunters
• Custom Earmolds for iPods, Cell phones, Headsets
• Assistive Listening Devices and Technology 

For more information, please go to our webpage here.

Wireless and Cell Phones Increase Risk of Brain Tumors

In an ongoing controversy regarding whether cell phones and wireless phones can lead to brain tumors like astrocytoma, malignant gliomas, and benign acoustic neuromas, several recent studies published since 2009 containing long-term (10+ years) follow-up have lent support that it does.

The group at greatest risk for development of brain tumors have the following characteristics:

1) Use of cell/wireless phone younger than age 20 (the younger the age with first use, the worse the risk)
2) Use of cell/wireless phone for more than 10 years
3) The more hours of cellular phone use over time, the higher the risk of developing brain tumors
4) Risk higher with analog cell/wireless phones (instead of digital)
5) Risk higher with increased overall total exposure

By some estimates, subjects who used cell phones for at least 10 years had a 2.4-fold greater risk of developing a brain tumor.

Though unclear how exposure to a phone’s microwave radiation leads to brain tumors, it is known that the cell signal is absorbed up to 2 inches into the adult skull. Even more worrisome is that the depth of penetration is even deeper in children.

The risk is not just to the brain, but even the parotid gland which sits just in front of the ear. In one study published in 2008 revealed an increased risk of parotid gland tumors with cell phone use. Also, contact allergy is another not uncommon risk with cell phone use.

Symptoms that a patient may exhibit that may suggest a brain tumor are subtle and include hearing loss or ringing of the ear on the same side the phone is used on.

It is interesting to note that it is just possible that the cell phone industry is aware of these risks even as it denies any risk of health problems with phone use. If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in use or when carrying around. Read more about this here.

However, all currently published results are based on retrospective studies and ideally, prospective studies will be required to provide more definitive results. However, that will take a long-time and perseverance on both the researchers as well as the subjects, since ideally, many of the study subjects should be children who are currently using cell phones.

In any case, to be on the safe side, it is recommended to talk on speakerphone or use a wired headset (not wireless), or avoid altogether if at all possible.

References:
Risk of Brain Tumors From Wireless Phone Use. Journal of Computer Assisted Tomography, 2010; 34 (6): 799 DOI: 10.1097/RCT.0b013e3181ed9b54

Cell phones and brain tumors: a review including the long-term epidemiologic data. Surg Neurol. 2009 Sep;72(3):205-14; discussion 214-5. Epub 2009 Mar 27.

Mobile phones, cordless phones and the risk for brain tumours. Int J Oncol. 2009 Jul;35(1):5-17.

Cell phone use and acoustic neuroma: the need for standardized questionnaires and access to industry data. Surg Neurol. 2009 Sep;72(3):216-22; discussion 222. Epub 2009 Mar 27.

Cellular phone use and risk of benign and malignant parotid gland tumors–a nationwide case-control study. Am J Epidemiol. 2008 Feb 15;167(4):457-67. Epub 2007 Dec 6.

Loud Noises Can Cause Heart Problems (Not Just Hearing Loss)!

According to a new study, people who work in noisy places for at least a year and a half could have triple the risk of a serious heart problem including a heart attack and severe chest pain compared to those who work in quiet environments. Of course, we all know such loud environment can also cause hearing loss.

6,000 people who were at least 20 years old and employed were surveyed from 1999 to 2004. Other heart risk factors including elevated Body Mass Index and smoking were statistically adjusted for.

Noisy occupations include not only welders, garage mechanics and forklift operators, but also dentists, construction workers, nursery school teachers and classical musicians.

Why would loud noises cause heart problems? It is felt that noisy environments typically are more stressful leading to higher levels of stress hormones which can contribute to heart problems. Still… quitting smoking and losing weight are more important to your heart health than avoiding noisy environments.

Read the research here.

Read a MSNBC article about this research here.

Reference:
Exposure to occupational noise and cardiovascular disease in the United States: the National Health and Nutrition Examination Survey 1999–2004. Occup Environ Med doi:10.1136/oem.2010.055269

Hearing Loss on the Rise in US Teenagers

JAMA published research showing a rise in hearing loss among US teenagers from 15% between 1988-1994 (2928 teens) to 20% from 2005-2006 (1771 teens). The study was a cross-sectional analyses of US representative demographic and audiometric data.

No one quite knows exactly why this has happened… but my guess is the increasing prevalence of portable music players where loud music can cause hearing damage.

Read a story on this in Reuters here.

Reference:
Change in Prevalence of Hearing Loss in US Adolescents. JAMA. 2010;304(7):772-778. doi:10.1001/jama.2010.1124