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.
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).
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.
Everyone has heard of the saying “If you don’t use it, you will lose it.”
Well, when it comes to hearing loss, that seems to apply to not just hearing per se, but the actual structure of the brain!
Researchers studied MRI scans of older individuals (ages 60-77) with hearing loss, they found less brain volume in the auditory cortex of the brain which is not entirely surprising. What was surprising was that there was less brain activity on functional MRI scans when these individuals listened to complex sentences (it is just not “hearing” that is lost, but higher level brain function of “comprehension” being lost too).
These results suggest that hearing loss can lead to a systematic decrease in neural activity of speech comprehension and may also contribute to loss of brain volume especially in the primary auditory cortex.
This finding also implies that by wearing hearing aids, such loss can be prevented.
The next step would be to do the same research on patients WITH known hearing loss, but hearing aids have been used. What would be also interesting would be to see if such brain changes can be reversed if hearing aids are used after such brain loss is seen on MRI.
This video is of an 8 month old child born deaf who underwent a cochlear implant. This special device allows hearing to be restored to children (and adults) who would otherwise be deaf.
Watch the expression and reaction of the child when the implant is turned on and the child hears his mom’s voice for the first time!
Our office has produced a new video on non-sedated ABR/OAE hearing testing. Such testing traditionally required sedation as the patient was required to be absolutely still and quiet in order to obtain accurate test results. However, new technology now enables such testing to be performed without sedation. Furthermore, given the testing can be performed wirelessly, the patient can stand and walk around. Absolute quiet is also no longer necessary and the patient can actively play and even eat while testing is going on.
What is ABR/OAE? ABR (Auditory Brainstem Response) as well as OAE (Oto-Acoustic Emission) are specialized hearing tests that can evaluate whether a child/infant/newborn can hear without requiring them to respond.
These tests are completely non-invasive. Just like an EKG measures a heart’s electrical activity using little stickers, ABR/OAE testing checks out the electrical activity from the ear to the brain. Special stickers on the head enable us to “see” whether the brain “hears” any sounds introduced into the ear.
If the ABR/OAE testing comes back normal, rest assured your child’s hearing in both ears is normal.
Specifically, OAE is performed by placing an earpiece and playing clicks into the ear. The machine than listens for an echo which indicates that the ear “heard” the clicks.
ABR is performed just like an OAE, but special leads are placed behind the ear and forehead which measures brainwaves (just like an EEG or an EKG) to see if the brain “hear” the clicks produced by the testing machine. There are several different types of ABR (regular, tone burst, bone conduction, ASSR) depending on the age of testing and reason for the testing.
Traditionally, ABR/OAE testing required sedation in order to obtain accurate and reliable results as any muscle activity can lead to false reports. Furthermore, there are a lot of wires going from the patient to the equipment and as such required the patient to stay still. In the case of infants/children, this mandated general anesthesia in a hospital operating room.
Fortunately, new technology that our office possesses eliminates the need for such sedation and still obtain accurate ABR/OAE test results. Our office uses Vivosonic Integrity which incorporates wireless technology and the use of an in-situ bio-amplifier which amplifies biologic electrical activity at the ear source thereby reducing interference from environmental electric, magnetic, and RF field-induced noises. This also dramatically reduces artifacts which result from other muscular and ocular electrical activity.
What does this all mean for a patient?
It means that an ABR/OAE can be obtained in our office on a child/infant who is actively moving and playing around, eating food, chewing gum… all without being attached to wires. No sedation. No medications. No needles. No pain.
Many people may be aware of the Sunday School story regarding the Wall of Jericho in the Bible. In this story, seven priests blew 7 trumpets of rams’ horns resulting in the collapse of the wall of Jericho (Joshua 6:4-5) allowing the Israelites to conquer the city.
“4: And seven priests shall bear before the ark seven trumpets of rams’ horns: and the seventh day ye shall compass the city seven times, and the priests shall blow with the trumpets. 5: And it shall come to pass, that when they make a long blast with the ram’s horn, and when ye hear the sound of the trumpet, all the people shall shout with a great shout; and the wall of the city shall fall down flat, and the people shall ascend up every man straight before him.”
Now… from an ENT standpoint, I can imagine the mayhem this weaponized horn sound must have caused not only to the wall of Jericho, but also to the surrounding soldiers and people.
Back than, city walls were constructed of brick and mud. It is entirely possible that a loud enough sound can certainly cause the collapse of this wall, but it would have to be very loud… at least 180dB (decibels) loud.
Just how loud is this sound? Well, a motorcycle is 100dB; a jet engine is 140dB. From a human ear standpoint, ear pain starts at 125dB. Permanent hearing loss due to ear tissue death occurs at 180dB… but before ear tissue death occurs, the eardrums will rupture at 160db.
Even if the Israelites wore ear plugs and ear muffs (like airplane workers do), it only decreases the sound intensity by 15-45dB. So, the rams’ horn sound blast at 180dB would still result in the Israelite soldiers being exposed to 140dB of sound with its attendant ear pain and temporary threshold shift (temporary hearing loss).
So… though not expressly reported in the Bible, I’m sure not only did God supply the device causing the fall of Jericho’s walls… but also appropriate ear & hearing protection for Joshua and his army.
In fact… even if the walls did not fall, its inhabitants certainly would be deaf from ruptured eardrums and hearing nerve death. And if Jericho’s army is unable to talk and hear each other, its fighting effectiveness would be pretty much severely compromised.
Of note… the United States military utilizes weaponized acoustic devices that produce only 155dB.
Lung rupture and presumably embolism due to air blast occur at 200 decibels which can lead to death.
If you want to read more about acoustic weapons, click here which will probably provide more info than you ever wanted on this subject.
For those not in the know, Groupon is a website that offers coupons and other savings on local merchandise and services. Groupon also has recently rejected a takeover bid by Google.
I recently encountered this amazing deal on Groupon offered by an ENT colleague, Dr. Ghaheri:
I wonder if such marketing and medical discount offerings like this will become the future. Clearly, procedures and other types of medical treatments that are not covered by insurance will be applicable.
For example… here are some medical treatments/services I am considering to discount on Groupon:
This fascinating iPhone app called EarTrumpet was developed in collaboration with the Department of Otolaryngology Head and Neck Surgery at University of California Irvine. The app claims to convert your iPhone/iPod into a hearing aid of sorts (hearing enhancer app is the term they use) via headphones with a built-in microphone (the ear buds that come with the iPhone work just fine). In essence, the microphone will pick up the surrounding sound and the app will instantly amplify the sound and play it into the headphones. The degree of amplification is customizable via the app.
Hearing testing is also available.
As per the manufacturer website, the EarTrumpet features include
• use of the built-in microphone on the supplied iPhone ear buds
• allows the user to select which frequencies to boost.
• choose the left or right ear to amplify
• store custom profiles once balance and equalization settings have been selected
You can download the app here which sells for $1.99 (much less than traditional hearing aids which go for $1000 and higher). Watch the tutorial of how the app works below.
On a further note, EarTrumpet was created by Allen Foulad, a medical student.
