An Introduction to Healthy Hearing Presented at the HLAA Hearing Tech Exhibition By: Jamie Marotto, Au.D. May 2015

Agenda What is “Better Speech and Hearing Month”? Introduction to how we hear Signs and symptoms of hearing loss Common treatment options Communication tips and advice Question & Answer Session

Better Speech & Hearing Month Created in order to highlight the importance of early detection and treatment for communication disorders in older Americans Roughly 40 million Americans experience a speech/language or hearing disorder About every 1 in 10 American adults have a hearing impairment Hearing and balance issues are also risk factors for falls, a serious public health concern for the older population

Better Speech & Hearing Month Hearing disorders are complex conditions with medical, psychological, physical, social, educational, and employment implications Treatment options include hearing aids and other assistive technologies that meet a host of different patient needs and preferences There is no “one-size fits all solution”

Better Speech & Hearing Month Many people have outdated perceptions of hearing aids and hearing loss in general Among adults ages 70 and older with hearing loss who could benefit from hearing aids, fewer than one in three have ever used them Untreated hearing loss is associated with anxiety, depression, reduced quality of life, and even earlier onset of dementia

Our Hearing System Photo retrieved from: http://www.lyrichearing.com/sites/default/files/assets/cutaway_ear.jpg

The Middle Ear Photo retrieved from: http://www.anatomybox.com/tag/coin/

The Inner Ear http://www.thirdage.com/healthgate/Images/AQ00008_cochlea.jpg

Hair cells Photo retrieved from: http://www.who.int/occupational_health/publications/noise2.pdf

How a healthy system works Photo retrieved from: http://www.highlands.edu/academics/divisions/scipe/biology/faculty/harnden/2121/images/hearing.jpg

Normal Cochlea vs. Damaged Cochlea Photo retrieved from: http://www.earplan.com/Portals/203976/images/IMG_3350.JPG

Causes of hearing loss Problems in the outer ear Impacted ear wax Foreign bodies in the ear canal Swimmer’s ear (an infection in the ear canal) Tumors or growths in the ear canal Lack of a pinna Malformed pinna

Causes of hearing loss Problems in the middle ear Ear infection or fluid behind the ear drum Perforation of the ear drum Arthritis of the ossicles Disarticulation of the ossicles Tumor or growth in the middle ear space Eustachian tube dysfunction

Causes of hearing loss Problems in the inner ear Natural aging process Excessive noise exposure Ototoxic medications Genetic makeup Viral and bacterial diseases Meniere’s disease (abnormality of the fluid composition in the inner ear) Malformed cochlea

Causes of hearing loss Problems beyond the inner ear Acoustic neuroma (benign tumor on the hearing nerve) Significant head trauma can lead to damage of the highly complex hearing pathways in the brain

Types of hearing loss Depends on where the problem is along the hearing pathway Conductive hearing loss occurs when there is a problem at the level of the outer or middle ear Problem with the transmission of sound to the inner ear

Types of hearing loss Depends on where the problem is along the hearing pathway Sensorineural hearing loss occurs when there is a problem at the level of the inner ear Typically damage to either the hair cells or structures surrounding them in the inner ear Degradation of the hearing nerve

Types of hearing loss Depends on where the problem is along the hearing pathway Mixed hearing loss occurs when there is a problem at the level of either the outer/middle ear and the inner ear Combination of conductive and sensorineural hearing loss (i.e. having an ear infection and nerve related hearing loss at the same time)

Signs and symptoms of hearing loss Do you often feel like people are mumbling? Do you have difficulty talking on the phone or listening to the TV or radio? Do you complain that you hear people, but you don’t understand what they are saying? When you are with other people, do you wish you could hear better? Do others complain that you have a hearing problem? Do you have trouble understanding conversation in background noise?

Signs and symptoms of hearing loss Do you frequently need to ask other people to repeat what they have said to you? Do you avoid social activities where you need to hear well? Do you have ringing or buzzing in your ears? Do you experience dizziness? Do you have a family history of hearing loss? Do you have any history of noise exposure? (To loud noise in recreational activities, at work or in the military?)

Do you think you or a loved one has difficulty hearing Do you think you or a loved one has difficulty hearing? If so, what should you do about it?

Visit an audiologist First, you need to have your hearing assessed by a licensed professional. In our assessment, we can tell you what type of hearing loss you have, how much hearing loss is present, and the appropriate recommendations.

Hearing Evaluation Photo retrieved from: http://cdn.shopify.com/s/files/1/0240/1547/files/audiogram_image_large.gif?4158

Common Treatment Options: Hearing Aids -Hearing aids are designed to make sounds louder and more clear in order for the person to understand better -They do not provide “perfect” hearing nor will they restore your hearing back to normal -There is an adjustment process when you first start wearing hearing aids -They help minimize some unwanted noise, however, the hearing aids cannot eliminate sounds you do not want to hear Hearing aids work very well when they are fit and adjusted appropriately.

Common Treatment Options: Hearing Aids -If you have hearing loss in both ears, two hearing aids are typically recommended -Why is it important to wear two hearing aids when two hearing aids are recommended? Does it really make a difference? -60% of individuals who wear hearing aids are fit with hearing aids in both ears

Common Treatment Options: Hearing Aids -Digital technology is now widely available in hearing aids -Audiologists have the ability to re-program and fine tune hearing aids with computer software -Digital hearing aids are flexible and should be able to provide you with more sound if your hearing changes -Some hearing aids are not universally programmable

Communication tips and advice WHEN SPEAKING TO SOMEONE WITH HEARING LOSS… Get the person’s attention before you start speaking Do not speak directly into the person’s ears Speak without anything in your mouth Speak clearly and decrease your speech to a slow to normal rate. Pause in between sentences. Do not exaggerate your speech. Alert the listener when the subject of the conversation is going to change. Rephrase instead of repeat Avoid background noise as much as possible! Be PATIENT and ask the person you are speaking to for any suggestions on how to communicate better.

Communication tips and advice FOR THE HEARING IMPAIRED PERSON… Avoid dimly lit and noisy areas Prepare ahead of time if possible When you misunderstand what is being said, do not simply ask for repetition, for example, tell the speaker you have trouble hearing and ask them to face you when they speak to you. Pay close attention to the person speaking. Make sure you can see the speaker’s face. Do not bluff! Bluffing robs you of opportunities to practice good communication skills. Set realistic goals about what you can expect to understand. Remember that hearing aids have limitations… using assistive listening devices may help.

Take home points Hearing loss effects over 36 million Americans There are different types of hearing loss, each which may indicate a different treatment option If you or someone you know suspects a hearing loss, get evaluated by a properly trained professional Hearing aids are the most common treatment for hearing loss. It is important to remember they do not restore natural hearing and will not make your hearing perfect. Using communication strategies, combined with hearing aids and/or assistive devices is typically the best way to help overcome hearing loss.

Questions?

Come visit us! Norwalk Location – 148 East Avenue, Suite 2I (In the Riverview East Medical Building) New Canaan Location – 45 Grove Street (Inside Halo Wellness Studios on the ground floor of the New Canaan Racquet Club) Westport Location – 611 Post Road East (In the Fresh Market Shopping Plaza)