Hearing Loss Archive

News briefs

A study published online March 2, 2017, by JAMA Otolaryngology–Head & Neck Surgery suggests that hearing loss is going to become a major public health issue. Using current hearing loss estimates and population projections, scientists concluded that hearing loss among adults 20 or older in the United States will go from about 44 million in 2020 to almost 74 million in 2060, with the greatest increases among older adults. The climb is expected to be gradual, except between 2020 and 2030, when researchers project that mild hearing loss among people ages 70 to 79 will jump from about nine million to 12 million people.

The study doesn't prove that hearing loss cases will increase. But scientists are urging greater attention to hearing loss prevention. Protect your hearing by wearing earplugs if you know you'll be around loud noise. For more, check out the Harvard Special Health Report Hearing Loss (www.health.harvard.edu/HL).

Project better and reduce breathiness with voice therapy, hydration, and a bit of homework.

 Image: © Ralf Nau/Thinkstock

Older adults have plenty to say, but changes to the vocal cords, nerves, or lungs sometimes make it harder to speak up. The voice may become soft or breathy, or it may grow hoarse, rough, or strained. "This sets up a real challenge for people to communicate. It may be difficult to speak over noise in a restaurant or in a group. It can be very isolating," says Barbara Worth, a speech-language pathologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

Age-related changes

The vocal cords are twin bands of muscles that open when you breathe and close when you swallow or speak. They are located in the voice box (larynx) on top of the windpipe (trachea), and they vibrate and make sound as you exhale and air moves through them.

The ear's self-cleaning system usually prevents wax from accumulating. But wax impaction requires medical attention.

 Image: © monkeybusinessimages/Thinkstock

If you are like 90% of Americans, you assume that wax is something to be cleaned from your ears regularly, and you may have tried using cotton swabs, toothpicks, bobby pins, or any number of other small implements to do the job. However, according to the American Academy of Otolaryngology–Head and Neck Surgery Foundation, you are not only performing an unnecessary task, you are risking hurting your ears and jeopardizing your hearing. The academy's new guidelines on earwax repeated a familiar warning — "Don't stick anything smaller than your elbow in your ear."

Dr. Rachel Roditi, an otolaryngologist at Harvard-affiliated Brigham and Women's Hospital, agrees that there usually isn't much reason to clean one's ear canals: "I advise people that the ear has a lot of self-cleaning mechanisms already and so you usually don't need to do anything. Just let the ear do its job."

The FDA announced in December 2016 that it would no longer enforce the requirement that adults receive a medical evaluation or sign a waiver prior to purchasing most hearing aids.

The realities of treatment can help relieve hearing loss concerns.

 Image: © Thinkstock

Hearing loss is common in older age. It affects one in three people ages 65 or older, and two out of three people ages 75 or older. The condition leaves people struggling to keep up with conversations or simply hear the phone or TV, which can lead to serious problems. "Hearing loss can make a person less likely to engage with friends and family, which can be associated with depression," says Dr. David Jung, an otologist (ear specialist) with Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Common excuses

Acoustic Neuroma

Questions to Discuss with Your Doctor:

• Do you have trouble hearing out of one ear or both?
• Do sounds seem distorted in one ear?
• Are sounds different between your two ears?
• Is the hearing loss getting progressively worse?
• Do you have difficulty understanding others when they are talking? For example, do you have trouble hearing people on the other end of the telephone?
• Do you have ear pain?
• Have you been dizzy or lightheaded? If so, does it seem as if the room is spinning?
• Do you feel unsteady when you walk?
• Have you heard ringing or unusual noises in one or both of your ears?
• Do the muscles on one side of your face feel weaker compared to the other side?
• Is there any weakness of your face?
• Have you lost your ability to taste certain foods?
• Have you had headaches? Nausea? Vomiting?
• Have you had double vision or unusual eye movements?

Your Doctor Might Examine the Following Body Structures or Functions:

• Ear, nose, and throat exam, including a screening test of your hearing in each ear
• Neurological exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Audiometry (formal hearing test) by a certified audiologist
• Brain-stem auditory evoked potentials
• MRI or CT scan of the head

Hearing Loss

Questions to Discuss with Your Doctor:

• Is your hearing loss on one side or both?
• For how long have you noticed the problem?
• Has your hearing loss been getting worse over time?
• Do you have difficulty understanding other people when they speak?
• Do you say "what?" a lot?
• When you turn on the television, do others say that it is too loud?
• Have you had any kind of ear surgery?
• Have you flown in an airplane recently?
• Do other people in your family have trouble hearing?
• Do you hear ringing in your ears?
• Do you suffer from dizziness or loss of coordination?
• Have you had multiple ear infections in the past?
• Do you currently have an upper respiratory infection (for example, a cold) or other infection?
• Have you had any head injuries or strokes in the past?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Examine your ears, nose, and throat.
• Test your balance, coordination, and walking.

Your Doctor Might Order the Following Lab Tests or Studies:

• Test your ability to hear.
• Formal hearing testing by an audiologist (hearing specialist)

When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. But a Harvard study published in the American Journal of Epidemiology suggests that frequent use of ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be an important contributor. In the study, women who took the pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24%. The findings are similar to a study of men and hearing loss, although aspirin was also found to contribute to risk in that study.

Researchers speculate that the pain relievers may be damaging the cochlea, the snail-shaped hearing mechanism in your inner ear. "Ibuprofen can reduce blood flow to the cochlea, which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage," says study author Dr. Sharon Curhan, instructor in medicine at Harvard Medical School.

Does this mean you should think twice before popping a pill for headache or back pain? These medicines do provide good pain relief for many people. "However, frequent use of these medications and use over long periods of time may increase the risk of hearing loss and may cause other adverse health effects. Therefore, it is important to take these medications mindfully and to limit their use as much as possible," says Dr. Curhan. As always, talk to your doctor before making any changes in your medication use.

To learn more about the things that can threaten your hearing, and what you can to do keep this sense sharp and clear, buy Hearing Loss: A guide to prevention and treatment, a Special Health Report from Harvard Medical School. 

If your child is rubbing his ear, should you run to the doctor's office to demand antibiotics? Probably not. Your child may simply have fluid in the ear and not the classic ear infection that parents and children dread.

Middle Ear Fluid (Otitis Media with Effusion)

Over 2 million American children experience fluid in the middle ear each year, often following a cold or an acute ear infection. The condition is also called a silent ear infection because many children have no symptoms. Some children, though, may rub their ear or experience mild pain, sleep disturbances, unexplained clumsiness, muffled hearing, or delays in language and speech development. The condition may be diagnosed during a routine well-child visit with the use of a pneumatic otoscope, which allows the doctor to see how easily the eardrum moves.