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What is the effect of hearing aids on tinnitus and Meniere’s disease?

Meniere’s disease is a combination of tinnitus, hearing loss, fullness in the affected ear, and dizziness caused due to the abnormal fluctuation in the fluid levels in the inner ear.

The hearing loss is one of the initial symptoms of Meniere’s disease but it is usually overlooked because it is the tinnitus that is considered to be more irksome.

There is a mistaken belief that hearing aids are of no help for those suffering from Meneire’s disease. However, with the introduction of digital sound processing integrated with the hearing aid technology, there is an increased chance of an enhanced hearing in Meneire’s disease. The modern hearing aids can amplify sounds to match the hearing loss very accurately and they can also reduce loud sounds to a more comfortable level.

When a hearing aid is successfully fitted the patients of Meniere’s disease can obtain the following benefits:

• The every-day sounds become clearer,
• The discomfort of recruitment gets reduced by compressing distressingly loud sounds to a more bearable volume,
• Reduction in the tinnitus perception to a less agonizing level.

The following facts should be kept in mind before choosing a hearing aid for Meniere’s disease:

• First and foremost it should be kept in mind that a hearing aid is a medical gadget and not a fashion accessory.
• The quality of the hearing aid is very important for those with Meniere’s disease.
• A suitable hearing aid should be selected only after the fluctuating hearing loss has been established on the basis of a series of hearing tests.

Tinnitus is an auditory disorder that is often found to be associated with a hearing loss. A study showed that 60% of the tinnitus patients who were surveyed experienced some amount of relief due to hearing aids whereas 22% indicated a major relief by using hearing aids.

The hearing aids apparently provide the following benefits to the tinnitus patients:

• Improvement in attention span
• The helps in focusing better.
• There is less fatigue, stress and tension.
• There is less irritability and anger
• There are lesser chances of social avoidance due to awkwardness.

Thus, we find that the hearing aids play an important role in the treatment of tinnitus and Meniere’s disease.

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Noise induced hearing loss is one of the major causes of tinnitus. Our hearing system can tolerate noise up to a certain level. Unprotected exposure to noise of around 85 decibels can damage one’s hearing system. This type of hearing loss often leads to tinnitus. Once the tiny sensory hair cells in our inner ears get damaged by loud noise then it is not possible to regenerate them or repair them. The damage is usually irreversible.

According to a survey around 1.1 million people are exposed to a dangerous level of noise in their workplace. The survey also shows that the workers who are employed in the traditional industries are not the only ones who are at risk of tinnitus because of power tools and noisy construction machinery. Those who are working in night-clubs, call-center, restaurants etc are equally at risk.

The employers are ordered by the law to provide their workers with a safe working environment. This makes it essential for them to prevent unsafe levels of noise at the workplace. If enough care is not taken then the workers can develop temporary or permanent hearing loss, acoustic trauma and tinnitus. This can reduce their efficiency and hamper the work progress.

Special ear muffs and ear plugs are available in the market for the industrial workers to protect them from a hearing loss and tinnitus.

It is the duty of the employers to make every possible effort to reduce the noise levels by modifying or replacing old, noisy equipment.

At the same time the workers should also be aware about the hazards of noise pollution at their workplace. They should take the following preventive measures to protect themselves from tinnitus:

1. They should request the employer to go through a complete noise assessment.
2. They should wear ear muffs for protection.
3. The employer should be informed about any problem in the noise control equipment or the ear muffs.
4. They should get periodic hearing tests done if their workplace is too noisy.

Moreover, taking regular breaks and job rotation can also reduce the levels of strain on the hearing system of the workers.

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Viral infections of various types can cause a hearing loss in humans. Such viral infections include:

1. Chronic otitis media or glue ear that can cause a subtle hearing loss.

2. Viral labyrinthitis that is characterized by a sudden, unilateral loss of hearing.

3. Viral meningitis can cause hearing loss and tinnitus.

4. Congenital cytomegalovirus (CMV) infection can cause loss of hearing in the children.

5. Idiopathic Sudden Sensorineural Hearing loss or ISSNHL that can be caused by viral cochleitis.

6. Vestibular neuronitis which is a viral infection of the vestibular nerve can also cause a hearing loss.

Alternative treatments for hearing loss caused due to viral infections provide a holistic solution.

This can be adequately proved by the following natural, home based remedies:

1. Use a blow drier from some distance into the ear to remove any trace of water trapped inside the Eustachian tube.

2. Put a few drops of warm olive oil into each ear.

3. Avoid the smoke from cigarettes as it can choke our Eustachian tubes.

4. Some drops of lobelia extracts should be put into the ears and massaged gently.

Nutritional therapy:

1. Vitamin C intake can strengthen our immune system. This helps the body in combating the viral infections and preventing hear loss.

2. Zinc is found to cure ear infections.

3. Avoid junk and processed foods. Eat healthy.

4. Include calcium in your daily diet.

5. Breast feeding reduces the chances of such infections in infants.

6. Nutritional supplements such as vitamin B- complex vitamins and iron supplements reduce the risk of chronic ear infections that can cause a hearing loss.

7. Vitamin A and C, bioflavonoids and zinc should be used to cure chronic ear infections in kids.

Herbal therapy:

1. Herbs such as echinacea and goldenseal are natural antibiotics that can cure ear infections. They promote a strong immune system and help in controlling viral infections.

2. Chinese herbal therapy is also widely popular in curing ear infections.

3. Put some drops of garlic juice into the ear as it is a powerful and natural antiseptic herb. It kills virus, parasites, bacteria, fungi etc.
Thus we find that there are various alternative therapies that can uproot the viral infections that lead to a hearing loss. They are safe and natural and look into all the aspects of the problem.

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What Causes Non-Pathological Head Noise?

Pathology implies a diseased condition. Apart from pathological causes tinnitus can also occur due to several non-pathological causes such as the following:

1. Toxic substances such as mercury, antibiotics, aspirin, cisplatin etc. can cause tinnitus.

2. Noise-induced hearing loss is often accompanied by hyperacusis, which is a reduced tolerance to noise. Acoustic trauma can destroy the hair cells in the cochlea and the neurons in the dorsal cochlear nucleus and the acoustic nerve. It is believed that the automatic repair process in these nerves is the primary cause of chronic tinnitus.

3. Temporomandibular joint syndrome and whiplash can also cause tinnitus.

4. Neck injury and electrocution that is caused by a direct and blunt neck trauma can trigger tinnitus.

5. Due to aging, the cells that secrete the inhibitory neurotransmitter glycine are lost. Glycine carries the inhibitory signal from one neuron to the next. When glycine-carrying nerve fibers are lost due to old age the inhibitory signal is also lost and some other neurons begin to fire spontaneously leading to tinnitus.

6. Dental problems such as an injury of the nerves during the process of extraction of a wisdom tooth have also been reported to cause tinnitus.

7. Ear-related problems such as ear wax impaction and conductive deafness that is caused by the perforation of eardrum can lead to tinnitus.

8. In around 80% of the tinnitus sufferers muscle spasms in the neck or head are the causal factor.

9. If syphilis is left untreated then it can also cause a fluctuating hearing loss and tinnitus. Migraines and sinus infections are also associated with tinnitus sometimes. Inflammation of the Eustachian tube can also produce tinnitus.

In all of these non-pathological causes of tinnitus the process usually starts with some injury in the ear. Later on, the brainstem gets involved and tinnitus is produced. Conventional medical thinking had suggested that tinnitus arises due to an injury to the middle ear or the vestibulocochlear nerve and hence is difficult to treat.

However, today the researchers have realized that rewiring of an area in the brainstem known as the dorsal cochlear nucleus plays a significant role in tinnitus. Recent breakthroughs based on this theory have lead to effective forms of treatment.

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What Safety Precautions should be taken when working in a Noisy Place?

Our auditory system is quite sensitive and delicate and it cannot tolerate noise beyond a particular level. The experts on acoustics state that a prolonged exposure to noise of around 85 decibels and above can damage one’s hearing.

Our ears do not have any pain receptors to warn us about the damage to the auditory system. Hence, it is our own responsibility to understand the capacity of our hearing system and to take safety measures to protect it.

In order to avoid the problem of noise pollution at workplace it is essential to follow some safety measures such as:

•There should be a sound level meter to measure the loudness of sound.

•The noisy machineries should be transferred to a sound proof room.

•Efforts should be made by the company to generate the minimum amount of noise at the workplace. This can be done by preventing a metal-on-metal impact, purchasing less noisy machinery, preventing the machinery from vibrating against some other surface and fitting silencers where ever possible.

•There should be a periodic examination of the machinery to ensure that any extra noise is not being produced.

•Workers should work in less noisy areas. If this is not possible then they should use hearing aids. The companies are obliged to provide its workers with suitable protection for ears.

The following hearing aids can be used by the workers:

1.The ear plugs are available with a noise reduction rating or NRR. This rating indicates how many decibels of noise can be reduced. An ear plug can fit just inside the ears. It should be of a right shape and should be at the right angle so that it can provide proper protection. Customized ear plugs can be a suitable choice for many workers.

2.Semi-aural inserts come on a band that gets fit below the chin or behind the neck. They should be used to protect against noise up to 87 dB only.

3.Ear defenders mostly come on a band that can be fitted across one’s head. For the workers who require head protection also the ear defenders can come attached to a helmet.

If these safety measures are followed then one can protect the precious auditory system that makes our life easier for us.

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Ecstasy, which is also known as M.D.M.A, is a stimulant drug. Stimulants can constrict the blood vessels in the body which in turn affects the blood supply. If the blood supply towards the ear gets reduced then the cells in the ear region are not able to function normally. This can lead to tinnitus.

There are various ototoxic medications that can affect one’s hearing or balance by one or more mechanisms. There are three main locations where medications cause ototoxicity. The first location is the cochlea and the medications that affect it are said to exhibit cochleotoxicity. This kind of ototoxicity that involves the cochlea can produce a hearing loss. It usually begins with high frequencies but ultimately progresses towards the lower frequencies that include speech. The hearing loss may be either one-sided or bilateral. Cochlear damage can also manifest as ringing in the ears syndrome or tinnitus. The tinnitus may be regular or uneven. There may be an aggravation of the tinnitus noise in the patients who have pre-existing tinnitus. Such patients can also experience a new sound that was not present earlier before the medication was administered.

The vestibulum is a second location that may get affected by the action of the ototoxic medications. Such medications are known as vestibulotoxic. Vestibulotoxicity usually appears as balance-related problems such as disequilibrium. The patients report a spinning sensation that is often worsened by motion and is related to nausea.

The stria vascular is the third location of the action for ototoxic medications. The stria vascularis is a kind of epithelium that is distinctively able to produce end lymph inside the cochlea. An excess of end lymph is responsible for triggering Meniere’s syndrome.

A case had been reported about a man who has been found unconscious. On interrogation he admitted to taking Ecstasy. Besides several physiological problems he also developed a bilateral and constant, high-pitched tinnitus. Incidentally, he did not have any history of tinnitus prior to this incident. His medical reports showed that Ecstasy had caused vestibulotoxicity and cochleotoxicity. This example is an ample proof that harmful stimulant drugs such as Ecstasy can cause ringing in the ears.

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What is the treatment for hearing loss and sensitivity to high sounds?

In many cases, the common causes of hearing loss can be easily detected through an examination of the ears and nose along with some simple hearing tests. These tests are helpful in producing a diagnosis. If any defect in the brain or the acoustic nerve is detected then further neurological tests and imaging has to be conducted. The treatment for a conductive hearing loss is case-specific.

The general guidelines for the treatment of a conductive hearing loss are as follows:

• One should try to identify and avoid the potential allergenic foods.
• Try to get rid of the accumulated ear wax.
• Otosclerosis can be surgically repaired by an operating microscope.
• One should take nutritional supplements such as B-complex vitamins and iron supplements.
• The herb Ginkgo biloba can be effective for the patients who have a hearing loss accompanied with tinnitus.
• If medications do not work in the treatment of a middle-ear infection involving fluid then the fluid can be surgically drained through the eardrum.
• Bone conduction hearing-aids and devices that are surgically implanted in the cochlea are available for complete conductive hearing loss.
• Other therapies that are helpful in improving hearing in some cases include auditory integration training, ayurvedic medicine and craniosacral therapy.

The treatment for a sensorineural hearing loss is as follows:

• Anti-vertiginous and tranquilizing drugs
• Vasodilative agents.
• Low-salt diets.
• Cochlear implant
• The use of hearing aids.
• Instructions in speech reading or lip-reading

The problem of sensitivity to sound is medically referred to as hyperacusis. This problem occurs rarely and is not congenital. It may develop because of a distorted tolerance to sound as a result of a noise trauma.

Till date, the most promising therapy for hyperacusis is pink noise, which is heard at barely audible levels till a fixed period of time daily. This therapy is known as Tinnitus Retraining Therapy or TRT and had been developed by Dr. Pawel Jastreboff and Dr. Jonathan Hazell. The theory of TRT suggests that our ears can be desensitized to all frequencies, i.e. white noise thereby facilitating the return of our ears to a more normal sound tolerance.

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