Tag Archive: Harvard Medical School

Harvard Medical School looks at hearing and brain health

Photo credit: A Health Blog licensed under CC BY-SA 2.0

by David M. Sykes, Vice Chair, The Quiet Coalition

Harvard Medical School publishes a number of useful, consumer-oriented newsletters and blogs on issues related to health. Sometimes they touch on noise-induced hearing loss and other hearing-related concerns. In this recent blog, James Maple, MD, discusses hearing health and its relationship to brain function. If you’re looking for some insight into this issue that avoids the hype, this is a good place to start. Research has recently shown that there is a clear correlation between diminished hearing and decline in cognitive function. Research is ongoing to determine whether there is a clear causal link between the two and how it might work. What is clear is that that preventing hearing loss is important.

An earlier article in this same publication gives an overview of the emerging market for personal sound amplification products, a market that opened last month thanks to the Warren-Grassley Act passed in 2017 and signed into law in 2018.  This law enables high tech “hearing assistive devices” to be sold over the counter without a prescription at drug stores, via online stores, etc.—for 1/10th the price of typical hearing aids. So now for a few hundred dollars you can purchase hearing assistive devices, try them out, and decide whether they’ll help you (or someone you know whom you suspect needs them). This article provides a useful, non-hyped description of PSAPs that makes good background reading before you begin shopping.

David Sykes chairs several professional organizations in acoustical science: QCI Healthcare Acoustics Project, ANSI Committee S12-WG44, the Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Committee. He is lead author of “Sound & Vibration 2.0” (Springer, 2012), a contributor to the NAE’s “Technology for a Quieter America” and the GSA’s “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics at Rensselaer Polytech. A graduate of UC-Berkeley with advanced degrees from Cornell, he is a frequent organizer of professional conferences in the U.S., Europe, Asia and the Middle East.

Unilateral hearing loss may affect brain processing of sound

Photo credit: Colin Behrens from Pixabay

by Daniel Fink, MD, Chair, The Quiet Coalition

This report from Harvard Medical School states that chronic conductive hearing loss, a condition that can result from repeated middle-ear infections, may interfere with speech recognition.

People with unilateral hearing loss are often reluctant to wear a hearing aid on one side because their good ear allows them adequate hearing. But researcher Stephane Maison and colleagues found that people with unilateral conductive hearing loss, such as that caused by chronic ear infections, appeared to develop changes consistent with neural damage found in hidden hearing loss.

Based on this research, Maison and colleagues recommend that clinicians and patients should consider treating unilateral hearing loss to prevent neural deficits that can lead to difficulty understanding speech in noisy environments.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Tinnitus and what to do about it

Photo credit: erik forsberg licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I think the title of this report from the Harvard Medical School is misleading. I have tinnitus so part of my response is a personal one. To me, the most important sentence in the report is this: “There are no FDA approved treatments for tinnitus.” That means that none of the many proposed treatments for tinnitus–from a variety of vitamins and drugs, to various auditory training programs–has been demonstrated to be safe and effective, the FDA’s standard for approval. Cognitive behavior therapy may improve the ability to accept or deal with a constant ringing in the ears, but it doesn’t change the underlying symptoms.

It can be difficult to live with a constant ringing in the ears. I haven’t tried any of these unapproved treatments because I believe in evidence-based medicine, both for patients and for myself. Also, I am fortunate–my tinnitus is relatively low volume, and the only time it really bothers me is when I wake at night and it’s loud enough to cause difficulty in falling back to sleep–but the symptoms can be so bad that people commit suicide because of them. I suppose that if my symptoms were worse, I might be willing to try some of the treatments mentioned. And I would add that I know people who have had success using some of them.

Perhaps most significantly, the report neglects to mention three important facts:

1. The overwhelming cause of tinnitus is noise exposure, not the many other possible causes listed in the report. I haven’t been able to find a percentage, but my estimate is at least 80% and probably 90 or 95%.

2. The article implies that temporary tinnitus after noise exposure is a normal thing. No, temporary tinnitus indicates that one has been exposed to too loud noise, and that auditory damage has occurred.

3. Avoiding loud noise exposure will most likely prevent tinnitus from ever developing.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Researchers confirm cheaper hearables work as well as hearing aids

by David M. Sykes, Vice Chair, The Quiet Coalition

Several Johns Hopkins researchers reported some research in the Journal of the American Medical Association that tested the notion that a cheap ($200-$400) unregulated “hearable” (also known as a personal sound amplification product or PSAP) may be a convenient and inexpensive alternative to a hearing aid.

The researchers tested a handful of the new hearable products just coming on the market and, sure enough, they perform as well as, or nearly as well as, expensive ($2000-$5000 per ear) hearing aids made by the “Big Six.” The Big Six are six companies that have controlled the hearing aid industry; their products are regulated in the U.S. by the Food and Drug Administration.

Recently legislation passed by Congress and signed into law just before the August recess, about which we have written earlier, requires the FDA to de-regulate, i.e. to take a hands-off approach to this new class of high-tech hearing devices. As a result, these new products can be sold over the counter, without a prescription.

Will you need to take them to an audiologist to get them fitted? Certainly you may choose to do so, and that may be the best option, particularly if you are concerned that improper use might endanger your hearing. But with a conventional hearing aid, patients were required to pay professional fees to an audiologist for fittings, etc., resulting in a bundled price that made the hearing aids unobtainable for many people who needed them. You can certainly expect to read articles claiming that these new devices pose a danger. Henceforth, it’s up to the consumer to decide—as he or she already does with regard to many other healthcare products, including over-the-counter drugs that formerly required a doctor’s prescription.

We say caveat emptor (buyer beware), but welcome these new products that cost 1/10th the price of conventional hearing aids. They are suitably priced to be able to meet the needs of 48 million Americans with noise-induced hearing loss, many of whom cannot afford the $4000 to $10,000 price tag for conventional hearing aids. Voters seem to want de-regulation—this is it!

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.