DrCraigKasper.com

Ask The Audiologist - Help With "Club Ear"

Q: My husband and I own a club located in New York City. When I work the bar, there are four very large speakers mounted directly behind me. On most nights I leave with my ears feeling full and they buzz well into the next day. Is this going to cause any long-term damage to my ears? If so, what could I do to protect myself?

A: Clubs and bars are notoriously loud. So loud, in fact, that the Mayor of New York City has introduced measures to keep the decibels from these establishments (and other acoustic irritants) at bay. What you describe is not uncommon. We have all left a loud club with our ears feeling dull and buzzing for a day or so. This is a sign that the sensory hair cells in our inner ears have been put into overdrive. Usually, after a day or so, things return to normal. This is known as a Temporary Threshold Shift (TTS). But over time and multiple overexposures to loud sounds, this temporary change in hearing becomes permanent. The buzzing you describe is called tinnitus and is often a by-product of damage to those inner ear hair cells. For millions of people, tinnitus is an ever-present intrusion that can significantly affect their overall well-being.

There is a simple way to reduce your chances of sustaining any ear damage from your work: turn down the volume from the speakers. Knowing this is not often the desirable solution, earplugs are your best bet. Although over-the-counter foam plugs will do the trick, they make it difficult to hear what others around you are saying. A better option is a plug made specifically for musicians. This is packaged in two forms: 1) generic, which you can pick up at any music store for under $15 and 2) custom fit, which will cost you around $150. For the custom plugs you will need to find an audiologist in your area to make molds of your ears. Both options offer you the protection you need and you shouldn't miss any orders at the bar. One final note, it might be worthwhile for you to offer this information to your employees. Better yet, present them with a gift of earplugs at your next staff meeting. Like you, they are exposed to an occupational hazard and will benefit from your insight.

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Effectiveness of Cognitive Behavioral Therapy for Tinnitus

Founded in 1993, the Cochrane Collaboration is a UK-based not-for-profit organization that is dedicated to making healthcare information readily available to the public. The organization recently released a meta-analysis of six randomized controlled studies that investigated the use of cognitive behavioral therapy for those with tinnitus. Cognitive behavioral therapy, or CBT, “uses relaxation, cognitive restructuring of thoughts and exposure to exacerbating situations in order to provide habituation”. CBT plays a role in several current tinnitus treatments. The Cochrane analysis revealed no significant difference in the subjective loudness of patients’ tinnitus, or in the associated symptoms of depression. However, the reviewers did uncover a significant improvement in quality of life (i.e. decrease of global tinnitus severity). The authors of the study concluded, “cognitive behavioral therapy has an effect on the qualitative aspects of tinnitus and contributes positively to the management of tinnitus”.

For more information on this study, visit The Cochrane Collaboration site.

Ask The Audiologist - Spin Doctors

This DrCraigKasper.com column explores questions presented by actual patients. If you have a question or comment, please submit it through the email address located on the “About” page. Questions may be featured in upcoming "Ask The Audiologist" segments.

Q: Over the past few months, my wife has been experiencing episodes of dizziness. Her doctor wants her to take a test called "ENG". What exactly is an ENG and what should we expect?

A: If your wife is experiencing dizziness, she is not alone. Dizziness is the second most common complaint heard in doctors’ offices and according to the National Institutes of Health, 70% of the US population will experience dizziness at some point in their lifetime. ENG stands for Electronystagmography. It is one of the first-line tests completed when a patient presents with symptoms of dizziness, vertigo or imbalance.

Many people have heard horror stories about the ENG and usually arrive for the evaluation with some level of anxiety. Patients believe the test might exacerbate their problem or they might leave feeling dizzy for days. The truth is, although your wife might experience some imbalance or dizziness during the test, she will most likely leave the office feeling fine.

The ENG test takes approximately one hour to complete and your wife will be asked to watch some lights on a screen, she will be placed in various head and body positions and either water or air will be passed in her ear canals. During testing, her eye movements will be monitored with either small recording electrodes placed around the eyes or through video goggles. Throughout the test, her clinician will be able to interpret those eye movements and translate them into a possible problem site somewhere within the complex balance system.

Once her physician obtains the results he or she will utilize that information as a piece to fill out the puzzle to understand what might be the underlying cause of the dizziness. Please keep in mind that dizziness can be a complex issue with numerous causes (including visual issues, inner ear abnormalities, joint problems, nervous system issues or a combination of any of the above). The ENG is just one of a number of tests her doctor might recommend. So don’t be alarmed if she is sent on for further evaluation to fine-tune the diagnosis.

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An Overlooked Health Issue.

Hearing loss currently affects over 500 million people around the world, and this number is poised to reach an astonishing 700 million by the end of this decade. Studies have demonstrated that untreated hearing loss leads to feelings of isolation, depression and anger and even has the potential to affect one’s level of income. Quality of life is altered on more levels than the obvious sound-based communication challenges.

Despite common thinking, hearing loss is not a disorder of “old age”. In fact, 65% of those with hearing loss are under the age of 65. Genetics, illnesses and over-exposure to high levels of sound contribute to the possibility that you or someone you love will sustain hearing loss. Everyone is at risk and with the sound levels in our world increasing on a daily basis, the likelihood we will experience damage to our hearing is higher than ever. These are not trivial issues and it is amazing to think that the health of the auditory sense does not receive more attention.