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Audiology: Resources

Educational, resource pages help prospective patients and their loved ones find information about hearing loss, general hearing health and hearing loss prevention.

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Impacts of Untreated Hearing Loss

Many people are aware they’re suffering from hearing loss, but find it difficult to get help. Those who have been diagnosed with hearing loss wait, on average, seven years before seeking treatment. The reasons for waiting on help vary; some are frustrated by hearing loss, believing it to be a sign of aging. Others think their condition isn’t that severe or may not even realize they have hearing problems.

Unfortunately, allowing hearing loss to remain untreated can lead to some serious consequences. The most recent studies highlight the social, psychological, cognitive and health effects of untreated hearing loss. These effects can vary as well, but all have serious impacts on your quality of life. 

The emotional effects of untreated hearing loss

Studies have linked untreated hearing loss to a number of emotional health conditions, including:

  • Irritability, negativism and anger
  • Fatigue, tension, stress and depression
  • Avoidance or withdrawal from social situations
  • Social rejection and loneliness
  • Reduced alertness and increased risk to personal safety 

When you have hearing loss, you may experience difficulty following conversations in a group setting. Due to this problem, you’re more likely to socially withdraw from visits with friends and family, which, over time, leads to depression and anxiety. The prospect of being immersed in a work meeting or large gathering, where numerous conversations will occur, can leave you feeling anxious.

Untreated hearing loss and cognitive decline

In addition to the impacts on your emotional wellbeing, untreated hearing loss can also affect your cognitive health. When your ability to hear declines, your brain receives less stimulation than it typically would because it’s not working to identify different sounds and nuances. Over time, this lack of exercise for your brain can lead to memory loss or even dementia. Think of your brain in the same way you think of your body; if you work out the different muscle groups of your body, you remain healthy overall. However, if you instead only focused on one specific area, the other parts of your body become weaker. This is how untreated hearing loss impacts your brain. The portion of your brain responsible for transmitting sound becomes weaker, making memory loss more likely.

Benefits of wearing a hearing aid

Treating your hearing loss is the first step toward a healthier, happier life. Wearing a hearing aid can enrich your life and reopen many doors that may have closed for you over the years. Other benefits of treating your hearing loss with hearing aids include:

  • Hearing your grandchild’s first words
  • Hearing nature again
  • Feeling safer in cities 
  • Attending dinners in noisy environments
  • Enjoying parties and understanding conversation

How to get help

Hearing loss isn’t age-specific; it can affect everyone, from babies to adults and seniors. The best way to know how to get help is to schedule an appointment with a hearing specialist. He or she will be able to help determine the type and degree of hearing loss you have. From there, the hearing care professional will be able to suggest a type and style of hearing aid that can help you begin to live a happier, more fulfilled life.

If you think you or a loved one suffers from hearing loss, don’t delay another day. Visit a hearing healthcare professional and take the first step toward a world of better hearing.


Hearing and Balance Disorders


Audiologists don’t simply treat hearing loss, they also provide solutions for a number of hearing and balance disorders, from symptoms of dizziness to conditions like Meniere’s disease. The following is an overview of several ways an issue with your auditory system can impact your inner balance. 

Discussion of dizziness

Dizziness is a symptom not a disease. It may be defined as a sensation of unsteadiness, imbalance or disorientation in relation to an individual’s surroundings. The symptom of dizziness may vary widely from person to person and be caused by many difference diseases or conditions. It varies from a mild unsteadiness to a severe whirling sensation known as vertigo. As there is little representation of the balance system in the conscious mind, it is not unusual for it to be difficult for the patient to describe their symptom of dizziness to the physician. In addition, because the symptom of dizziness varies so widely from patient to patient and may be caused by many different diseases, the physician commonly requires testing to be able to provide the patient with some knowledge about the cause of their dizziness. Dizziness may or may not be accompanied by a hearing impairment

Function of the normal ear

The ear is divided into three parts: external ear, middle ear and inner ear.

The external ear structures gather sound and direct it toward the eardrum. The middle ear chamber consists of an eardrum and three small ear bones. These structures transmit sound vibrations to the inner ear fluid.

The inner ear chamber is encased in bone and filled with fluid. This fluid bathes the delicate nerve endings of the hearing and the balance mechanism.

Fluid waves in the hearing chamber (cochlea) stimulate the hearing nerve endings, which generate an electrical impulse. These impulses are transmitted to the brain for interpretation as sound. Movement of fluid in the balance chambers (vestibule and three semicircular canals) also stimulates nerve endings, resulting in electrical impulses to the brain, where they are interpreted as motion.

Maintenance of balance

The human balance system is made up of four parts, the eye, inner ear, muscles and central nervous system. The brain acts as a central computer receiving information in the form of nerve impulses (messages) from its three input terminals: the eyes, the inner ear, and the muscles and joints of the body. There is a constant stream of impulses arriving at the brain from these input terminals. All three systems work independently and yet work together to keep the body in balance.

The eyes receive visual clues from light receptors that give the brain information as to the position of the body relative to its surroundings. The receptors in the muscles and joints are called proprioceptors. The most important ones are in the head and neck (head position relative to the rest of the body) and the ankles and joints (body sway relative to the ground).

The inner ear balance mechanism has two main parts: three semicircular canals and the vestibule. Together they are called the vestibular labyrinth and are filled with fluid. When the head moves, fluid within the labyrinth moves and stimulates nerve endings that send impulses along the balance nerve to the brain. Those impulses are sent to the brain in equal amounts from both the right and left inner ear. Nerve impulses may be started by the semicircular canals when turning suddenly, or the impulses may come from the vestibule, which responds to changes of position, such as lying down, turning over or getting out of bed.

When the inner ear is not functioning correctly the brain receives nerve impulses that are no longer equal, causing it to perceive this information as distorted or off balance. The brain sends messages to the eyes, causing them to move back and forth, making the surroundings appear to spin. It is this eye movement (called nystagmus) that creates a sensation of things spinning.

Remember to think of the brain as a computer with three input terminals feeding it constant up-to-date information from the eye, inner ear and muscles and joints (proprioceptors). The brain itself is divided into several different parts. The most primitive area is known as the brainstem, and it is here that processing of the input from the three sensory terminals occurs. The brainstem is affected by two other parts of the brain, the cerebral cortex and the cerebellum.

The cerebral cortex is where past information and memories are stored. The cerebellum, on the other hand, provides automatic (involuntary) information from activities, which have been repeated often.

The brainstem receives all these nerve impulses: sensory from the eyes, inner ear, muscles and joints; regulatory from the cerebellum; and voluntary from the cerebral cortex. The information is then processed and fed back to the muscles of the body to help maintain a sense of balance.

Because the cortex, cerebellum and brainstem can eventually become used to (ignore) abnormal or unequal impulses from the inner ear, exercise may be helpful. Exercise often helps the brain to habituate the dizziness problem so that is does not respond in an abnormal way and does not result in the individual feeling dizzy. An example of habituation is seen with the ice skaters who twirl around, stop suddenly, and do not apparently have any balance disturbance.

Ear dizziness

Ear dizziness, one of the most common types of dizziness, results from disturbances in the blood circulation or fluid pressure in the inner ear chambers, from direct pressure on the balance nerve or physiologic changes involving the balance nerve or balance mechanisms. Inflammation or infection of the inner ear or balance nerve is also a major cause of ear dizziness.

Any disturbance in pressure, consistency or circulation of the inner ear fluids may result in acute, chronic or recurrent dizziness, with or without hearing loss and head noise. Likewise, any disturbance in the blood circulation to this area or infection of the region may result in similar symptoms. Dizziness may also be produced by an over stimulation of the inner ear fluids, which may be encountered if you spin very fast and then stops suddenly.

Symptoms of ear dizziness

Any disturbance affecting the function of the inner ear or its central connections may result in dizziness, hearing loss or tinnitus (head noise). These symptoms may occur singly or in combination, depending upon which functions of the inner ear are disturbed.
Ear dizziness may appear as a whirling or spinning sensation (vertigo), unsteadiness or giddiness and lightheadedness. It may be constant, but is more often intermittent, and is frequently aggravated by head motion or sudden positional changes. Nausea and vomiting may occur, but you should not lose consciousness as a result of inner ear dizziness

Central dizziness

Central dizziness is usually an unsteadiness brought about by failure of the brain to correctly coordinate or interpret the nerve impulses which it receives. An example of this is the “swimming feeling” or unsteadiness that may accompany emotional stress, tension states, and excessive alcohol intake. Circulatory inefficiency, tumors or injuries may produce this type of unsteadiness, with or without hearing impairment. A feeling of pressure or fullness in the head is common. Occasionally true vertigo (spinning) may be caused by central problems.

Visual dizziness

Eye Muscle imbalance or errors of refraction may produce unsteadiness. An example of this is the unsteadiness, which may result when you attempt to walk while wearing glasses belonging to another individual.

Another example of visual dizziness is that occasionally produced if you are seated in a car looking out the side window at passing objects. The eyes respond by sending a rapid series of impulses to the brain indicating that the body is rotating. On the other hand, the ears and the muscle-joint systems send impulses to the brain indicating that the body is not rotating, only moving forward. The brain, receiving these confused impulses (from the eyes indicating rotation, from the ears and muscle-joint systems indicating forward motion) sends out equally confusing orders to various muscles and glands that may result in sweating, nausea and vomiting. When you sit in the front seat looking forward, the eyes, ears and muscle- joint systems work more uniformly, making it less likely to develop carsickness.

Causes and symptoms of dizziness

Dizziness may be caused by any disturbance in the inner ear, the balance nerve or its central connections. This can be due to a disturbance in circulation, fluid pressure or metabolism, infections, neuritis, drugs, injury or growths.
At times an extensive evaluation is required to determine the cause of dizziness. The tests necessary are determined at the time of examination and may include detailed hearing and balance tests, x-rays, and blood tests. A general physical examination and neurological tests may be advised.

The object of this evaluation is to be certain that there is no serious or life-threatening disease, and to pinpoint the location of the problem. This lays the groundwork for effective medical or surgical treatment.

Circulation changes

Any interference with the circulation to the delicate inner ear structures or their central connections may result in dizziness and, at times, hearing loss and tinnitus. These circulatory changes may be the result of blood vessel spasm, partial or total occlusion (blockage), or rupture with hemorrhage.

Atypical migraine or basilar migraine

Inner ear dizziness due to blood vessel spasm is usually sudden in onset and intermittent in character. It may occur as an isolated event in the patient’s life or repeatedly in association with other symptoms. If it is recurrent it usually is associated with migraine headache-type symptoms. Predisposing causes include fatigue and emotional stress. Certain drugs such as caffeine (coffee) and nicotine (cigarettes) tend to produce blood vessel spasm or constriction and should be avoided. Blood vessel spasm has been noted to occasionally begin after head injury. Although there may have been no direct injury to the inner ear by the trauma, the spasm may begin to damage the ear.

Occlusion

As you get older, blood vessel walls tend to thicken due to an aging process known as arteriosclerosis. This thickening results in partial occlusion, with a gradual decrease of blood flow to the inner ear structures. The balance mechanism usually adjusts to this, but at times persistent unsteadiness develops. This may be aggravated by sudden position changes such as that encountered when you get up quickly or turn suddenly.

Complete occlusion of an inner ear blood vessel (thrombosis) results in acute dizziness often associated with nausea and vomiting. Symptoms may persist for several days, followed by a gradual decrease of dizziness over a period of weeks or months as the central nervous system and uninvolved ear compensates for the loss of the involved ear.

Hemorrhage

Occasionally, one of the small blood vessels of the balance mechanism ruptures. This may occur spontaneously, for no apparent reason, or it may be the result of high blood pressure or head injury. Symptoms are the same as those of occlusion.

Treatment

Treatment of dizziness due to changes in circulation consists of anti-dizziness medications to suppress the symptoms. They also stimulate the circulation and enhance the effectiveness of the brain centers in controlling the symptoms. An individual with this type of dizziness should avoid drugs that constrict the blood vessels, such as caffeine (coffee) and nicotine (tobacco). Emotional stress, anxiety and excessive fatigue should be avoided as much as possible. Often, increased exercise will aid in the suppression of dizziness in many patients by stimulating the remaining function to be more effective.

Benign Positional Paroxysmal Vertigo (BPPV)

BPPB is a common form of balance disturbance due to circulatory changes or to loose calcium deposits (cupuliths) in the inner ear. It is characterized by sudden, brief episodes of imbalance when moving or changing head position. Commonly it is noticed when lying down or arising or when turning over in bed. This type of dizziness as its names suggests is benign, related to positional changes and is short-lived. The vertigo brought on by the movement rarely lasts more than a few minutes, is usually self-limited and responds well to treatment. However, it may reoccur in some patients. Treatment involves attempts to reposition the loose particles and keep the dizziness from occurring (Canalith Repositioning Procedure). If this isn’t successful, additional exercises may be recommended. Occasionally, postural dizziness may be permanent and surgery may be required.

Imbalance related to aging

Some individuals develop imbalance as a result of the aging process. In many cases this is due to circulatory changes in the very small blood vessels supplying the inner ear and balance nerve mechanism. Fortunately, these disturbances, although they may persist, rarely become worse.

Postural or positional vertigo (see above) is the most common balance disturbance of aging. This may develop in younger individuals as a result of head injuries or circulatory disturbances. Dizziness on change of head position is a distressing symptom, which is often helped by vestibular exercises.

Temporary unsteadiness upon arising from bed in the morning is not uncommon in older individuals. At times this feeling of imbalance may persist for an hour or two. Arising from bed slowly usually minimizes the disturbance. Unsteadiness when walking, particularly on stepping up or down or walking on uneven surfaces, develops in some individuals as they progress in age. Using a cane and learning to use the eyes to help the balance is often helpful.

Infection

Imbalance due to ear infection is usually insidious and mild in onset. Such imbalance may occur with or without hearing impairment. As the infection gets closer to the vital balance mechanism in the inner ear, the dizziness becomes more constant and severe in nature, and is often associated with nausea and vomiting.

Control of an ear infection is imperative in this type of dizziness in order to prevent spread of the infection directly into the balance center of the inner ear. Should this develop, serious complications including total loss of hearing in the involved ear may result. If the infection cannot be eliminated by medical treatment, surgery is indicated to remove the infection.

Neuritis

Neuritis is a physiological change that occurs in the nerve after injury by trauma, a virus, autoimmune disease or vascular compression. When this occurs, the balance function is impaired, resulting in a severe, and at times prolonged, episode of dizziness, often followed by some unsteadiness or motion for weeks to years. Fortunately, this balance disturbance usually subsides in time and usually does not recur in the majority of cases. It may be, however, very chronic at a moderate to mild level. Medical treatment is helpful in eliminating symptoms until the central nervous system can compensate for the injured nerve. This usually consists of dizziness- suppressing drugs. On occasion, the central nervous system cannot compensate and surgery may be necessary.

Meniere’s disease and endolymphatic hydrops

Meniere’s disease is a common cause of repeated attacks of dizziness and is thought to be due to (in most cases) increased pressure of the inner ear fluids due to impaired metabolism of the inner ear. Fluids in the inner ear chamber are constantly being produced and absorbed by the circulatory system. Any disturbance of this delicate relationship results in overproduction or underabsorption of the fluid. This leads to an increase in the fluid pressure (hydrops) that may, in turn, produce dizziness that may or may not be associated with fluctuating hearing loss and tinnitus.

A thorough evaluation is necessary to determine the cause of Meniere’s disease, if possible. Circulatory, metabolic, toxic and allergic factors may play a part in any individual. Emotional stress, while making the disease worse, does not cause Meniere’s disease
Meniere’s disease is usually characterized by attacks consisting of vertigo (spinning) that varies in duration from a few minutes to several hours. Hearing loss and head noise, usually accompanying the attacks, may occur suddenly. Violent spinning, whirling, and falling associated with nausea and vomiting are common symptoms. Sensations of pressure and fullness in the ear or head are usually present during the attacks. The individual may be very tired for several hours after the overt spinning stops.

Attacks of dizziness may recur at irregular intervals and the individual may be free of symptoms for years at a time, only to have them recur again. In between major attacks, the individual may have minor episodes occurring more frequently and consisting of unsteadiness lasting for a few seconds to minutes.

Occasionally hearing impairment, head noise, and ear pressure occur without dizziness. This type of Meniere’s disease is called cochlear hydrops. Similarly, episodic dizziness and ear pressure may occur without hearing loss or tinnitus, and this is called vestibular hydrops.
Endolymphatic hydrops is a term that describes increased fluid pressure in the inner ear. In this respect it is similar but not related to glaucoma of the eye fluids. A special clinical form of endolymphatic hydrops is called Meniere’s disease. All patients with Meniere’s disease have endolymphatic hydrops, but not all patients with hydrops have Meniere’s disease.

There may be many causes of endolymphatic hydrops. It occurs widely in people of European decent and rarely in oriental or black people. It may be caused or aggravated by excessive salt intake or certain medications. The symptoms are highly variable. You may have one symptom or a combination of signs. Often there is a combination of hearing changes, disequilibrium, motion intolerance or short dizzy episodes. There may be tinnitus and/or a pressure feeling in the head or ears. The patient does not have the well-defined attacks of Meniere’s disease (fluctuating hearing loss, tinnitus and episodes of spinning lasting minutes to hours). Often the division between the two diagnoses may be blurred and difficult to separate, even for the patient. Endolymphatic hydrops may progress to Meniere’s disease in some patients.

The treatment of endolymphatic hydrops is similar to that for Meniere’s disease. Medications are first used. Diuretics (water pills) are almost always used. Their purpose is to decrease the fluid pressure in the inner ear. In addition to diuretics, other medications may be indicated, depending on the cause of symptoms in each patient’s case. If these fail, surgery is sometimes indicated. (See Surgery for vertigo elsewhere in this document). 

Treatment of Meniere’s disease and endolymphatic hydrops

Treatment of cochlear and vestibular hydrops is the same as for classic Meniere’s disease. The treatment of Meniere’s disease may be medical or surgical, depending upon the patient’s stage of the disease, life circumstances and the condition of the ears. The purpose of the treatment is to prevent the hearing loss and stop the vertigo (spinning).

Treatment is aimed at improving the inner ear circulation and controlling the fluid pressure changes of the inner ear chambers..
Medical treatment of Meniere’s disease varies with the individual patient according to suspected cause and magnitude and frequency of symptoms. It is effective in decreasing the frequency and severity of attacks in 80% of patients. Treatment may consist of medication to decrease the inner ear fluid pressure or prevent inner ear allergic reactions. Various drugs are used as anti-dizziness medication.

Vasoconstricting substances have an opposite effect and, therefore, should be avoided. Such substances are caffeine (coffee) and nicotine (cigarettes).

Diuretics (water pills) may be prescribed to decrease the inner ear fluid pressure.
Meniere’s disease may be caused or aggravated by metabolic or allergic disorders. Special diets or drug therapy are indicated at times to control these problems.

On rare occasions, gentamycin injections may be used to selectively destroy balance function. This treatment is reserved for patients with Meniere’s disease in their only hearing ear or with Meniere’s disease in both ears.

Metabolic disturbances

Occasionally metabolic disturbances produce dizziness with or without associated hearing loss by interfering with the function of the inner ear or the central nervous system. Occasionally hearing loss may occur without the presence of dizziness.

A change of thyroid function or abnormalities in the blood sugar are the most common metabolic disturbances resulting in dizziness. Rarely, fat metabolism abnormalities may also cause problems resulting in hearing loss and/or dizziness. Thyroid dysfunction is diagnosed by blood tests and treatment consists of taking a thyroid hormone. Abnormalities in the blood sugar are diagnosed, again by blood studies and treatment usually consists of diet control and/or drug therapy. Fat metabolism problems are diagnosed by studies of the fatty acids and cholesterol in the blood. Treatment of these may consist of diet control with or without drug therapy.

Allergies

Rarely, allergies may cause dizziness and/or vertigo. Allergies are usually diagnosed by obtaining a careful history and occasionally performing a series of skin tests with inhalants and food or blood tests. Treatment usually consists of elimination of the offending agents when possible, or, if this is not possible, by allergy shots to stimulate immunity.

Injury

Injury to the head occasionally results in dizziness of long-standing origin. If the trauma is severe, it is usually due to the combined damage to the inner ear, balance nerve and central nervous system. Lesser injury may damage any one, or a combination of these components. The unsteadiness is at times prolonged, and may or may not be associated with hearing loss and head noise as well as other symptoms.

Tumors

A noncancerous tumor occasionally develops on the balance nerve between the ear and the brain. When this occurs, unsteadiness, hearing loss and head noise may develop. Extensive hearing tests, balance tests and x-rays are necessary to diagnose such tumors.
If the diagnosis of a tumor is established, surgical removal is often recommended. Continued growth of the tumor would lead to complications by producing pressure on vital adjacent nerves and the brain. An operation has been developed which allows the removal of these tumors at an early stage. Best results can be obtained if the tumor is diagnosed early and removed while the only symptoms are hearing loss, dizziness and tinnitus (head noise). 

Surgical treatment options for dizziness

Surgery is indicated when medical treatment fails to control the vertigo. The type of operation selected depends on the degree of hearing impairment in the affected ear, the life circumstances of the individual, and the status of the individual’s disease. In some operations the hearing may be occasionally improved following surgery, and in others it may become worse. In most cases it remains the same. Head noise may or may not be relieved, and in some cases may become even more marked. 

Surgery is most successful in relieving acute attacks of dizziness. . Some unsteadiness may persist over a period of several months until the opposite ear and the central nervous system are able to compensate and stabilize the balance system.
Surgical procedures include the use of an endolymphatic shunt, selective vestibular neurectomy and labyrinthectomy. The endolymphatic shunt surgery is intended to drain excess endolymph from the inner ear. It is usually performed under general anesthesia and requires hospitalization for one to two days.

Selective vestibular neurectomy is a surgical option where the balance nerve is cut at the point it leaves the inner ear. This procedure has a high success rate of eliminating the bouts of vertigo and usually preserves hearing. However, imbalance may remain. 

Labryinthectomy is a surgical procedure where the balance and hearing portions of the inner ear are destroyed. This procedure is only considered for those who have very little hearing remaining in the affected ear. This procedure has a high rate of success but does destroy any remaining hearing and imbalance may continue to be a problem for the patient.

Nonsurgical dizziness treatments

Typically, a physical therapist evaluation of patients with vestibular or balance disorders takes approximately 60-90 minutes. The evaluation begins with a history of the patient’s symptoms. This includes how long the patient has been symptomatic, how long the symptoms last, general activity level and medications that the patient is currently taking. Range of motion, strength, coordination, balance and various sensory systems are also assessed. Patients are asked to perform transitional movements such as rolling, supine to sit and sit to stand. This is to determine whether these motions produce or increase symptoms. One of the most difficult things for patients with vestibular disorders to do is walk and move the head. Different combinations of head and neck movements are performed during gait to provoke symptoms. Balance is also tested on a firm surface and again on a compressible surface with eyes open and closed. Time tests of balance are performed with eyes open and closed, while standing on one foot and with feet aligned as if on a tightrope.

Following the evaluation, a treatment plan is developed. The treatment plan may consist of habitual exercises, balance retraining exercise and usually a general conditioning program. The goal of habituation exercises is to decrease the patient’s symptoms of motion provoked dizziness or lightheadedness. The exercises are chosen to address the patient’s particular problems that were discovered during the evaluation. The length and intensity of the program depends upon the patient’s previous activity level and how easily their symptoms are provoked. The patient must consistently perform all the exercises as described in their treatment program to achieve the goals of improving their balance and decreasing their dizziness. Typically, the exercises are performed twice a day. Patients are advised not to avoid positions that provoke symptoms unless they are unsafe.

There are many causes of dizziness. This dizziness may or may not be associated with hearing loss. In most instances the distressing symptoms of dizziness can be greatly benefited or eliminated by medical or surgical management.


How to Prevent Hearing Loss for Musicians

Because of the nature of their work, musicians of all genres are at risk for noise-induced hearing loss. Additionally, being able to hear properly is vital to the musician’s livelihood, from being able to hear the right notes and words to playing in the correct pitch and key. Without proper hearing protection, the loud sounds most musicians experience on stage and while playing their instrument can cause permanent damage to their hearing. Additionally, musicians are also at risk for developing tinnitus, or a ringing-in-the-ears sensation. Tinnitus can be present with or without hearing loss, and while not life-threatening, can seriously deteriorate the quality of life for an individual.

Hearing protection for musicians

Both custom and non-custom products are available for musicians to help prevent hearing loss. Wearing the right ear protection not only helps combat hearing loss, but can also help to prevent   tinnitus. 

  • Musician earplugs: These earplugs for made for musicians playing a variety of different types of instruments. They’re available in several types of materials, from foam to a softer plastic, and enable the musician to still hear the music being performed. These earplugs are also beneficial for concert-goers to protect their hearing while still enjoying the music. 
  • Electronic earplugs: These earplugs are electronic and can be programmed to adjust to different pitches and sounds depending on the loudness and environment the musician is in. These adaptive earplugs allow musicians to hear the sounds that are important, while filtering out damaging noise levels.
  • In-ear monitors: These high-tech devices are used by musicians or audio-engineer professionals and deliver sound to the ear while creating a barrier to background and damaging noise levels. In-ear monitors are available in custom or universal options.

Who Can Benefit From Musician Earplugs?

Musician earplugs and protection aren’t simply designed for individuals in a band, they can actually be beneficial to a number of different people, including: 

  • Students in the school band or orchestra
  • Music teachers or conductors
  • Concert or festival attendees
  • Nightclub workers or patrons
  • Entertainment industry staff

Finding the right ear protection

Finding the right ear protection is vital for musicians to not only perform their jobs, but also prevent hearing loss. If you need additional information or assistance in purchasing musicians’ earplugs consider visiting a hearing professional near you. A hearing specialist will be able to evaluate your wants and ensure you find the right product for your specific needs.
 


Types of Hearing Loss

Hearing loss can be experienced in varying degrees, such as mild, moderate, moderately-severe, severe or profound. Additionally, this loss can also vary depending on pitches or frequencies. A series of hearing tests can determine the amount of loss you experience compared to an average of many other adult listeners with typical hearing.

The volume of sounds you hear is measured in decibels (dB), 15-20 dB being the softest whisper and 120 dB being a jet engine. The softest sounds one can hear are called thresholds. Normal hearing thresholds for adults are considered 0-25 dB across the range of frequencies tested. Speech testing is also conducted as a part of this series of evaluations and helps to assess the levels of particular words you can hear clearly. These tests can help determine the type of hearing loss you’re experiencing, which can be categorized conductive, sensorineural or mixed. 

Conductive hearing loss

Conductive hearing loss occurs when there is a problem with the way sound is conducted to the inner ear and a structure called the cochlea. The problem may lie in the ear canal, eardrum (tympanic membrane) or the middle ear (ossicles and Eustachian tube). The inner ear and auditory nerve remain unaffected in this type of hearing loss.

Symptoms for conductive hearing loss are similar to the other types; however, individuals may complain of sounds being muffled or far too quiet. 

Some causes of conductive hearing loss can include:

  • Outer or middle ear infections
  • Complete earwax blockage
  • Deterioration of the middle ear bones (ossicles)
  • Otosclerosis, the fixation of the ossicles
  • Perforated tympanic membrane or a hole in the eardrum
  • Absence of the outer ear or middle ear structures

Conductive hearing loss may be temporary or permanent, depending on the source of the problem. Medical management can correct some cases of conductive hearing loss, while hearing instruments may be a recommended treatment option in long-standing or permanent cases.

Sensorineural hearing loss

Sensorineural hearing loss occurs when there is a problem with the sensory receptors of the hearing system, specifically in the cochlea of the inner ear or auditory nerve. The majority of sensorineural hearing loss occurs as a result of an abnormality or damage to the hair cells in the cochlea. This abnormality prevents sound from being transmitted to the brain normally, which results in a hearing loss.  
Individuals with sensorineural hearing loss may hear muffled speech, suffer from tinnitus (or ringing in the ears), have difficulty hearing in background noise or clarity of speech problems.

There are a number of causes of sensorineural hearing loss, including:

  • Congenital: These hair cells have been abnormal since birth, which is considered a congenital condition.
  • Damage to hair cells: A deficit in hearing also occurs when the cells are damaged as a result of genetics, infection, drugs, trauma or over-exposure to noise (late-onset or acquired).
  • Presbycusis: Age-related hearing loss

Sensorineural hearing losses are generally permanent and may remain stable or worsen over time. Routine hearing tests are needed to monitor the hearing loss. Hearing aids are the most common and successful treatment, allowing hearing professionals to adjust settings as needs change. 

Mixed hearing loss

Mixed hearing loss occurs when a person has a sensorineural hearing loss in combination with a conductive hearing loss. This means there is a problem in the inner ear as well as in the outer and/or middle ear. 

The conductive hearing loss may be temporary or permanent, depending on the source of the problem. Mixed hearing loss can sometimes be treated with medical management and hearing aids are a common treatment recommendation. 
 


Frequently Asked Questions

What is an audiologist?

Audiologists are healthcare professionals who evaluate, diagnose and treat hearing loss and other auditory conditions like tinnitus and balance disorders. Audiologists also provide valuable insight and products to help you prevent hearing loss, like protective custom earplugs. Audiologists are trained to work with all ages, from newborns to the elderly, however some do specialize in certain age groups or conditions. An audiologist holds an advanced degree in audiology. Currently, audiologists are required to obtain a doctoral degree and must be licensed by the state in which they practice. Additionally, audiologists must be licensed in the state they practice and are regulated by the Division of Consumer Affairs.

In addition to their education and state licensure, an audiologist may be awarded the Certificate of Clinical Competence in Audiology by the American Speech-Language-Hearing Association (ASHA), otherwise known as the CCC-A. With additional training and expertise, the audiologist may receive the Honor of Fellow, which is awarded by the American Academy of Audiology (AAA).


What types of tests and treatments do audiologists perform?

Common services and treatments provided by an audiologist include:

  • Diagnostic hearing tests
  • Audiologic evaluations
  • Hearing aid fittings and consultations
  • Hearing aid repairs and maintenance
  • Aural rehabilitation
  • Pediatric hearing loss detection and treatment
  • Hearing loss prevention and protection programs
  • Earmold and earplug fitting and consultation
  • Custom musicians earplugs and monitors
  • Tinnitus treatment programs
  • Dizziness and balance testing and treatment
  • Hearing rehabilitation and auditory training
  • Cochlear implant candidacy evaluations and implant programming

How do I know if I have hearing loss?

If you’re concerned you or a loved one may be experiencing hearing loss, you are not alone. Because hearing loss can come on gradually, it’s often the people around you who notice your hearing problems before you do. Typically, it takes people an average of seven years to seek treatment. If you exhibit the following symptoms, consider visiting an audiologist:

  • You hear mumbling when people are speaking to you
  • You have to ask people to repeat what they said
  • You laugh at jokes even though you may not have heard the details
  • You frequently complain that people mumble
  • You need to ask others about the details of a meeting you just attended
  • You play the TV or radio louder than your friends, spouse or relatives
  • You cannot hear the doorbell or the telephone
  • You find that looking at people when they speak to you makes it easier to understand
  • You miss environmental sounds, such as birds chirping or leaves blowing
  • You find yourself avoiding certain restaurants because they are too noisy 
  • You hear a ringing sound in your ears, especially when it is quiet.

What causes hearing loss?

Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. It is estimated that nearly 20 percent of adults in the United States (48 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.


How is hearing loss diagnosed?

If you exhibit symptoms of hearing loss, you should see an audiologist to have a formal hearing evaluation. This hearing test, or audiologic evaluation, is diagnostic and allows the audiologist to determine the type and degree of your hearing loss. There will also be a hearing test that evaluates your sensitivity, acuity and accuracy to speech understanding. Your audiologist may also test for speech understanding at different volume levels and conditions – like noise – to help the professional recommend the best hearing aids for your particular needs.

The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. Additional tests of middle ear function may also be performed depending on your symptoms. The results of the evaluation can be useful to a physician, if the audiologist believes your hearing loss may benefit from medical intervention.

Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech. The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.


What are the different degrees of hearing loss?

The results of your hearing test are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. The top of the graph is very quiet and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories. The general hearing loss categories used by most hearing professionals are as follows:

  • Normal hearing (0-25 dB HL)
  • Mild hearing loss (26-40 dB HL)
  • Moderate hearing loss (41-70dB HL)
  • Severe hearing loss (71-90 dB HL)
  • Profound hearing loss (greater than 91 dB HL)

What are the different types of hearing loss?

There are three main types of hearing loss and each can be caused by different factors and require different hearing aid technology and features to have the best listening experience. The three types of hearing loss include:

  1. Sensorineural hearing loss: When the problem is in the inner ear or a problem with the auditory nerve, a sensorineural hearing loss is the result. This commonly occurs from damage to the small hair cells, or nerve fibers, in the auditory system. Sensorineural hearing loss is the most common type of hearing loss in adults and accounts for more than 90 percent of hearing loss in all hearing aid wearers. The most common causes of this hearing loss are age-related changes and noise exposure. Loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure or from disturbances of nerve transmission. There are many excellent options for the patient with sensorineural hearing loss.
     
  2. Conductive hearing loss: When there is a problem in the external or middle ear, a conductive hearing loss occurs. Conductive hearing loss develops when sound is not conducted efficiently through the ear canal, eardrum or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane or disease of any of the three middle ear bones. Individuals with conductive hearing loss can benefit from hearing aids, medical implants, medication or surgical options.
     
  3. Mixed hearing loss: When there are problems in the middle and inner ear, a mixed hearing impairment is the result. Because mixed hearing loss involves both sensorineural and conductive hearing loss, treatment options from hearing aids to surgery depends on the nature of the impairment and the symptoms experienced.

What are the signs of hearing loss in children?

Hearing loss in children can occur at any time in life from acquired factors such as ear infections, head trauma, certain medications and genetic factors. You may suspect your child has a hearing loss if you observe any of the following:

  • Failed newborn hearing screening
  • Delays in speech and language acquisition, including baby babbling
  • Frequent ear infections
  • Not startled by loud sounds
  • Not turning to the location of sounds after six months of age
  • Difficulty following verbal directions
  • Daydreaming in many situations
  • Concerns by school teachers or failed school hearing screening
  • Loud volume on the TV or radio
  • Complaints from the child that they cannot hear

A pediatric audiologist is trained to test children of all ages. Any symptom of hearing loss in children should be addressed promptly so that speech, language and academic development are not delayed or negatively impacted.


What style of hearing aid do I need?

There are many types of hearing aids today and the style or device depends on your lifestyle, budget and hearing loss needs. There are in-the-ear styles as well as behind-the-ear styles. In addition to selecting the right style of device, it’s also important to consider what features would be most beneficial to you. From directional microphones to waterproof options, there are numerous varieties to meet everyone’s personal needs. Today’s hearing aids are even equipped with Bluetooth connectivity to work with wireless technology like a cell phone or television.

Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today’s hearing aids are considered sleek, compact and innovative – offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:

  • The type/degree of the hearing loss
  • Power requirements
  • Manual dexterity and visual abilities
  • Budget
  • Cosmetics and aesthetics
  • Anatomical and medical considerations
  • Lifestyle requirements

What are assistive listening devices (ALDs)?

People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio can be limited. However, ALDs are designed to increase the loudness of a desired sound, such as a radio, television or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device being used, while the microphone of the hearing aid is always close to the listener.

ALDs include alarm clocks, TV listening systems, telephone amplifying devices and auditorium-type assistive listening systems. Many newer devices are small, wireless and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV or on the wall.


What is tinnitus?

Tinnitus is a common disorder affecting over 50 million people in the United States. It is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, buzzing or clicking. Tinnitus is not actually a disease, but a symptom of another underlying condition of the ear, auditory nerve or other influencing factor. Tinnitus can be intermittent or constant, with single or multiple tones. The perceived volume can range from very soft to extremely loud and may be recurrent or constant.


What causes tinnitus?

The exact cause of tinnitus is not known in every case. However, there are several likely factors that may worsen tinnitus. These include:

  • Noise-induced hearing loss
  • Wax build-up in the ear canal
  • Certain medications
  • Ear or sinus infections
  • Age-related hearing loss
  • Ear diseases and disorders
  • Jaw misalignment
  • Cardiovascular disease
  • Certain types of tumors
  • Thyroid disorders
  • Head and neck trauma

How is tinnitus treated?

Depending on the severity and underlying condition causing the tinnitus, there are several treatments available to improve the perception of unwanted noise. The most common treatments for tinnitus include:

  • Hearing aids with tinnitus-masking features
  • Tinnitus retraining therapy
  • Sound therapy
  • Avoidance measures
  • Avoidance of certain medications
  • Behavioral therapy

What is the difference between an audiologist and a hearing instrument specialist (HIS)?

There are a number of different hearing healthcare professionals available, but each has different education and training requirements. An audiologist and a hearing instrument specialist (HIS) are two of the most common professionals when seeking treatment for hearing loss. To better understand which professional is best for you, it’s important to distinguish the differences between the two.

Audiologist: An audiologist is trained to diagnose, treat and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear implants, electrophysiology, acoustics, psychophysics and auditory rehabilitation. Doctors of Audiology complete, at a minimum, an undergraduate and doctoral level degree in audiology, as well as a supervised externship prior to state licensure and national certification. This usually requires eight years of post-secondary education (four years of college and four years of graduate school). The graduate school years focus on the medical, diagnostic and rehabilitative aspects of hearing loss, hearing aids and the vestibular system. Upon completion of training, audiologists must also pass a national standardized examination in order to be eligible for state licensure. Continuing education requirements must be met in order for an audiologist to maintain state licensure. For individuals with hearing loss, auditory issues or balance problems, an audiologist is the most qualified professional to assist with diagnosis and treatment.

Hearing instrument specialist (HIS): A hearing instrument specialist is licensed to perform audiometric testing to sell and fit hearing aids. In order to obtain a license, a HIS generally has to take a certification program in hearing aids, complete in-the-field training hours and pass an exam. Hearing instrument specialists are able to fit and repair hearing aids, however, they cannot diagnose a hearing loss. 


Guide to Hearing Aids