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What is the best way to clean out your ears. I have recently noticed a clogged or heavy feeling in my ear. I have always used a few drops of peroxide and have never had a problem. as of the past month I can not seem to dislodge my wax?

Dr. Robert Beiny: The best thing is to have the ears checked by a physician or hearing healthcare professional to rule out any contraindications and to advise on a self cleaning regime- if suitable for you.

There are numerous products available on the market but most hearing professionals advise against putting anything into your ear as you can't see what you are doing. It is best to have your ears cleared out by a doctor, nurse or hearing professional 

i am able to hear more clearly and in one ear than the other. in one ear its normal and crisp but in the other the sound is less crisp and kind of muffled i am growing very concerned about this can you please tell me what might be wrong?

Dr. Craig Kasper: There are a number of possible causes that may lead to what you have briefly described. As with any unilateral abnormality, it is important that you seek the guidance of your ear, nose and throat physician and your audiologist as soon as possible. The medical and audiological assessments will provide a clearer picture of what might be causing the loss of clarity for you. If the initial testing in your audiologist’s office reveals a true difference between the ears, don’t be surprised if your ENT doctor refers you for further testing to take some pictures of the inner ears and hearing nerves. Once a complete picture of your hearing ability and hearing system is obtained, your physician and audiologist will work together to determine what the best options might be to help you hear better.

Even though the hearing test I took at an audiologist's office did not include a test with background noise, do the ususal hearing tests somehow account for that. That's my biggest hearing issue. Thanks.

Dr. Craig Kasper: Hearing difficulty in a background of noise is one of the most common complaints hearing healthcare providers encounter. The basic hearing tests of function, sensitivity and clarity usually do not provide your audiologist with a definitive picture of your ability to function in a background of noise. There are specific tests designed to help your clinician compile this information. The HINT (Hearing In Noise Test) and QuickSIN (Speech In Noise) are two tests available to help understand your speech-in-noise ability. Should you have specific problems understanding conversation in noisy environments, you may ask your audiologist if they have the ability to perform one of these tests. The results will help them formulate a clearer picture as you both look toward the rehabilitative process and possibilities of using advanced hearing instruments.

Can constant wind noise from being on a motorbike cause hearing loss?

Dr. Craig Kasper: A number of research studies around the world have set out to answer this very question. The studies have shown that excessive wind noise around the helmet (the turbulent airflow) results in a level of 90 dB (A weighted) at 60 km/hour and reaches 110 dB (A weighted) at 160 km/hour. For comparison, industrial hearing loss prevention programs must be instituted when noise in the environment reaches 85 dB(A). Some of the studies also investigated the level of reduction some of the more modern helmet technologies offered. The outcomes suggested this to be minimal. These studies only took into consideration the variable of a turbulent airflow, and not the sound level of the motorcycle itself.

The potential for hearing loss is an issue that most motorcyclists are aware of, but do not take action. You might take a visit to your local audiologist and undergo a baseline hearing evaluation to determine if you actually do have a noise-induced hearing loss. Also investigate one of the many custom in ear product manufacturers that make products specifically for professionals who compete in motor sports. There are a number of products to help protect your hearing while allowing you to still hear the warning signals around you when you’re out on your bike.

Firecracker went of near ear month ago. It sounds like a high pitched ring or static in my ear when i plug it, some noises sound like a blown speaker. Doctor said there was no hole in drum. Hearing seem to have went down what shold i do?

Dr. Craig Kasper: Noise exposure is the number one preventable cause of hearing loss. Unfortunately, there are instances in our lives where we do not have control of certain sudden sounds that may be harmful to our hearing structures. Firecrackers produce a sudden, intense noise that may be similar in sound pressure level to that of a gun. When sounds reach a certain level, there is the possibility it could result in sudden physical damage to the delicate structures of the ear. In some cases, the eardrum could rupture, the small bones behind the eardrum could break apart and the cellular structures of the inner ear could tear. If this occurs, permanent hearing loss is the result. Whenever damage occurs to the hearing structures, the function of the system is changed and may result in a distortion of sounds. Additionally, one might experience the symptoms of tinnitus (ringing or buzzing in the ears) as a result of the structural damage/ hearing loss that has occurred. Unfortunately, there is no quick fix to repair damage that we might experience as a result of acoustic trauma. Your ear, nose and throat physician might offer you certain medications in the days and weeks immediately following the incident, while your audiologist monitors your hearing through comprehensive testing. Based on the degree of hearing loss and the level of distortion in the hearing system, it may be recommended that you have a trial period with a hearing aid. If this course of treatment is appropriate, it may also serve to help reduce your awareness of the tinnitus, as well.

6 days ago, a high-pitched, siren-like wail began emanating from a nearby NYC rail yard. It’s incredibly annoying, & causing people headaches, but can a prolonged, specific, high-pitched frequency cause hearing loss as high decibel levels do?

Dr. Craig Kasper: Noise-induced hearing loss may occur if a sound (any sound) is loud enough and for a long enough period of time. In industry, occupational hearing prevention programs are required when any worker is exposed to a level of noise of 85 decibels over an 8-hour workday. In order to determine if the noise emanating from the nearby rail yard reaches or exceeds this minimal standard, a noise study by a professional (such as an audiologist or engineer) would provide you with the information you need. Although the sound levels may not reach the point where noise-induced hearing loss would occur, even low-level sound in our environment has been shown to have a negative impact. For example, numerous studies have shown us that constant low-level noise changes our physiology (heart rate, blood pressure, overall stress levels) and can impact a child’s ability to learn.

After the mass was removed from my ear, the doctor was checking my hearing with a prong that he put on top and in back of my head that he binged with a metal prong. One section didn't elicit a sound to me. What was that?

Dr. Craig Kasper: Before sophisticated computers allowed us to evaluate a patient’s hearing, much of the testing was performed in the physician’s exam room with small metal tuning forks. These tuning forks are still used today, and many physicians are experts in using them to determine the location and cause of hearing loss. There are several tuning fork tests that your physician may have performed and it is difficult to determine which test resulted in what you have described. At your next visit, you may wish to ask you physician to provide you with a brief understanding of what the results of his tuning fork tests meant as it relates to your specific case.

I have a hearing loss.Should I take multivitamins+minerals.What vitamin supplement will help me?

Dr. Craig Kasper: There are a number of supplements currently marketed that target those in search of auditory longevity or to reverse a pre-existing hearing loss. A simple pill to prevent or reverse the effects of the aging process or noise exposure is an attractive concept with the potential of significant benefit for those affected. Unfortunately, there is no one (or group of) vitamin or supplement that has been proven effective in accomplishing this. Some interesting studies have been undertaken with vitamin B12, folic acid, vitamin C, vitamin E, n-acetylcysteine, D-methionine, and a combination of a number of vitamins, antioxidants and other compounds. But I believe more research is warranted before we will feel comfortable suggesting to patients that they take dietary supplements to help preserve hearing or reduce the effects of hearing loss. In the meantime, I would suggest the following:

• Read labels with a healthy dose of skepticism; if it seems too good to be true, it probably is,
• If you are considering taking dietary supplements, consult your physician to ensure there will be no interaction with any other medical conditions or medications,
• Practice preventive hearing health; have your hearing tested regularly, protect your ears in noisy environments, eat healthy foods, omit smoking and lead a healthy life overall.

Audiologists warn:"Don’t wait too long! Your brain loses its ability to hear". Are there tests to confirm this? Can the brain be re-trained to hear? How many years after first having been diagnosed as having some hearing loss is too long?

Dr. Craig Kasper: Studies have demonstrated that the average hearing-impaired person waits about seven years from the time they first notice a hearing problem to the point they actually take action and pursue hearing aids. The brain is a remarkable entity and it is very "plastic" in nature. This means it has the ability to change the way it is wired as a result of experience (or lack of). In the case of hearing loss, the hearing centers of the brain may receive information, but it is compromised. This may result in a decreased ability of the brain to interpret sound. I have always viewed it as a "use it, or lose it" type of phenomenon. When we test hearing clinically, we will not see the "normal" progression of hearing loss accelerate in patients who do not choose to use hearing aids. What we do see, and studies have demonstrated this, is the clarity of sound may deteriorate at a more rapid pace. It is the clarity of sound that we are not able to correct for with hearing aids. Despite the fact today’s hearing aids are very sophisticated computers, they are not capable of replacing normal function. To sum up, it is always recommended that you pursue hearing aids as soon as a problem is identified to ensure that your brain is adequately stimulated.

What is your opinion on the future of stem cell treatment and hearing loss? Apparently there is a young woman, Chloe, who received treatment outside the US who had a remarkable improvement.

Dr. Craig Kasper: The promise of stem cell research for chronic disorders such as diabetes, Parkinson’s, and hearing loss is great. Unfortunately, the research and ultimate “product” development is very expensive and takes many years before we can officially say if something is effective in providing a cure. In the case you mentioned, Chloe Sohl received stem cell treatment through a company based in Korea. The reported hearing improvement Ms. Sohl experienced appears to be quite remarkable. It will be very interesting to see the long-term effects of her treatment as well as that of others with the same set of circumstances. To my knowledge, the specifics of her case are not available to the public and we are not clear if the treatment simply addressed the autoimmune response and allowed her hearing system to function better. Finally, it is important to keep in mind that this treatment is still considered experimental. Regardless, it is successes such as this that offer hope for the millions affected by hearing loss worldwide.

10 years with mp3 player tipped my 57 y/o auditory system into red alert. HF hearing loss/tinnitus. What is on the horizon for sufferers? Unlike France and the UK why doesn't the US limit decibel volume in mp3 players?

Dr. Craig Kasper: Ask the Expert posts for information related to tinnitus. When it comes to limiting the decibel output of mp3 players, there are a number of variables that must be considered. Although device limiters might be instituted, there are always ways for tech savvy people to get around the limits that have been set. It is my belief that the responsibility is on the manufacturers of mp3 players to educate the consumer, but it is ultimately the consumer’s responsibility to use that information wisely. I view the mp3/ volume issue much in the same vain as the sun exposure/ skin cancer issue. This is not to compare music-induced hearing loss to the severity of skin cancer, although some who have suffered hearing loss may disagree. For most of us, sun bathing has been viewed as something that contributed to our overall health and feelings of well-being. The dermatology community has taught us that over exposure to the sun will have negative, potentially deadly, effects. The message of safe listening, preventive hearing health and the products that will help us achieve those benign levels is just starting to make its way into the public conversation. Unfortunately, like sun over exposure, music over exposure will likely be an issue for those who believe themselves to be invincible.

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I have inilateral hearing loss & tinnitis caused by a CVA which was caused in turn by a clotting disorder. Is there any help for this hearing loss?

I don't expect a miracle but would like some sort of answer.

Dr. Craig Kasper: I will assume you have already had a full medical and audiological evaluation including comprehensive hearing testing, word recognition testing and otoacoustic emissions. The information obtained from those hearing tests will provide you and your hearing healthcare provider with a better understanding of what steps can be taken to potentially help you hear better and reduce the symptom of tinnitus. Two key areas to focus on are the degree of hearing loss and the clarity of speech sounds. In the case of a CVA, various areas of your brain responsible for interpreting sounds might have been affected. To understand if your hearing loss also includes an auditory processing component, specialized testing would be able to provide a clearer picture. Ultimately, a hearing aid might be an effective rehabilitative tool but the degree of success may be dependant upon the amount of hearing loss you have as well as the clarity of sounds and the manner in which your brain interprets those sounds. Additionally, hearing aids have been known to provide some relief from tinnitus.

I have an right ear trauma from a recent concert. All the tests I carry says my hearing is normal. But since two months there is an acuphen. I read that when it comes from a sound, it may dissapear after a couple of months. Is it true ?

Dr. Craig Kasper: Most of us have experienced a ringing or buzzing in our ears after a loud concert. When that happens, it indicates that we have significantly over-stimulated the tiny hair cells in our inner ears. In most cases, this is just temporary in nature and after a day or two our hair cells start to function again and the tinnitus fades. Other times, if the music is loud enough for a long enough period of time, we suffer permanent damage to those hair cells. I’m curious to know if your battery of tests included a test of hair cell function called otoacoustic emissions (OAEs). OAEs are a very sensitive test that allows your hearing healthcare provider to understand if subtle changes have occurred to your ears, even before it would be evident during a standard pure-tone hearing exam. In the case of tinnitus following potential noise trauma, there is a possibility it might fade as time moves on. This has more to do with your emotional response to the noise in your ears than the catalyst for you experiencing it in the first place. As always, the best way to avoid any damage to your hearing during a concert is to wear hearing protection.

Can you explain to me how Cholesterol can create hearing loss in one ear?

Dr. Michaela Fuchs: High Cholesterol can not directly lead to a hearing loss in one ear. A hearing loss could be an indirect effect from a bad blood circulation because of the high cholesterol. However, usually it is not a hearing loss in only one ear that is created in such a way.

I was at work,Iater that day I lost all the hearing in one ear. steriods since with no results, ENT says I have a severely profound hearing loss. I had no symtons and really no explanation , I'm trying to see what if any options how can this happen?

Our expertsThe reasons for sudden hearing loss have still not been clearly determined. Sometimes stress or tension in the cervical spine can cause a sudden hearing loss; however, to be on the safe side, I would recommend a MRI to exclude other reasons. For most patients, no concrete reason can be established and we have to wait for a certain time if the hearing comes back.

Is chelation a safe treatment for hearing loss and is it safe for me?

I have tinnitus in my right ear along with hearing loss also. I take heart medications, (Lisinopril, Metoprolol, and Pravastatin and aspirin therapy). I am 66, male,weigh 185lbs.

Dr. Michaela Fuchs: Chelation is a soft therapy for a better blood circulation. It may have a positive effect on your tinnitus, but the effects on hearing loss are not really good. You definitely should talk to your cardiologist to find out it if it is safe for you.

What are the symptons of im,pacted ear wax? I woke up this morning and my voice and other sounds sounded echoey and reverberated and my ears felt full. Is this just ear wax build up or something more serious?

Dr. Robert Beiny: Wax is a very common cause of sudden reduced hearing as the ear canal blocks reducing the level of sound, sometimes this can be associated with an increase in internal noise (tinnitus) which can sound like a humming or bussing noise in the ear or head. A quick visit to your doctors office or a hearing healthcare professional can easily identify if wax is the cause of the problem. If so, this can easily be removed and hearing function restored.

There are other caused of sound perception altering and although most are not serious the advise is to go and seek the advise of a professional at the first suitable opportunity.

I bought an Inversion Table for back problems. After hanging upside down for the adviced time, I am suffering from a "locust" noise which never stops. My Dr. diagnosed an ear infection with drops & oral medication. Did I damage my ears permanently?

Dr. Craig Kasper: The “locust” noise you are experiencing is called tinnitus and it is a symptom of an underlying problem. The topic of tinnitus has been covered in a number of previous “Ask The Expert” columns, so I encourage you to look back at those answers for more general information on the topic. Although tinnitus may become present during an ear infection episode, I would be more interested in understanding more about your “back problems”. In my clinical experience I have encountered many patients with back and neck problems that we believe may have played a significant role in the onset/ exacerbation of their tinnitus. It is important to keep in mind there are many causes/ exacerbating factors we must consider when a patient presents with tinnitus. For this reason it is important to follow up with you ear, nose and throat physician and audiologist for a comprehensive tinnitus/ hearing assessment.

Do people with hearing loss experience a decreased quality of life as a result of low self-esteem?

Dr. Craig Kasper: Our ability to hear connects us with our world. One of the most commonly cited studies on the topic was conducted by the National Council on the Aging (NCOA) in 1999. The study demonstrated that untreated hearing loss was linked to withdrawal and feelings of isolation and depression. More recent studies conducted by the Better Hearing Institute (BHI) also revealed the fact that untreated hearing loss resulted in reduced function on the job as well as a loss of income. The interesting part of the equation, once those with hearing loss did something about it (in other words, pursued appropriate hearing aids), they noted a positive improvement in the way they felt about themselves, their self-confidence, relationships, and life overall. A small percentage even noted an improvement in their sex life!

What's the difference between high frequency and low frequency hearing loss?

Dr. Craig Kasper: When we refer to "frequency", we refer to the pitch of a sound. For example, a dog whistle (high frequency sound) versus a foghorn (low frequency sound). High frequency hearing loss occurs in the region of sounds that sound like a whistle. Low frequency hearing loss occurs in the region of sounds that sound like a foghorn. If a hearing loss is identified in the high frequencies, this usually affects the person’s ability to hear speech clearly. This is because the information sounds of speech, the consonants (for example: sh, th, f, etc.) are found in this frequency region. A low frequency hearing loss may not demonstrate such obvious symptoms, this is because low frequency sounds are more intense and do not carry as much information as high frequency sounds. Typically, low frequency speech sounds are the vowel sounds (for example: u, o, a, etc.). Depending on the degree and configuration of your hearing loss, you might experience very different challenges. As always, it is important that you visit with your local hearing healthcare provider to get a better picture of your hearing and allow them to present appropriate options the help you hear better.

I'd like to know if there is a vitamin or herb to take for hearing loss?

Dr. Craig Kasper: There are a number of supplements currently marketed that target those in search of auditory longevity or to reverse a pre-existing hearing loss. A simple pill to prevent or reverse the effects of the aging process or noise exposure is an attractive concept with the potential of significant benefit for those affected. Unfortunately, there is no one (or group of) vitamin or supplement that has been proven effective in accomplishing this. Some interesting studies have been undertaken with vitamin B12, folic acid, vitamin C, vitamin E, n-acetylcysteine, D-methionine, and a combination of a number of vitamins, antioxidants and other compounds. But I believe more research is warranted before we will feel comfortable suggesting to patients that they take dietary supplements to help preserve hearing or reduce the effects of hearing loss. In the meantime, I would suggest the following:
1) read labels with a healthy dose of skepticism; if it seems too good to be true, it probably is
2) if you are considering taking dietary supplements, consult your physician to ensure there will be no interaction with any other medical conditions or medications
3) practice preventive hearing health; have your hearing tested regularly, protect your ears in noisy environments, eat healthy foods, omit smoking and lead a healthy life overall.

What is the outlook for the future for people like myself who have high frequency hearing loss? I wear hearing aids, but I still find understanding speech challenging in any situation.

Dr. Craig Kasper: Hearing loss in the high frequency regions is a common, and often frustrating, health issue. Oftentimes called "presbycusis", high frequency hearing loss will usually occur gradually over the course of a lifetime. Sounds in this frequency region include whistles, bird songs, keys jingling, and turning pages of a newspaper or book. When we refer to our ability to hear and understand conversation, the high frequencies play an important role. High frequency speech sounds include the consonants (f, s, th, p, etc.) and account for about 95% of the information of speech. If you have a hearing loss (even a mild one) in the high frequency regions, this would impair your ability to hear those consonant sounds. In the clinic, professionals will usually hear the complaint "I hear, but I don’t understand what is being said". This is a direct result of missing out on those high frequency speech sounds. Hearing aids have come a long way over the past few years, and there are certain styles of devices that are better suited to help those with this configuration of hearing loss. Assuming your hearing aids are relatively new (last 2 years or so), you may wish to revisit your hearing healthcare provider to ensure they are still the best option for your specific hearing loss. At that time, your provider may wish to retest your hearing and/or reprogram your current devices. Keep in mind, even with the ideal devices and the optimal fit, you may still experience some challenges in certain listening environments. Even people with normal hearing have some difficulty now and then. Finally, use your hearing aids and assistive listening devices as a component of communicating better. In challenging listening environments, take charge and situate yourself in a position at the dinner table or meeting that will help you communicate without significant effort. As for the future, it is difficult to predict, but with the tremendous strides that have been made recently in technology and service/rehabilitation models, my guess is that life will continue to improve for those with hearing loss as well as their loved ones.

I had pain on & off and now I have buzzing and hearing loss in left ear. Per doctor it was a slightly inflamed with no ear wax. Can this be reversed or treated?

Dr. Craig Kasper: As audiologists, whenever we are presented with a patient who is experiencing unilateral (one sided) hearing loss, pain and tinnitus (buzzing in the ear), we strive to understand (with the medical doctor) any potential underlying cause(s). The treatment that is ultimately prescribed will be dictated by the nature and cause(s) of those symptoms. If you have not already done so, I would recommend a comprehensive hearing evaluation by a licensed audiologist. Your audiologist should work with your physician to determine the specific tests necessary to help understand the cause(s) of your hearing loss, pain and tinnitus. Once they have that information, they will be better equipped to make a decision regarding your care.

Referred to ENT for ear pain/pressure hearing loss. Family Doctor said it was allergies. ENT said hearing aids would stop pain/pressure. Does not sound like good advice to me as I thought it was due to allergies.

Dr. Craig Kasper: Ear pain and pressure may be caused by a number of different issues including earwax, temporomandibular joint disorder (TMJ), infection of the ear canal, inner ear problems or nerve abnormalities. In my experience, hearing aids have not been shown to help and may actually be inappropriate in many of these cases. It strikes me that this might be more of a medically-treatable issue and I would suggest you first have a comprehensive hearing examination by a licensed audiologist to help determine the nature of any ear-related issues. That audiologist should then work collaboratively with your ENT physician who will plan the most appropriate course of action to manage your symptoms.

In the Army I fired 8-inch howitzers. Hearing tests at discharge were within normal limits. Hearing decline began 2-3 later; my hearing loss is now approaching profound. Can repeated exposure to impulse noises over 180 decibels be responsible?

Dr. Craig Kasper: Exposure to noises such as gunfire or artillery holds the potential to cause significant damage to our hearing structures if we do not wear hearing protection. The fact that your hearing was tested and shown to be within normal limits prior to your discharge from military service, leads me to believe the decline you experienced in your hearing 2-3 years later might not be directly related to exposure during your service. Although hearing loss as a result of noise exposure is cumulative over the course of time, there may be other factors you should consider with your audiologist and medical doctor. Our genetic composition, illnesses, occupational and recreational noise exposure and certain medications all contribute to the health of our hearing. It would be important to take into consideration all of these factors, including your military exposures, to help determine what might be contributing to your hearing loss. If it is possible to obtain a copy of your discharge hearing test, that piece of information may be very useful to your hearing healthcare team in helping provide more clarity to your question.

I suffered severe infection resulting in a temporary loss of hearing in my right earl and my balance has been affected. My specialist's best guess is that the vestibular nerve has been damaged. Rehap has not helped. Can you suggest an approach?

Dr. Craig Kasper: What you have described may be labyrinthitis, or an infection that affected your inner ear, hearing nerve and balance nerve. Labyrintihis may be caused by a bacterial or viral infection and may result in temporary hearing loss and severe vertigo. The symptoms of dizziness and imbalance usually do not resolve immediately, instead the balance system progresses slowly through a period of compensation. This may take months or years but patients usually benefit significantly through vestibular rehabilitation therapy. The symptoms are usually exacerbated when patients are under stress or feeling anxious. While I am not aware of a better approach to accelerate the compensation process, your physician may be able to modify your treatment or therapy to move you along the path to feeling better.

Can a person with scar tissue from surgey regain lost hearing after time?

Dr. Michaela Fuchs: In cases where scar tissue results from a middle ear surgery (tympanoplasty), the possibility exists that hearing could still (gradually) improve, usually in the first 6 months post-op (after the surgery).The ENT physician can determine this with a hearing test. A second operation could also be beneficial if middle ear problems are causing conductive hearing loss. If the inner ear (cochlea) is affected, also easily determined by a hearing test, then amplification with hearing instruments will likely be of benefit.

I have neuro-sensory deafness with tinitus on the R side caused by a CVA. Are there any new developments which might help me?

Dr. Craig Kasper: If your hearing loss (and associated symptom of tinnitus) occurred as the result of a CVA (cerebrovascular accident), a hearing aid may or may not be helpful in helping you hear better and possible help reduce your tinnitus. I assume you have had comprehensive ear, nose and throat as well as audiological evaluations. The outcomes from your hearing tests (degree of hearing loss, clarity of speech sounds, etc.) would help determine the level of potential benefit you may receive from a hearing aid. For some patients with tinnitus, appropriately fit hearing aids that are programmed to take into consideration any sound sensitivity issues, may also be helpful in reducing the buzz. In addition to enhancing hearing and environmental sounds through a hearing aid, some patients benefit from counseling or stress reduction techniques to reduce the impact of their tinnitus. Unfortunately, there does not exist a quick fix, but by working closely with your healthcare team you may be able to address these issues in a calculated manner.

My son had streptococcus pneumoniae bacterial minigitis two years ago. He was four at the time. His hearing was fine before he was released from the hospital. Recently he failed a hearing test. Could this be from the minigitis?

Dr. Craig Kasper: Hearing loss resulting from bacterial meningitis may vary in severity, may affect one or both ears and usually occurs during the acute stages of the illness. The type of hearing loss that results is sensory-neural in nature, usually affecting the inner ear and/or hearing nerve. If your son’s hearing was evaluated prior to his discharge from the hospital, and it was normal, the likelihood of the meningitis being the root cause of his current failed hearing test is not high. There are other potential causes that must be considered and investigated by your son’s medical doctor and audiologist. A comprehensive medical and audiological assessment would be recommended and it would be beneficial for you to bring previous hearing test results with you for comparison.

I have sound sensitivity, hyperaucis w/ hf hearing loss/tinnitus. In the future when hearing aids are necessary how will I be able to adjust to hearing aids while controlling this sensitivity?

Dr. Craig Kasper: Hyperacusis is a phenomenon whereby sounds in the environment may be comfortable to others but quite disturbing and/or painful to the sufferer. To help those with this problem, many audiologists will try to desensitize the auditory system. This could be accomplished through a calculated program of gradually reintroducing volume to the individual. Hearing loss, and the need for hearing aids, presents an interesting challenge for the audiologist and the hyperacusic patient. The bottom line is that the audiologist must frequently measure the patient’s levels of discomfort (or Loudness Discomfort Levels). They must also monitor closely how the hearing aids are programmed and insure the overall levels introduced into the ears will not approach the person’s level of discomfort. With patience and time, the hope is that those levels will actually increase (meaning get better) allowing the audiologist to provide the patient with appropriate prescribed amplification levels to address their hearing loss needs.

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Can anything other then surgery be done to restore hearing loss when hearing aids are not an option? Thank you

Dr. Craig Kasper: For most people managing hearing loss, there does not exist a special treatment that has the ability to restore the delicate structures of the hearing mechanism. Only 5-10% of hearing loss cases can be improved through surgery. For the remaining 90%+ of those with hearing loss, appropriately fit hearing aids are currently the best option to address the communication challenges faced on a daily basis.

With a test result of nearly perfect hearing, even though that's not my experience, would hearing aids even make a difference? A 3% difference (to get the one ear that tested at 97%, up to 100%) doesn't seem like it'd be noticeable. Thanks.

Dr. Craig Kasper: As you have described, even people with “normal” hearing may experience difficulties communicating. I would be interested in understanding the situations in which you are having trouble. Is it a highly reverberant space, or a crowded room? Do you have difficulty hearing a small child or your spouse across the table in a crowded restaurant? Many factors may contribute to our inability to hear throughout our days. In some cases, even slight to mild hearing loss will make it very challenging to communicate. It is also possible that you may experience difficulty separating speech from a background of noise. To answer these questions you would need to spend some time with your audiologist and possibly undergo some additional testing that will help your clinician understand how you process sound. In the end, a hearing aid might not be the best option for you at this juncture but you should discuss this with your audiologist once they have more information about your hearing abilities.

Is there help for single-sided deafness? After all...I don't LOOK handicapped, but it has made a serious impact on quality of life. The specialist I saw 3 years ago was not sensitive to single-sided deafness.

Dr. Craig Kasper: Single-sided deafness (SSD) may present you with a number of challenges in your everyday life. For example, you might encounter difficulties localizing sound in your environment (such as someone calling your name from across the street or understanding the direction of a horn from a car). For most people dealing with SSD, they face tremendous challenges when trying to communicate in noisy environments such as a restaurant or party.

There are a number of technologies that are available to help those with SSD "hear" from the side with hearing loss. First, there is a special hearing aid called a CROS, or contralateral routing of signal, device. A CROS hearing aid has components worn on both ears. A small microphone is placed on the "poor" ear and a receiver (speaker) on the "good" ear. The job of the microphone is to pick up sounds from the "poor" side and then wirelessly transmit the sound so it is heard in the "good" ear.

Second, there is an implantable device known as the BAHA (bone-anchored hearing aid). In the case of the BAHA, a small titanium post (similar to a dental implant) is implanted directly behind the "poor" ear. A small, digital hearing aid is then attached to the post, retrieves sounds from the environment, and creates small vibrations in that titanium post. In turn, those small vibrations are transmitted through the bones of the head, including the inner ear on the "good" side where sound is perceived. A surgical procedure is necessary for the BAHA, but an experienced audiologist can help you gain a feel for what you might experience through a simulation BAHA device.

Regardless what technology might be used, there are limitations to what can be accomplished. In order for us to truly localize sound and function optimally in noisy environments, it is necessary for both of our ears to have equal (or near equal) hearing ability. The use of a CROS or BAHA system does not replace the hearing on the "poor" side. For this reason, you should be aware of the following recommendations:
1) always be visually aware of potential hazards, for example when crossing the street
2) in noisy social environments, try to reduce the amount of noise by sitting off to the side of the room or having conversations away from the main source of noise
3) well lit environments will help your eyes fill in the blanks when your ears miss out
4) prevention of hearing loss for the "good" ear is paramount. Use of hearing protection in a noisy work environment or concert is highly recommended, and
5) annual hearing evaluations to monitor the health of your hearing is suggested as well.

Although there is not a perfect fix for those with SSD, the right combination of technology and communication strategies will help minimize the associated challenges.

What is Nadia?

Dr. Craig Kasper: Naida is the brand name of a powerful behind-the-ear hearing aid produced by the manufacturer Phonak. It was originally introduced a couple of years ago and has shown itself to be a wonderful option for those with hearing loss in frequency regions that were once thought to be “unaidable”. The Naida was the first hearing aid to offer an interesting technology called “Sound Recover”. Sound Recover allows the wearer to obtain critical high-frequency sound information by introducing those amplified sounds to their better hearing regions. Through consistent use (i.e. training of the brain through the hearing aids) wearers have been able to benefit from high-frequency sound information they would not have perceived through many other hearing aid technologies. In turn, this has enhanced their communication ability and their ability to monitor their own pronunciation of consonant speech sounds. For many, this also results in clearer speech production.

I lost most of my hearing due to a mass that was in my inner ear. I can only hear a little out of it now. I have tried a gizmo from Walgreens, and it is horrible. would a hearing aid be any different?

Dr. Craig Kasper: Countless devices have been introduced into the marketplace promising better hearing. Many patients might decide to pursue those over-the-counter products because they are relatively inexpensive, therefore there is little risk if it does not work properly for their hearing loss. In addition to the question of adequate gain (or if the device provides sufficient prescribed volume for your hearing loss), the intelligence of those in-store devices may not be equal to the sophistication offered by today’s digital hearing aids. Finally, the most important component of the equation is the fitting expertise of the licensed audiologist who will make sure your hearing aids are appropriate for your hearing loss, needs and pocketbook. It is the audiologist, who will ultimately help you succeed with hearing aids.

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Is it possible for continuous 127 decibel sound (measured from a vuvuzela) to have an effect on a 4 month old fetus? Can this sound affect the babies hearing, since I assume the hearing will still be developing?

Dr. Robert Beiny: At about 24 weeks, your baby's outer, middle, and inner ear — including the cochlea, the snail-shell-shaped tube in the inner ear where vibrations are converted into the nerve impulses we perceive as sound — are well-developed. By 27 to 30 weeks, your baby's ear is mature enough to start to respond to the sounds that filter through to him or her. The sounds, of course, are muffled — and not just by the physical barrier of amniotic fluid and your own body. In his or her fluid-filled home, a baby's eardrum and middle ear can't do their normal job of amplifying sounds.  So even sounds that are quite loud to you won't be for the fetus.

If the noise exposure is continuous for a long period of time then there is a raised chance of hearing damage but the situation you describe is highly unlikely.

My daughter is 3 years and 3 months old, she has a severe/profound hearing loss (better ear 95db) and relies on hearing aids. Will I hinder her progress if I delay an implant until she is around 6 years old?

Dr. Craig Kasper: From the information provided, it is not clear when your daughter first started using hearing aids and how effective they might be. The question of hindering her progress is not an easy one to answer. Your daughter’s overall success will depend on many factors including how well she utilizes her residual hearing, the benefit she currently gains through the use of her hearing aids, and the support network (professional and family) surrounding her. Because I am not close to the case my recommendation would be to have your daughter assessed by more than one audiologist/ ENT/ implant specialist as soon as possible. The result of those meetings will hopefully provide you with the information you require to make an educated decision.

My daughter's ASSR results are: right 60,70,95,100 and left 65,80,100. She is using Naida IIISP for 7 months. We discovered her hearing loos when she was 2,5 years old. Is it possible that she can hear almost everything with Naida?

Dr. Craig Kasper: The ASSR, or Auditory Steady State Response, is a test that may be used to help estimate hearing ability in patients who are unable to respond to traditional tests of hearing function. For example, it may be used to gain a better understanding of an infant’s hearing and may provide valuable information to help the audiologist appropriately fit hearing aids. In the case of a child with hearing loss, the importance of early detection and action cannot be emphasized enough. Additionally, the appropriate use of hearing aids, as well as the services necessary to help infants and young children make sense of sound, will serve as a catalyst for improved learning. The Naida SP is one hearing aid that has shown itself to be a wonderful choice, particularly for those with hearing loss that requires a more powerful hearing aid option. The device’s ability to represent high-frequency information (Sound Recover) has also been a good technology to help provide certain auditory cues that were not available in previous generations of hearing aids. It is important to understand though, no hearing aid (regardless how sophisticated it may be) will be able to restore hearing to what is considered “normal” function. It is the hope of the audiologist, and the goal of the fitting, to amplify sounds so that the wearer will be able to receive acoustic information in a range that will help them better perceive speech sounds. The wearer should also be more aware of environmental sounds for safety as well as other enjoyable sounds such as music.

Have you heared of Muckle Wells syndrome? I need all information. My daughter is most likely diagnosted with this disease. Its a rare disorder. Her brother is diagnosted with familial cold-urticaria. .

Dr. Craig Kasper: Although one of the characteristics of Muckle-Wells Syndrome is sensory-neural hearing loss, I am not an expert on the Syndrome. As with any health information resources (online or in print) it is important to make sure the information is up-to-date and accurate. One resource you may wish to investigate further is the National Organization for Rare Disorders (NORD) based in Washington, DC.

My 2yr old has had two abnormal ABRs. More specifically, the impressions section of the reports indicates abnormal ABR, ASSR and acoustic reflexes with normal OAE results, suggestive of a bilateral neural hearing loss. What does this really mean?

Dr. Craig Kasper: The hearing system is comprised of many different parts that work in concert and allow us to hear the sounds of life. The external and middle portions of the ear help to funnel and amplify sounds from our environment. In the inner ear, the mechanical sound wave is converted into electrical impulses. Those impulses are then transmitted through the hearing nerves to the brain, where we “hear” sounds. Generally speaking, the ABR (auditory brainstem response), and acoustic reflexes are tests that assess the neural function of the hearing system. Through the interpretation of ASSR (auditory steady state response) test results, the experienced audiologist can make some determinations regarding hearing abilities. The OAE (or otoacoustic emissions) is a test that looks at the hair cells in the inner ear, the epicenter of activity for converting the mechanical sound to the electrical impulse. In sum, based on the information you provided, your child has normal inner ear function but the neural auditory pathways are not functioning optimally. What you describe might be viewed as auditory neuropathy. In cases of auditory neuropathy, sound enters the outer, middle and inner parts of ear normally but the transmission of sound to the brain is abnormal. Depending on the specifics of your daughter’s case, her audiologist may recommend a variety of devices/ tactics to help her. Devices such as hearing aids, FM microphone solutions and cochlear implants have all been recommended for patients presenting with auditory neuropathy. Ultimately, a collaborative approach that incorporates the family and a team of knowledgeable professionals will be a key element in determining what is most appropriate for your daughter.

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Is there any help for sufferers of tinnitus? I have mild to moderate hearing loss, but it's the tinnitus that is really difficult. Thanks

Dr. Craig Kasper: Ringing in the ears is commonly known as "tinnitus". Sometimes it is described as a buzzing, hissing, or beating sound and may seem like it emanates from the ears, head or both. The key point to keep in mind is that tinnitus is not a disease or illness. Like pain, it is a symptom of an underlying problem. Often,  tinnitus sprouts as a result of changes to the hearing system, ultimately causing changes in the way the hearing centers of our brain interpret and manage sound. Other physical or physiological issues may also cause or exacerbate tinnitus. Something as simple as earwax may make tinnitus more pronounced. On the other end of the severity spectrum, neurological disorders may also serve as the underlying cause of tinnitus. Ultimately it is believed that we all experience ear or head noises to some degree, but for some of us the tinnitus becomes a severe disturbance. In cases where tinnitus is bothersome, there is evidence that the emotional centers of our brain become involved. Additionally, it has been found that stress contributes significantly to how aware and bothered we become of our tinnitus. At this point there is not one "cure" for this potentially bothersome symptom, but the management options (including sound therapy, stress management/ reduction and tailored counseling) have been shown quite effective in helping people manage their tinnitus to the point they no longer pay attention to it. For many people, the use of appropriately-fit hearing aids are enough to reduce the impact of their tinnitus. Of course, you should always consult with your physician and audiologist to investigate potential causes of tinnitus in your specific case.

I have constant ringing in my ears. I have been told that this is a sign of hearing loss. I can hear everything pretty good except certain tones.

Dr. Craig Kasper: What you are experiencing is called tinnitus. I encourage you to look back at previous questions/ answers on this website as you should find a wealth of information on this topic. Tinnitus is often a symptom of hearing loss. Other health issues may also result in the perception of a ringing, buzzing, hissing or beating type sound. A simple blockage of wax in the ear canal may contribute to the sensation of tinnitus, but it may also be caused by more severe problems such as neurological or cardiovascular disorders. Because of the broad range of possibilities it is important for anyone experiencing tinnitus to undergo a full medical evaluation and audiological assessment with a team of healthcare providers that understands tinnitus.

I have tinnitus and no hearing loss - does this indicate a cause other than cochlear hair cell damage/acoustic trauma? Is it possible to medically image the hair cells in my cochlear to determine/assess if significant hair cell damage is present?

Dr. Craig Kasper: Tinnitus without measurable hearing loss is very common and it is quite possible there may be a cause other than an inner ear abnormality. A standard hearing test will provide your audiologist with a basic understanding of your hearing ability. But if your hearing test results are considered normal, it is also important to have a test called otoacoustic emissions (OAEs). OAE is a very sensitive measure that will provide a clear understanding of subtle changes that may have occurred to the hair cell structures in your inner ears. OAE testing will reveal those subtle changes even before they are evident on a standard hearing test. As always, check with your licensed hearing healthcare provider when you have specific questions about your hearing and/ or tinnitus.

What causes high frequency ringing in both ears constantly?

Dr. Craig Kasper: Ringing in the ears is commonly known as “tinnitus”. Sometimes it is described as a buzzing, hissing, or beating sound and may seem like it emanates from the ears, head or both. The key point to keep in mind is that tinnitus is not a disease or illness. Like pain, it is a symptom of an underlying problem. Often, tinnitus sprouts as a result of changes to the hearing system, ultimately causing changes in the way the hearing centers of our brain interpret and manage sound. Other physical or physiological issues may also cause or exacerbate tinnitus. Something as simple as earwax may make tinnitus more pronounced. On the other end of the severity spectrum, neurological disorders may also serve as the underlying cause of tinnitus. Ultimately it is believed that we all experience ear or head noises to some degree, but for some of us the tinnitus becomes a severe disturbance. In cases where tinnitus is bothersome, there is evidence that the emotional centers of our brain become involved. Additionally, it has been found that stress contributes significantly to how aware and bothered we become of our tinnitus. At this point there is not one “cure” for this potentially bothersome symptom, but the management options (including sound therapy, stress management/ reduction and tailored counseling) have been shown quite effective in helping people manage their tinnitus to the point they no longer pay attention to it. Of course, you should always consult with your physician and audiologist to investigate potential causes of tinnitus in your specific case.

I know that I have some hearing loss, however my real problem seems to be that I have a constant steady noise in my head.

Dr. Craig Kasper: Ringing in the ears is commonly known as "tinnitus". Sometimes it is described as a buzzing, hissing, or beating sound and may seem like it emanates from the ears, head or both. The key point to keep in mind is that tinnitus is not a disease or illness. Like pain, it is a symptom of an underlying problem. Often, tinnitus sprouts as a result of changes to the hearing system, ultimately causing changes in the way the hearing centers of our brain interpret and manage sound. Other physical or physiological issues may also cause or exacerbate tinnitus. Something as simple as earwax may make tinnitus more pronounced. On the other end of the severity spectrum, neurological disorders may also serve as the underlying cause of tinnitus. Ultimately it is believed that we all experience ear or head noises to some degree, but for some of us the tinnitus becomes a severe disturbance. In cases where tinnitus is bothersome, there is evidence that the emotional centers of our brain become involved. Additionally, it has been found that stress contributes significantly to how aware and bothered we become of our tinnitus. At this point there is not one "cure" for this potentially bothersome symptom, but the management options (including sound therapy, stress management/ reduction and tailored counseling) have been shown quite effective in helping people manage their tinnitus to the point they no longer pay attention to it. Of course, you should always consult with your physician and audiologist to investigate potential causes of tinnitus in your specific case.

I have no low frequency in my left ear, it has a mid low hum. I am a musician its three weeks now. What shall i do? Thanks. John

Dr. Craig Kasper: As a musician, your hearing plays a significant role in your life and, possibly, livelihood. The hum that you describe is known as tinnitus and this is a symptom of an underlying problem, usually within the hearing system. As is the case with any sudden onset hearing loss, it is imperative that you seek the advice of your local ear, nose and throat physician and audiologist. There are many causes of sudden onset hearing loss and the sooner you are evaluated, the better.

Can 'pulsatile tinnitus' be caused by noise exposure? Also, can tinnitus that is caused by noise exposure occur without any hearing loss?

Dr. Craig Kasper: It is believed that pulsatile tinnitus may be associated with our circulatory system (blood flow, heart beat), a spasm of one of the muscles located in our middle ear or other underlying physiological activities. This is not to limit the possible contributing factors associated with pulsatile tinnitus. For this reason, it is important for you to consult with your physician (preferably an ear, nose and throat physican). They may recommend radiologic imaging studies to investigate any physical and/or physiological causes for your pulsatile tinnitus.

Regarding tinnitus without any hearing loss: even subtle changes that occur in the hearing system may result in the presence of tinnitus. In addition to a full medical evaluation, your comprehensive audiological evaluation should also include a very sensitive measure called otoacoustic emissions, or OAEs. OAEs measure the function of one type of hair cell in our inner ear. This test has been proven to unveil changes in the inner ear even before it might be noted on a standard hearing test.

My unilateral tinnitus started in 1994, just suddenly. No noise exposure or noisy job. It changes completely in direct proportion to my posture. It responds to whether I am vertical or horizontal and changes virtually every time. Any ideas ? Tx !

Dr. Craig Kasper: I’m curious to understand the quality of your tinnitus. Is it a tone or a buzz? Does it sound like a heartbeat? In my experience tinnitus can be modulated by many different things including visual gaze, jaw clenching and positional changes. In some cases (particularly with positioning) the changes in the quality or intensity of the tinnitus may be related to blood flow or circulatory changes. It is important to visit your ear, nose and throat physician (preferably one who understands the subtleties of tinnitus causes) for a complete medical evaluation. Your physician might place you in a variety of body, head and neck positions to determine what might be exacerbating or reducing your tinnitus. They may also order specific laboratory tests to check your hearing structures and visualize the circulatory system around your head and neck. It is important to remember that tinnitus is a symptom of an underlying issue, it is your healthcare provider’s responsibility to determine what that issue might be.

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My husband lost his hearing in the hospital from antibiotics used in his trach. He got a cochlear implant and can hear sound, but does not understand words, so I think his hearing loss is in his brain. Can his brain be retrained to understand words?

Dr. Craig Kasper: Certain medications have the ability to damage the delicate structures and hair cells of the inner ear. Unfortunately, once those inner ear structures have been damaged, there is no chance that they will regenerate themselves. As a result of the inner ear changes, the entire auditory system changes (including the hearing centers of the brain) due to the reduced auditory stimulation. A cochlear implant is a remarkable device that provides stimulation to the auditory system through electrical impulses. Although cochlear implant technologies have been available for several decades, and the processors have become very sophisticated, the device is not capable of replacing the normal hearing system. As a result, the rehabilitative component of your husband’s treatment becomes imperative to his success. Over time, his audiologist and therapist will work diligently with him to help retrain his brain to hear and make sense of the new types of sounds he hears.