Telephone Use with Hearing Aids

Courtesy of Coastal Ear, Nose & Throat

During the holidays, we have the opportunity to spend time our family members and friends who we might not get to see often throughout the rest of the year. Why not enhance your daily communication with those close to you by improving hearing ability on the telephone? Understanding speech on the phone is a significant area of difficulty for the majority of individuals with hearing loss.
Our ability to understand speech is augmented by the cues provided by looking at someone’s face when they are talking and by binaural listening (hearing with two ears). Communication via the telephone can be extremely difficult due to the loss of visual cues and relying on only one ear. In the past, individuals with hearing aids may have experienced whistling when attempting to use the telephone in conjunction with their hearing aid. The technology available today allows for improved telephone communication.
Hearing aids can now come equipped with a telecoil to improve telephone use. The telecoil circuit allows for electromagnetic communication between the telephone and the hearing aid by positioning them appropriately close together – a program button can be provided on the hearing aid if an individual has difficulty with maintaining the position of the phone. How do you obtain the most optimal telecoil response with a hearing aid? Your landline phone should have at least a 100 milliamps per meter (mA/m) magnetic strength in order to achieve a good connection to the hearing aid telecoil. If your phone is not emitting a strong enough magnetic field, a magnet can be placed on the phone receiver. Cell phones should have a minimum of a M3/T3 rating. The M refers to use with the hearing aid microphone; whereas the T refers to the use with the hearing aid telecoil. The higher the rating, the better compatibility is with the hearing aid – M4/T4 provides the best compatibility.
Even more exciting … some of the hearing aid manufacturers have recently developed technology that allows the hearing aid to automatically send the telephone response to both hearing aids simultaneously to regain the binaural listening, which is lost with traditional telephone use. In addition, many hearing aids are Bluetooth compatible to allow for hands-free cell phone use without having to take out the hearing aids to use a hands-free Bluetooth device for the cell phone while driving.
Individuals with a more severe degree of hearing loss may require use of a captioned telephone or phone relay service. Captioned telephones have a visual display of every word that the person you are communicating with to improve your ability to understand speech on the phone. IP Relay Service is available for individuals who use American Sign Language as their primary means of communication to allow for telephone communication.

Remember to enjoy your holiday season and keep in touch with the ones you love!

Suzanne McCorry is Doctor of Audiology at Coastal Ear, Nose and Throat in Neptune, NJ, and can be contacted at 732-280-7855; sbmccorry@coastalhearing.com; http://www.coastalhearing.com

Medications and Their Effect on Hearing

Medications that can damage the ear, resulting in hearing loss and/or balance disorders are considered ototoxic. (Mudd, Edmunds, Glatz, Campbell, & Rybak, 2008) Literally, ototoxic means “ear poison.” There are over 100 known ototoxic prescription and over-the-counter medications on the market today. (Mudd, Edmunds, Glatz, Campbell, & Rybak, 2008) These include, but are not limited to, medicines used to treat serious bacterial infections, cancers, and heart disease.
What are the Effects of Ototoxic Medications?
The first sign of ototoxicity is most often ringing in the ears (tinnitus). Permanent, high frequency hearing loss may also occur. Although uncommon, hearing loss as a result of ototoxic medications may be temporary. The hearing loss often remains unnoticed by a person until speech understanding is affected.
In addition to hearing loss, a person may also experience a loss of balance and the feeling of bouncing vision from the medication. These side effects are often temporary as the human body can learn to adapt to theses deficits. (Guthrie, 2008)
Who is affected by Ototoxic Medications?
Use of ototoxic medications can have serious affects on its users’ quality of life. Not being able to hear conversation, or perhaps always feeling dizzy, may cause a person to stop participating in their usual activities. Therefore, it is important that the pros and cons be weighed before the start of a treatment plan.
All people who take ototoxic medications should be aware of its side effects. However, there are those who are at greater risk than others. Infants who are born prematurely are at a greater risk of ototoxicity than adults when taking medications known as aminoglycosides, which treat serious bacterial infections. Children are also at a greater risk for ototoxicity when using cisplatin (a drug used to treat cancer). (Garcia, Martinez, Agusti, Mencia, & Asenjo, 2001)
The elderly, those with kidney disorders, people who already have hearing loss, those who have previously used ototoxic medications, those using multiple ototoxic medications at one time, and those who have genes linked to ototoxic weakness, are also at a higher risk for experiencing ototoxic effects than others. (Garcia et al., 2001; Mudd et al., 2008; Vasquez & Mattucci, 2003)
The “who” is not the only factor to consider when thinking of vulnerability to ototoxic medications. The “how”is also important. The way that medications are delivered can play a role in severity of ototoxic effects. For example, medications put directly into the blood stream by intravenous injection may be more severe than those applied by liquid drops on the eardrum. (Guthrie, 2008)
Can a person protect themselves against ototoxicity?
There is a lot of research being done to develop ways of protecting a person from ototoxic medications. Animal experimentation shows promising results. However, the extent that the animal study results extend to humans is unknown at this time and human studies have not yet been performed. Therefore no protective strategy has been formally approved. (Guthrie, 2008)
What should a person do if they are going to begin using an ototoxic medication?
Monitoring the hearing and balance systems are very important. By thorough monitoring, if a change occurs, adjustments can be made by the doctor to try to save as much hearing and/or balance as possible. Adjustments in treatment can include, but are not limited to, changing the dose, the schedule of treatment, a switch to a less ototoxic medication, or possibly stopping the treatment temporarily. (Vasquez & Mattucci, 2003)
Prior to starting the treatment plan, a baseline evaluation should be conducted which includes a conventional hearing test, high frequency hearing test, word recognition test, otoacoustic emission test, and an electronystagmography or videonystagmography test when possible. Throughout the course of treatment, weekly tests should be performed consisting of at least conventional and high frequency hearing tests and the otoacoustic emission test. Post-treatment tests should also be performed as reactions to the drugs make not take affect right away and cannot be predicted. (Vasquez & Mattucci, 2003)
What can be done when treatment has ended and a person has hearing loss and/or balance problems?
Unfortunately, even with careful monitoring, ototoxic effects may be unavoidable as the primary concern is the treatment of the disease which requires the drug in the first place. If a person is left with tinnitus, hearing loss, imbalance, and/or dizziness, an audiologist can work to develop a rehabilitation plan. This plan may include lessons on better hearing strategies, hearing aids, and/or balance therapy.
If you suspect that you may have, or had, problems related to ototoxic medications, please feel free to make an appointment with our team of physicians and audiologists at Coastal Ear, Nose and Throat.

Coastal Hearing and Balance Center

3700 Route 33

Neptune, NJ 07753

www.coastalhearing.com

(732) 280-7855