Presentation on theme: "Understanding and Treating Hearing Problems Dr. Diana Barreneche, CCC, FAAA Audiologist/Clinical Educator."— Presentation transcript:
Understanding and Treating Hearing Problems Dr. Diana Barreneche, CCC, FAAA Audiologist/Clinical Educator
Topics To Be Discussed Ear Anatomy and Physiology Signs of Hearing Loss in Adults Causes of Hearing Loss Hearing Loss Treatment Options Tinnitus Signs of Tinnitus Tinnitus Treatment Options
Anatomy and Physiology of the Ear Outer Middle Inner ear
Anatomy and Physiology of the Ear Outer Ear Consists of the auricula or pinna the external acoustic meatus
Anatomy and Physiology of the Middle Ear Eardrum Ossicles
Anatomy and Physiology of the Inner Ear Cochlea/Hearing OrganVestibular Canals/Balance Organ
Acoustic Nerve (8 th ) The vestibular/auditory nerve runs in the internal auditory canal and the peripheral end organs to the central nervous system (CNS) Nerve..
Diagnostic Tools Otoscopy OAEs (Otoacoustic Emissions) Tympanometry (Middle Ear Test) Pure tone and Speech Audiometry (Sound Booth) Auditory Brainstem Response(8 th Nerve and Hearing Thresholds Estimation)
Common Myths Hearing loss affects only "old people" and is merely a sign of aging. Actually it is the reverse of what most people think. The majority (65%) of people with hearing loss are younger than age 65.
Common Myths There are more than six million people in the U.S. between the ages of 18 and 44 with hearing loss, and nearly one and a half million are school age. Hearing loss affects all age groups.
Common Myths “If I had a hearing loss, my family doctor would have told me” Not true! Only 13% of physicians routinely screen for hearing loss during a physical. Since most people with hearing impairments hear well in a quiet environment like a doctor's office, it can be virtually impossible for your physician to recognize the extent of your problem. Without special training, and an understanding of the nature of hearing loss, it may be difficult for your doctor to even realize that you have a hearing problem. betterhearing.org
Common Myths Hearing might be at the bottom of the medical checklist, but it might be the number one medical cause of your problems. Why?
Signs of Gradual Hearing Loss in Adults The perception that people are speaking too soft or mumbling. Frequent misinterpretation of what is being said. Difficulty understanding conversations on the phone.
Signs of Gradual Hearing Loss in Adults/ Continuation… Difficulty understanding conversations in different environments: restaurants, theater, automobile, family reunions, seminars or places of worship. Blocked or stuffy feeling in the ears. Ringing in the ears. betterhearing.org
Prevalence of Hearing Loss In US 3 in 10 people over age of 60 have hearing loss; 1 in 6 baby boomers (ages 41-59), or 14.6%, have a hearing problem 1 in 14 Generation Xers (ages 29-40), or 7.4%, already have hearing loss At least 1.4 million children (18 or younger) have hearing problems It is estimated that 3 in 1,000 infants are born with serious to profound hearing loss. betterhearing.org
Types of Hearing Loss Hearing loss is categorized by which part of the auditory system is damaged. 1. Conductive hearing loss 2. Sensorineural hearing loss 3. Mixed hearing loss 4. Retro-cochlear hearing loss
Conductive Hearing Loss
Sensorineural hearing loss
Sensori-neural Hearing Loss SENSORINEURAL HEARING LOSS (DAMAGE TO THE INNER EAR CELLS CALLED CILIA)
Healthy Dead and Damage Cilia Cilia
Mixed Hearing Loss Damage to Outer or Middle and Inner ear
Causes of Conductive Hearing Loss Ear infection (Otitis) Allergies Poor Eustachian tube function Perforated eardrum Benign tumors (growths along the outer and middle ear) Impacted earwax (cerumen) Presence of a foreign body Fluid in the middle ear from colds Atresia (Anotia)
Causes of Conductive Hearing Loss Microtia and Atresia Ear malformations PE tube: Surgical tube to drain fluid in middle ear
Causes of Conductive Hearing Loss Impacted Wax External Otitis (Inflammation due to infection of ear canal)
Ear Drum Perforation with a Q-Tip When cotton tipped applicators are used to clean out ear wax, there is a risk of breaking the ear drum (perforation). Although we realize that this is commonly done, we recommend against using cotton tipped applicators, hair pins, and similar devices to clean the ear.
Causes of Sensorineural Hearing Loss SNHL reduces the ability to hear faint sounds. Even when speech is loud enough to hear, it may still be unclear or muffled. Some possible causes of SNHL include: »Illnesses »Drugs that are toxic to hearing »Hereditary »Aging (Presbycusis) »Head trauma »Malformation of the inner ear »Exposure to loud noise »Auditory nerve occupied lesion/ (8 th ) tumors
Presbycusis (Age Related Hearing Loss)
Presbycusis Hearing Loss due to Aging Causes: There is no known single cause for age- related hearing loss. Most commonly, it is caused by changes in the inner ear that occur as you grow older. However, your genes and exposure to loud noises (such as from rock concerts or loud machinery) may play a large role.
Presbycusis Hearing Loss due to Aging The following factors contribute to age-related hearing loss: –Family history (age-related hearing loss tends to run in families) –Repeated exposure to loud noises –Smoking –Certain medical conditions (Diabetes) and medications (Ototoxics) also contribute to age-related hearing loss.
Presbycusis Hearing loss related to Aging Prevalence: About half of all people over the age of 65 have some amount of age- related hearing loss. Impact in life style: The loss of hearing occurs slowly over time. It is most difficult to hear high-frequency pitch sounds. (ex: speech of women and children) As hearing gets worse, it may become difficult to hear sounds at lower pitches. (ex: men’s voices)
Presbycusis (Age Related Hearing Loss) It becomes difficult hearing things in noisy areas like restaurants. Hard time distinguishing high-pitched sounds such as "s" or "th" from one another. Other people's voices sound mumbled or slurred. Ringing in the ears and lack of tolerance to loud sounds is reported.
Understanding the Audiogram
Presbycusis (Age Related Hearing Loss)
Retro-cochlear Hearing Loss 8 th nerve (Auditory nerve) tumor Auditory Neuropathy (Connection between Cochlea and auditory nerve) Problems in the Auditory path from the cochlea to the auditory section in the brain (Auditory Processing Issues)
Hearing Loss Treatment options Medication Surgery Types of Amplification: - Hearing Aids -Cochlear Implants (CIs) -Assisted Listening Devices
Amplification Goals patient specific Audibility ComfortTolerance
Different Types of Hearing Aids
Hearing Aid Technology - Enhances speech intelligibility - Sound flows from one environment to the other - Wind block & Echo block -Automatic phone program -Feedback (Whistle control) “Go with your specific needs and do not compare with others”
Assisted Listening Devices FM systems Bluetooth loops Amplified Close captioned TV Phones
Hearing Aids Insurance Coverage Insurance: Medicare (Exam) Some Insurance Coverage e.g., Government, VA, and Medicaid. UCF LIFE members at UCF Communication Disorders Clinic (UCF Family Benefits)
The cycle of tinnitus Stress Anxiety Level Tinnitus
The Impact of Tinnitus Thoughts and emotions: annoyed, bothered, depressed, anxious or angry Hearing: the sound of the tinnitus competes with or masks speech or environmental sound perception.
The Impact of Tinnitus Sleep: tinnitus interferes with the ability to fall asleep. It can also make it more difficult to get back to sleep when awaking up in the middle of the night because of the tinnitus. Concentration: difficulty focusing on a task because of the loudness of the tinnitus.
Tinnitus Treatment Options Multiple Treatments Avoidance of dietary stimulants: coffee, tea, cola, etc. Smoking cessation Avoid medications known to cause tinnitus
Tinnitus Treatment Options Amplification (Hearing Aids) Sound Generators Acupuncture Medication (Xanax) Counseling Tinnitus retraining therapy Neuromonics (customized, music therapy, through a tinnitus evaluation/ tinnitus pitch match/frequency/Hypersensitivity Levels)
Thanks to LIFE’s 2011 Grant to UCF Communication Disorders Clinic Tinnitus Treatment Neuromonics, music therapy, was used to treat tinnitus and hyperacusis in an autistic female. It has proven to help reduce her tinnitus, hyperacusis, anxiety levels and improve her ability to focus while in speech therapy and school.
How the Ear Works &v=PeTriGTENoc
QUESTIONS? THANK YOU!
University of Central Florida Communication Disorders Clinic Research Parkway, Suite 155 Orlando, FL Phone (407) Audiology (407) Main