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While children receiving chemotherapy routinely undergo hearing tests, adults don’t, and a new study by UC San Francisco reports for the first time that significant hearing issues often occur among adult survivors of the most common forms of cancer.

The researchers found that more than half the survivors in their study who had been treated with chemotherapy experienced significant hearing problems.

Previously, it was unknown how frequently survivors of breast, gastrointestinal, gynecologic or lung cancer suffered clinically meaningful levels of hearing loss and tinnitus (ringing in the ear).

The paper is published Wednesday, July 27, 2022 in BMJ Supportive & Palliative Care.

“While hearing loss associated with the administration of platinum drugs was reported in adults with testicular and head and neck cancer, our study is the first to demonstrate that hearing loss and tinnitus are highly prevalent problems in survivors of the four most common types of cancer,” said first author Steven W. Cheung, MD, a UCSF professor of Otolaryngology—Head and Neck Surgery.

“Another important and previously unknown finding from our study is that these high rates of hearing loss and tinnitus occur not only with platinum drugs, but with another class of chemotherapy drugs called taxanes,” he said. “Given that platinum and taxane-containing chemotherapy regimens are the ones most commonly used to treat the majority of cancers, these findings have huge implications for clinicians who treat cancer patients, as well as for cancer survivors.”

The study had 273 cancer survivors who were 61 years old on average and had completed cancer treatment about five years earlier.

The investigators found that more than 50 percent experienced significant hearing loss confirmed by an audiogram, a type of hearing exam, and more than 35 percent reported tinnitus.

Reflecting the negative impact that hearing loss and tinnitus can have on mood and social interactions, participants with hearing loss reported moderate to severe levels of impairment with routine activity, such as listening to television or radio, talking with family members and friends, or conversing in restaurants.

Those with tinnitus reported that this problem interfered with their ability to concentrate or relax, their mood and enjoyment of life, and their sleep.

The findings hold important implications for the care of cancer patients and survivors, said the investigators. Given that hearing loss and tinnitus are not assessed routinely in patients receiving chemotherapy for breast, gastrointestinal, lung and gynecologic cancers, and that many of these individuals may be experiencing some degree of age-related hearing loss, evaluations of hearing loss and tinnitus should be done prior to, during, and following chemotherapy administration, the authors said.

Additionally, the authors noted that because hearing loss is often underestimated, routine screening and follow-up should be done by hearing professionals. Individualized management plans for tinnitus require consultation with specialist clinicians.

Notably, while 31 percent of the participants denied having hearing loss, they were later found to have hearing impairment on audiometry.

“While individuals often underestimate hearing problems, our findings point to the need for cancer survivors to have their hearing tested,” said senior and corresponding author Christine Miaskowski, RN, PhD, a member of the UCSF School of Nursing and the UCSF Helen Diller Family Comprehensive Cancer Center. She is also a Fellow of the American Academy of Nursing in recognition of her achievements in nursing.

“Though the type of hearing loss that occurs with platinum and taxane drugs is permanent, patients’ hearing can be improved with the use of a hearing aid,” Miaskowski said. “Only 17 percent of the survivors in our study were using a hearing aid, which suggests that clinicians need to refer survivors for a hearing test on a routine basis.”

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Following a 90-day outreach period, the U.S. Department of Labor’s Occupational Safety and Health Administration’s Regional Emphasis Program for Noise Induced Hearing Loss will move into the enforcement phase beginning May 17, 2022. The emphasis program targets manufacturing industries with high rates of occupational hearing loss in Colorado, Montana, North Dakota and South Dakota.

Historically, hearing loss is the most recorded occupational illness in manufacturing, except for illnesses related to COVID-19 in 2020. In 2019, the Bureau of Labor Statistics estimated that potentially damaging noise levels put 18 million workers at risk and produced 14,500 cases of work-related hearing loss. Like many occupational injuries, work-related hearing loss is preventable when controls are implemented, proper protection is provided and required standards are followed.

“This regional emphasis program will help ensure manufacturing employers in Colorado, Montana, North Dakota and South Dakota do what is necessary to protect their workers from exposures to excessive noise and prevent permanent hearing loss.,” said OSHA Regional Administrator Jennifer Rous in Denver. “OSHA hopes the emphasis program will remind manufacturing industry employers to follow required safety standards and alert workers to the related hazards and reduce workplace injuries,” Rous added.

Excessive noise exposure has been shown to also cause increased physiological stress, muscle tension, loss of sleep and fatigue. Read more about how to control and reduce excessive noise exposure in the workplace.

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The number of tools used to caption words has been expanding in recent years. The tools are especially helpful for people with hearing loss who may not be able to use traditional hearing aids.

Captioning services used to be limited mostly to television shows. But in recent years, developers have created apps for phones and other electronic devices. These apps are making it possible for many people to use captioning technology wherever they go.

In the United States, hearing loss issues affect an estimated 40 million adults. Many people use hearing aids to fight the problem. But high-quality hearing aids can cost up to $5,000. The devices are often not covered by insurance and do not work for everyone.

Frank Lin is the director of the Cochlear Center for Hearing and Public Health at Johns Hopkins University in Maryland. He told The Associated Press that many people are not dealing with their hearing problems because of a lack of effective options.

“The solutions out there are clearly not a one-size-fits-all model and do not meet the needs of a lot of people based on cost, access, a lot of different things,” Lin said.

Industry experts say lower-cost quality hearing devices are currently being developed. But for now, only about 20 percent of people who could be helped by hearing aids use them.

Captions are usually a lot easier to access than hearing devices. They have started appearing in many more forms of media. These include videoconferencing apps like Zoom, television show providers like Netflix and social media services YouTube and TikTok. Captions can also be found in some movie theaters and at live event centers.

There are also several phone apps that provide captioning, such as Otter, Google’s Live Transcribe, Ava and InnoCaption. Some of these apps are aimed at people with hearing loss and use humans to improve the quality of the captions.

Otter and the Live Transcribe apps depend on a technology called automatic speech recognition (ASR). This system uses artificial intelligence to learn and capture speech.

ASR can produce mistakes or experience delays when transcribing spoken words. But many users and experts say the technology has greatly improved over the years.

While there are more offerings to help improve hearing, none of the solutions are perfect.

Toni Iacolucci of New York says she sometimes had difficulties when using Otter to transcribe during book club meetings. The captions were often not correct and did not identify individual speakers. This could make it hard to keep up, she said.

“It worked a little bit,” said Iacolucci, who lost her hearing nearly 20 years ago. After coming home, she would be so tired from trying to follow the meeting’s discussion that she had to lie down. “It just takes so much energy,” she said.

Otter said in a statement that it welcomes comments about its products from people who are completely deaf or have hearing issues. The company noted that it now provides a paid software assistant that can transcribe virtual meetings.

A new law that took effect in New York City on May 15 requires movie theaters to offer captioning on the screen for up to four show times per movie each week. Captions are also becoming increasingly available for live performances, as well.

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Expanded genomic sequencing may be an effective adjunct hearing screening to detect hearing loss among patients in the neonatal intensive care unit (NICU), according to a study published online July 11 in JAMA Network Open.

Yunqian Zhu, from National Children’s Medical Center in Shanghai, and colleagues examined the association between expanded genomic sequencing combined with hearing screening and detection of hearing loss as well as improvement in the NICU. The analysis included 8,078 newborns.

The researchers found that 52 of 240 newborns (21.7 percent) received a diagnosis of hearing loss. When expanded genomic sequencing was used, there was a 15.6 percent increase in cases of diagnosed hearing loss that were missed by existing newborn hearing screening. Genetic factors were identified for 39 of 52 patients with hearing loss, with GJB2 and SLC26A4 emerging as the most common genes identified. Compared with those without genetic findings, those with genetic findings experienced a more severe degree of hearing loss (21 profound, four severe, seven moderate, and seven mild versus two severe, four moderate, and seven mild). Patients with genetic factors had more bilateral hearing loss (100 versus 69.2 percent).

“Genetic factors associated with hearing loss need to be identified for the proper clinical management of hearing loss in patients,” the authors write.

Article originally appeared on MedicalXpress.

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Human papillomavirus (HPV) infection was associated with an increased risk for sudden sensorineural hearing loss (SSNHL), according to findings published in EClinicalMedicine.

According to the researchers, proposed mechanisms explaining the relationship between HPV infection and subsequent SSNHL included “direct viral invasion of the inner ear [or] …reactivation of latent virus within tissues of the inner ear,” and “a systemic viral infection that triggers an immune-mediated reaction or…stress response.”

Given these proposed etiologies, researchers conducted a population-based cohort study between January 2000 and December 2013 to determine whether HPV infection is associated with an increased risk for SSNHL. Patients with a prior diagnosis of HPV infection were propensity-score matched in a 1:2 fashion on the basis of age, sex, index year, and comorbidities against those with no history of HPV infection (controls). The primary outcomes included mortality and the time between initial HPV diagnosis and occurrence of SSNHL.

Among patients in the HPV (n=49,247) and control groups (n=98,494), the mean age was 33 years, the majority were women (51%), and the most common comorbidities included cervical disease, hypertension, and chronic liver disease.

The researchers found that patients in the HPV group were at increased risk for incident SSNHL vs those in the control group (incidence rate [IR], 3.24 vs 2.18 per 10,000 person-years). Similar results were observed after adjustment for patient characteristics, with a prior HPV diagnosis associated with a 37% increased risk for incident SSNHL (adjusted hazard ratio [aHR], 1.37; 95% CI, 1.07-1.74; P =.011).

Further analysis was conducted after stratification by age, sex, and comorbidities. For patients aged between 40 and 60 years, the risk for incident SSNHL was significantly increased among those in the HPV group vs those in the control group (IR, 5.44 vs 3.53; aHR, 1.50; 95% CI, 1.03-2.20; P =.037). Among patients in both groups, the occurrence of herpes simplex virus infection significantly increased the risk for incident SSNHL (aHR 1.78; 95% CI, 1.17-2.70).

A previous history of cerebrovascular disease was associated with a significantly increased risk for SSNHL among patients with HPV infection (aHR 4.59; 95% CI, 1.47-14.3; P =.009).

This study was limited as HPV and SSNHL diagnoses were made on the basis of diagnostic codes rather than clinical evaluation. Other limitations included potential confounding, limited generalizability, and that patients’ HPV vaccination status was not considered.

As these findings show that patients with HPV infection may be at increased risk for SSNHL, the researchers suggested a need for additional “…studies to explore the underlying mechanisms and to determine the potential efficacy of specific precautions.”

Article originally appeared on Infectious Disease Advisor

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There’s a health spiral associated with hearing loss. Hearing loss has more impact on an elderly person than you might think.

Whether it’s your dad, your grandmother, your spouse, or even you, we all know someone who suffers from age-related hearing loss. In fact, 50% of people older than 75 experience disabling hearing loss. Now, doctors are using cochlear implants to restore hearing and save lives.

102-year-old Irvin Poff survived WWII but is still feeling the impact 80 years later.

Ear surgeon, Akira Ishiyama, MD, says, “In the past when you’re flying a bomber, there really wasn’t any concept of hearing protection. Hearing loss, in this age group, is quite important to treat because it could deteriorate dementia or make dementia worse.”

A new study found people over 75 with hearing loss are nearly twice as likely to develop dementia and lose their cognitive abilities up to 40% more quickly than people without a hearing problem.

Until recently, someone Poff’s age would not be considered for a cochlear implant, which is a small electronic device that electrically stimulates the cochlear nerve, but now, he’s become one of the oldest people to receive this life-changing technology.

“We also have a technology to combine the use of a hearing aid and a cochlear implant called the hybrid technology. By both taking advantages of the hearing aid and an implant, we can help patients who have some hearing in a low frequency, but no hearing in the mid and higher frequencies.”

The combination of the two technologies took Poff’s hearing from 30 to 60%.

“My understanding of words is almost twice what it was before,” Poff explains.

Dementia is not the only risk factor associated with hearing loss. If you suffer a mild hearing loss you are three times more likely to fall, and suffer from cardiovascular disease, diabetes, and depression.

Article originally appeared on WFAB

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Can you imagine a time when hearing loss would be commonplace? When it would be more prevalent than not in a social setting? When it would be the new normal? Given demographic trends, we may be rapidly approaching such a time. This is driven by three important factors — (1) the median age of the U.S. population is increasing, (2) people are living longer, and (3) the higher incidence of hearing loss in older adults.

Hearing Health Care Will Be Increasingly Important

In the National Academies of Sciences’ report Hearing Health Care For Adults, the authors use demographics to demonstrate the increasing impact hearing health care will have from a social policy standpoint.

According to the report, in 1900, 4.1 percent of the U.S. population was 65 years or older, representing a little over 3 million people; by 2012, 13.7 percent of the population or 40 million people were 65 or older, and by 2060, 24 percent of the U.S. population is expected to be 65 or older. These trends are similar in other developed nations around the world.

Combined with the fact that people are living longer and the higher incidence rates of hearing loss in older adults, we may be approaching a time when hearing loss is the new normal among adults. Higher rates of noise pollution and ubiquitous earbud use may also make hearing loss more common across other age groups, although this could be offset by better-regulated noise levels in work settings.

Increasing Hearing Loss Prevalence Has Some Silver Linings

The trends are frightening, but the good news for those of us with hearing loss is that as hearing loss becomes more “normal,” social change is inevitable. I can imagine several positive developments.

1. Reduced stigma. When something is commonplace, stigma recedes. This would be wonderful news for people living with hearing loss and might push people to seek treatment for hearing loss more quickly. Currently, people wait an average of seven to ten years before seeking assistance.

2. Cheaper and more widespread access to hearing solutions. This is already in process as companies prepare for a new FDA category of over-the-counter hearing aids for people with mild to moderate hearing loss. With increased demand and new competitors entering the market, innovation and lower prices are likely.

3. Trendier hearing devices. When everybody has one, individuality will become more important, making hearing devices fair game for fashion. That will be fun.

4. Quieter spaces. Wouldn’t that be wonderful! Restaurants might begin turning down the music to attract older patrons. Movies and other theaters may also start turning down the volume while dialing the sound clarity.

5. Better hearing assistance everywhere. Captioning, looping, and other assistive technologies could soon become the norm. Maybe the captioning on live T.V. programs would also improve. As demand grows, new forms of hearing assistance for public spaces will likely result.

6. More regular screening by doctors. Changing demographics should lead to changes in the medical profession. Since earlier detection and treatment of hearing loss could help reduce associated health problems such as depression, a greater risk of falls, and a higher likelihood of dementia, we may see hearing screenings become a standard part of an annual physical.

7. Clearer speech patterns. With more people with hearing loss, enunciation and careful diction may again become the typical speech pattern. That would certainly make things easier to hear!

8. Increased emphasis on hearing research. This can only be good news. The more scientists learn about how hearing works (and doesn’t work), the more successful they will develop new cures and better ways to prevent hearing loss.

Article originally appeared on PsychologyToday

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Around 15 percent of the world’s population suffers from tinnitus, a condition which causes someone to hear a sound (such as ringing or buzzing) without any external source. It’s often associated with hearing loss.

Not only can the condition be annoying for sufferers, it can also have a serious effect on mental health, often causing stress or depression. This is especially the case for patients suffering from tinnitus over months or years.

There’s currently no cure for tinnitus. So finding a way to better manage or treat it could help many millions of people worldwide.

And one area of research that may help us better understand tinnitus is sleep. There are many reasons for this. First, tinnitus is a phantom percept. This is when our brain activity makes us see, hear or smell things that aren’t there. Most people only experience phantom perceptions when they’re asleep. But for people with tinnitus, they hear phantom sounds while they’re awake.

The second reason is because tinnitus alters brain activity, with certain areas of the brain (such as those involved in hearing) potentially being more active than they should be. This may also explain how phantom percepts happen. When we sleep, activity in these same brain areas also changes.

Our recent research review has identified a couple of brain mechanisms that underlie both tinnitus and sleep. Better understanding these mechanisms – and the way the two are connected – could one day help us find ways of managing and treating tinnitus.

Sleep and tinnitus

When we fall asleep, our body experiences multiple stages of sleep. One of the most important stages of sleep is slow-wave sleep (also known as deep sleep), which is thought to be the most restful stage of sleep.

During slow-wave sleep, brain activity moves in distinctive “waves” through the different areas of the brain, activating large areas together (such as those involved with memory and processing sounds) before moving on to others. It’s thought that slow-wave sleep allows the brain’s neurons (specialized brain cells which send and receive information) to recover from daily wear and tear, while also helping sleep make us feel rested. It’s also thought to be important for our memory.

Not every area of the brain experiences the same amount of slow-wave activity. It’s most pronounced in areas we use most while awake, such as those important for motor function and sight.

But sometimes, certain brain areas can be overactive during slow-wave sleep. This is what happens in sleep disorders such as sleep walking.

A similar thing may happen in people with tinnitus. We think that hyperactive brain regions might stay awake in the otherwise sleeping brain. This would explain why many people with tinnitus experience disturbed sleep and night terrors more often than people who don’t have tinnitus.

Tinnitus patients also spend more time in light sleep. Simply put, we believe that tinnitus keeps the brain from producing the slow-wave activity needed to have a deep sleep, resulting in light and interrupted sleep.

But even though tinnitus patients have less deep sleep on average than people without tinnitus, the research we looked at in our review suggests that some deep sleep is hardly affected by tinnitus. This may be because the brain activity that happens during the deepest sleep actually suppresses tinnitus.

There are a couple of ways the brain may be able to suppress tinnitus during deep sleep. The first has to do with the brain’s neurons. After a long period of wakefulness neurons in the brain are thought to switch into slow-wave activity mode to recover. The more neurons in this mode together, the stronger the drive is for the rest of the brain to join.

We know that the drive for sleep can get strong enough that neurons in the brain will eventually go into slow-wave activity mode. And since this especially applies to brain regions overactive during wakefulness, we think that tinnitus might be suppressed as a result of that.

Slow-wave activity has also been shown to interfere with the communication between brain areas. During deepest sleep, when slow-wave activity is strongest, this may keep hyperactive regions from disturbing other brain areas and from interrupting sleep.

This would explain why people with tinnitus can still enter deep sleep, and why tinnitus may be suppressed during that time.

Sleep is also important for strengthening our memory, by helping to drive changes in connections between neurons in the brain. We believe that changes in brain connectivity during sleep are contributing to what makes tinnitus last for a long time after an initial trigger (such as hearing loss).

Treating tinnitus

We already know that intensity of tinnitus can change throughout a given day. Investigating how tinnitus changes during sleep could give us a direct handle on what the brain does to cause fluctuations in tinnitus intensity.

It also means that we may be able to manipulate sleep to improve the wellbeing of patients – and possibly develop new treatments for tinnitus. For example, sleep disruptions can be reduced and slow-wave activity can be boosted through sleep restriction paradigms, where patients are told to only go to bed when they’re actually tired. Boosting the intensity of sleep could help us better see the effect sleep has on tinnitus.

While we suspect that deep sleep is the most likely to affect tinnitus, there are many other stages of sleep that happen (such as rapid eye movement, or REM sleep) – each with unique patterns of brain activity.

In future research, both the sleep stage and tinnitus activity in the brain could be tracked at the same time by recording brain activity. This may help to find out more about the link between tinnitus and sleep and understand how tinnitus may be alleviated by natural brain activity. The Conversation

Article originally appeared on Science Alert

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Millions of years ago, all mammals lived on land, but at some point, several species left land and evolved to a life in the sea: think of seals and whales, which today are adapted to life underwater.

The rest who remained on land have similarly adapted to a life on land, and it can hardly come as a surprise that we humans today hear better on land than underwater — which is the conclusion from a group of scientists in a new study. But the study also reveals surprising news about human hearing..

Jakob Christensen-Dalsgaard is an expert in animal hearing and in his laboratory at University of Southern Denmark, he tirelessly throws himself into hearing studies of animals such as cormorants, geckos, frogs, crocodiles — and now also humans. This time, together with Ph.D. student Kenneth Sørensen and biologist Magnus Wahlberg, also from University of Southern Denmark, and an expert in animal underwater hearing.

Decades of hearing tests

Since the 1950s, several different attempts have been made to measure human hearing underwater. The US military, for example, has had an interest in understanding how divers are affected by underwater explosions, and in general, the hearing tests have been very different.

Some subjects have been tested with diving equipment on, others with neoprene caps and still others with air-filled diving masks — all of which can affect the test subjects’ hearing.

“But common to all these scientific studies is that they all find hearing thresholds that are higher than the thresholds we have found in our new study, he says.

We hear as well as seals underwater

In the new study, in which 7 people participated, the average hearing threshold of 71 dB (3.5 mPa) is at 500 Hz. Hearing threshold is a measurement of which volumes you can only just hear.

“It is 26 dB lower than hypothesized in previous studies, so we must conclude that humans hear significantly better underwater than previously reported by science. In fact, the threshold at 500 Hz is in line with how well animals such as cormorants and seals hear underwater,” says Jakob Christensen-Dalsgaard.

Worth noting in this context is, that e.g., seals and dolphins — unlike us — can hear very loud sounds underwater — also sounds that humans cannot hear.

The previous studies hypothesized that the human ear underwater works by so-called bone conduction; that is, that the sound waves vibrate the skull. That hypothesis would fit the high hearing thresholds found in previous studies.

“But we believe that resonance in the enclosed air in the middle ear amplifies the sound and makes the ear more sensitive. We have also shown this in previous studies of cormorants, turtles, and frogs,” explains Jakob Christensen-Dalsgaard

You should not expect to be able to jump into the sea and orient yourself perfectly using only your sense of hearing, says Jakob Christensen-Dalsgaard: sense of hearing is not just about being able to pick up a sound. It is also about determining the direction of the sound — and this is very difficult for a person underwater.

“In air we can determine the sound direction within a few degrees, but in water there is an up to 90 degrees error margin. This is not so strange, because we are trained to react to the small time differences between the ears, which are due to the speed of sound in air. In water, the speed of sound is four times greater, and the time differences are much smaller,” Jakob Christensen-Dalsgaard explains, concluding: “The results tell us that humans have a reduced ability to determine the direction of sounds underwater, thus confirming that human hearing is not adapted to work well underwater.”