Hearing Loss

What are the primary causes of hearing loss?

Coastal Ear, Nose and Throat along with Healthy Hearing would like to educate the public on the primary causes of hearing loss.

There are three types of hearing loss: conductive, sensorineural and mixed hearing loss, all of which have different causes.

Conductive hearing loss is caused by issues with the middle ear such as fluid in the middle ear space or issues with the middle ear bones. Many types of conductive hearing loss are not permanent and can be treated by medical intervention. A full hearing evaluation followed with a medical evaluation by an ear physician will help to determine the cause of the conductive hearing loss. Once the cause is identified, the physician will recommend medical treatment.

Most causes of sensorineural (nerve) hearing loss are never known; however, through a hearing evaluation and medical evaluation, various causes of hearing loss can be suspected based on the outcome of the evaluations. The most common causes of sensorineural hearing loss are genetics, aging and noise exposure. Medications, diseases associated with small vessel disease, arthritis, diabetes, and heart disease are all associated with a higher incidence of hearing loss.

Recent studies have also found persons who smoke increase their probability of having hearing loss. Finally, high levels of blood lipids and cholesterol have been associated with an increased incidence of hearing loss, possibly through the promotion of small vessel disease.

Currently, noise-induced hearing loss is the only type of hearing loss that can be fully prevented by the use of ear protection. Noise induced hearing loss may be caused by a single exposure to excessive noise or from many years of being exposed to loud levels of noise.

Mixed hearing loss is a combination of conductive and sensorineural hearing loss, and is caused by the previously mentioned causes.

Unfortunately, even if you live healthy and take all precautions possible, the majority of us will slowly develop hearing loss due to the natural aging process. The inner ear hair cells do not replace themselves and once they are lost, their function is not recovered.

Recent studies have found high doses of antioxidants may be associated with the prevention of noise induced hearing loss. Other studies have shown a diet rich in folates may also help prevent hearing loss by up to 20% (2009, AOO-HNSF); however, further research is needed.

Joanne Slater M.S. CCC-A. Copyright 2009, www.HealthyHearing.com - The leading web resource on hearing loss and hearing aids. This article was reprinted with permission. Article Source: http://www.healthyhearing.com

Please visit our website at www.coastalhearing.com for more information on healthy hearing.
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Suzanne McCorry is Director 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

Hearing Aid Dispenser

Coastal Ear, Nose and Throat is proud to announce Jessica Miller has joined the staff of Coastal Hearing and Balance Center. Dr. Miller received both her Bachelor’s and Doctorate in Audiology degrees from James Madison University in Virginia. She is a licensed Audiologist and Hearing Aid Dispenser. Jessica also holds a Certificate of Clinical Competence in Audiology from the American Speech-Language Hearing Association. After experiencing a variety of clinical settings including hospitals, VA medical centers, ENT offices, & private practice, she has found her niche working with hearing aids.

Call (732) 280-7855 or visit us on our website to make an appointment.

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

Tobacco and Children

From the desk of Samuel Engel, MD, MPH
www.coastalhearing.com
732-280-7855

Ear, Nose, and Throat Doctors Warn of the
Many Dangers of Exposing Children to Cigarette Smoke

NEPTUNE, NJ — Despite how far the U.S. has come in its ongoing fight to help people avoid the dangers of cigarettes and smokeless tobac­co products, millions of children are still at risk for being exposed to the dangers of secondhand and “third-hand smoke” that can cause a num­ber of health problems such as head and neck cancer, upper respiratory tract disorders, tooth decay, and behavioral issues. Coastal Ear, Nose and Throat reinforces the need for public aware­ness the dangers to children of tobacco smoke.

The term “third-hand smoke” is a relatively new phrase that describes the chemical contam­inants from cigarette smoke that remain in the air and on surfaces even after the cigarette is extinguished. These chemicals linger for a long period of time and can be reabsorbed into the body if inhaled or ingested.

A recent study in the medical journal Pediatrics found that of adults surveyed, the impact of third-hand smoke is less well known to the public than other smoking-related risks. Since the term is so new, the researchers asked people if they agreed with the statement that “breathing air in a room today where people smoked yesterday can harm the health of infants and children.” Only 65 percent of nonsmokers and 43 percent of smokers agreed with that statement.

Secondhand smoke is a combination of the smoke from a burning cigarette and the smoke exhaled by a smoker. Also known as environ­mental tobacco smoke (ETS), it can be recog­nized easily by its distinctive odor. ETS contam­inates the air and is retained in clothing, curtains and furniture. Beyond being unpleasant, annoy­ing, and irritating to the eyes and nose, ETS represents a dangerous health hazard. Over 4,000 different chemicals have been identified in ETS, and at least 43 of these chemicals cause cancer.

Furthermore, on average, children are exposed to more secondhand smoke than non­smoking adults. Coastal Ear, Nose and Throat warns parents and caregivers that exposing chil­dren to any kind of tobacco smoke is dangerous to their health and could result in immediate health problems like triggering an asthma attack, to long-term issues like tooth decay and chronic ear infections that can lead to hearing loss if left untreated.

Dr. Samuel Engel of Coastal Ear, Nose and Throat recommends the following ways to help limit a child’s exposure to tobacco smoke:
First, and most importantly, if you do smoke, stop. Consult your physician for help, if needed. There are many new resources available to help you quit from medications to support groups.

Consider a home/car smoking ban. Do not allow anyone to smoke anywhere in your home or at any time in your car. Studies have shown that parents who enforce a no-smoking ban at home are less likely to have teens who experi­ment with cigarettes.

Finally, if you used to allow regular smoking in your home, consider replacing low-cost items like throw pillows, area rugs, and curtains. For items like couches and rugs, consider a thor­ough steam cleaning which can help reduce the amount of dangerous particles, pollutants, and allergens that are trapped in their fibers.

The American Academy of Otolaryngology - Head and Neck Surgery (AAO­HNS), seeks to advise parents and caregivers that ear, nose, and throat disorders remain among the primary reasons children and adoles­cents visit a physician.
For more information on kids’ ear, nose, and throat health, visit our website at www.coastalhearing.com/.

Sean Houston, MD

Sean Houston, MD

Dr. Sean Houston received his undergraduate degree in Biology from Georgetown University and his Medical Doctorate from the Georgetown School of Medicine. He completed his internship and residency at the University of Pittsburgh.

Dr. Houston is a contributing author to a textbook entitled Decision Making in Ear, Nose and Throat Disorders and has been a featured speaker at the Academy of Otolaryngology, Head and Neck Surgery Annual Conference.

In 2007, Dr. Houston was voted by his peers as one of New Jersey Monthly's Top Doctors. He serves as a Clinical Instructor for the Residency Program at Jersey Shore University Medical Center.

Dr. Houston is Board Certified to treat both adult and pediatric Otolaryngology patients.

Mary Mitskavich, MD

Mary Mitskavich, MD

Founder, Coastal Ear, Nose and Throat

Dr. Mary Mitskavich is the founder of Coastal Ear, Nose and Throat, LLC and is the managing partner. She received her undergraduate degree in Pharmacy from Duquesne University, graduating Summa Cum Laude as the class Valedictorian. She worked as a registered Pharmacist until deciding to pursue a career in medicine.

Dr. Mitskavich completed medical school, internship and residency at the University of Pittsburgh where she was elected to the Alpha Omega Alpha Honor Society. Dr. Mitskavich has had multiple scientific publications and presentations at national meetings. Grant money was awarded to fund her clinical research.

Currently, Dr. Mitskavich serves as a clinical instructor at Jersey Shore University Medical Center. She serves on the management committee of the Center for Advanced Surgery and Pain Management. She was on the Board of Directors of Meridian Ambulatory Care, Inc. She was recently selected to participate in the Meridian Physician Leadership Program. In 2007, Dr. Mitskavich was voted by her peers as one of New Jersey Monthly's Top Doctors.

Dr. Mitskavich is Board Certified in Pediatric and Adult Otolaryngology. She specializes in Balloon Sinuplasty, a less invasive endoscopic sinus surgery. You can see her interviewed on our Balloon Sinuplasty video.