10/23/2018 WE REALLY USE THE BRAIN TO HEAR; GIVE YOUR CLIENTS THE TOOLS TO COMMUNICATE STRESS FREE!!! Susan Antonellis, Au.D. CCC-A/F-AAA Director of Audiology Center for Hearing Health Program of Mill Neck Services INTRODUCTIONS • SPEAKER • AUDIENCE • Who are your clients??? • What is your client base??? • Types of procedures seen??? STRESS HAS NO AGE LIMIT OR GENDER!!!!!!! 1
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10/23/2018 Cochlear .org Hearing is thinking. You hear with your brain , not with your ears. Hearing , and especially speech understanding, is a cognitive process, not a mechanical one. The ears receive sounds and it is in the brain that they are processed to give meaning to you. RESEARCH SHOWS!!! cognitive hearing science . • This field examines the way our minds process the auditory signals being sent to the brain, factor in the complexity of what we’re listening to, and adjust to the quality of listening conditions. • The findings hold significance for people with hearing impairments • Long-term effects of insufficient bottom-up signal processing may affect what is stored in the brain • (Ronnberg, J., 2/2016) 4
10/23/2018 Cognitive hearing science is not just about auditory aspects of speech but also relates to lip reading and to visual language, such as sign language. It also includes cross-cultural comparisons of tests and tools that address the mechanisms involved in auditory perception. “ It really doesn't seem fair: Hearing loss , a troublesome fact of life for more than 48 million Americans, according to the Hearing Loss Association of America, may increase the risk of cognitive problems and even dementia . By the time Americans reach their 70s, two-thirds have hearing loss. ” STATISTIC BRAIN & HEARING • Hearing affects the brain Speech understanding is a cognitive process – it happens in the brain. Research shows, that untreated hearing loss is associated with accelerated cognitive decline and a higher risk of dementia. The greater the untreated hearing loss, the greater the risk of dementia. (Oticon, 2016) 5
10/23/2018 HOW DOES OUR HEARING WORK? • YOUR EARS PICK UP SOUNDS AROUND YOU AND THEN TRANSLATE THE AUDITORY STIMULI INTO INFORMATION YOUR BRAIN CAN UNDERSTAND. • THE IMPORTANT THING TO REMEMBER IS THIS PROCESS IS COMPLETELY MECHANICAL — WHILE OUR OTHER SENSES INVOLVE CHEMICAL REACTIONS — HEARING IS COMPLETELY PHYSICAL. THE PROCESS • The pinna serves to catch the sound waves. It has many curves and its’ structure helps you determine direction of sound. The way it bounces off the pinna alters the pattern of the sound wave. Your brain recognizes the change in patterns and determines whether the sound is in front of you, behind you, above you or below you. THE EAR CATCHES THE SOUND WAVES! • THE EAR NEEDS TO DO THREE BASIC THINGS: • 1-DIRECT THE SOUND WAVES INTO THE HEARING PART OF THE EAR. • 2-SENSE THE FLUCTUATIONS IN AIR PRESSURE. • 3-TRANSLATE THESE FLUCTUATIONS INTO AN ELECTRICAL SIGNAL THAT YOUR BRAIN CAN UNDERSTAND. 6
10/23/2018 SOUND THEN TRAVELS TO THE MIDDLE EAR • The sound waves then travel down the ear canal and then vibrate the tympanic membrane — more commonly known as the eardrum. • The eardrum is positioned between the ear canal and the middle ear. SOUND THEN TRAVELS TO THE MIDDLE EAR • The eardrum is rigid and sensitive--- it is attached to the tensor tympani muscle, which constantly pulls it inward. • This keeps it tight so it will vibrate no matter which part of it is hit by a sound wave. • THE EARDRUM IS THE ENTIRE SENSORY ELEMENT IN YOUR EAR. THE COCHLEA • The cochlea is in the inner ear and conducts sound through a flluid, instead of through air. • Of course it is harder to move through fluid than through air, so the sound has to be amplified. 7
10/23/2018 THE COCHLEA • That is the job of the ossicles — the tiny bones in the middle ear — in fact they are the smallest bones in the body. “ THE COCHLEA IS THE MOST COMPLEX PART OF THE EAR! • Its job is to take the ” physical vibrations caused by the sound wave and translate them into electrical information that the brain can recognize as distinct sound. SENSORINEURAL HEARING LOSS • THIS TYPE OF HEARING LOSS IS ONE IN WHICH THE INNER SYSTEM IS AFFECTED. • BOTH AIR CONDUCTION AND BONE CONDUCTION IS AFFECTED EQUALLY ON THE AUDIOGRAM. • IT VARIES IN DEGREE. • IT IS USUALLY IRREVERSIBLE. • IN OLDER ADULTS WE REFER TO IT AS PRESBYCUSIS. 8
10/23/2018 CAUSES OF SENSORINEURAL HEARING LOSS • PRESBYCUSIS • SPOUSACUSIS • LABRYNTHITIS • ADOLESTHITIS • NOISE INDUCED HEARING LOSS • HEAD TRAUMA • OTOTOXICITY • ACOUSTIC NEUROMA Presbycusis *Hearing loss due to aging. *Usually a sloping hearing loss. *Poor understanding of speech. *Difficulty hearing in noise. 9
10/23/2018 THE PARTNERSHIP SPOUSACUSIS NOW HEAR THIS!!! WHAT DO YOU MEAN?? CAN YOU HEAR THIS?? I HEAR JUST FINE!!! YOU MUMBLE! NOISE INDUCED HEARING LOSS 10
10/23/2018 CENTER FOR DISEASE CONTROL AND PREVENTION, FEB. 2017 • Hearing loss is the third most common chronic health condition in the US. Almost twice as many people report hearing loss as report diabetes or cancer. • Noise exposure away from your job can damage your hearing just as much as working in a noisy place. • Being around too much loud noise — like using a leaf blower or going to loud concerts — can cause permanent hearing loss. And once it’s gone, you can’t get it back! More about noise…. . • About 40 million US adults aged 20-69 years have noise-induced hearing loss. • More than 1 in 2 US adults with hearing damage from noise do not have noisy jobs. • About 1 in 4 US adults who report excellent to good hearing already have hearing damage. LET’S SUMMARIZE THUS FAR!!!! HEARING LOSS CAUSES MANY SOME PEOPLE ARE AT HIGHER PROBLEMS. RISK FOR HEARING LOSS, INCLUDING THOSE WHO: 1. are exposed to loud sounds at home and in the community. • Continual exposure to noise can cause stress, anxiety, 2. work in noisy environments (especially • depression, high blood pressure, heart noise of 85 dB or more for 8 hours or longer). disease, and many 3. take medicines that increase their risk. • other health problems. 4. are male. 5. are age 40 or older. 11
10/23/2018 OTOTOXICITY Drugs that can cause hearing loss: MYCIN DRUGS: -Gentamycin -Kanamycin -Neomycin (found in many OTC antibiotic ointments) DRUGS CAUSING TINNITUS: -Cancer Medications -Some Diuretics -Salicytates SPEECH H RECOGNIT NITION N SCORE RE SRS OR WRS • INTELLIGIBILITY • DISCRIMINATION • ABILITY TO UNDERSTAND SPEECH SOUNDS • ASSISTS IN DETERMINING A GOOD HEARING AID CANDIDATE. 12
10/23/2018 HEARING LOSS AND ITS RELATIONSHIP TO AGE In Jan. 2014-Health Day News reported in a new study suggesting that older adults with impaired hearing may have a faster rate of brain shrinkage as they age. Many studies have found that older people with hearing loss tend to have a quicker decline in their memory and thinking skills, compared to those with normal hearing. 13
10/23/2018 Dr. Lin’s Findings from Johns Hopkins University in Baltimore • Older adults with hearing problems lose brain volume more quickly than their peers with normal hearing. • The big question---Dr. Lin said — Does treating hearing impairment slow changes in the brain structure and more importantly delay dementia? • He is planning a trial to test that idea. THE STUDY • Results are based on 126 adults ages 56-86 who underwent annual MRI scans to track brain tissue changes for up to 10 years. • At the time of the first scan-a hearing test was performed and a physical. • 51 of the participants showed some degree of hearing loss-majority of mild degree. • Dr. Lin’s team found that older adults with hearing problems showed a faster decline in brain volume over years---especially in brain regions involved in processing sound and speech. CONCL CLUSIO SIONS “USE IT OR LOSE IT” 14
10/23/2018 Things to think About!!! • The study is interesting---does treating hearing loss prevent brain tissue loss and slow mental decline. • Dr. Ian Storper , an otologist from Lenox Hill Hospital says “ we need a study to test that and it has yet to be done.” • Even though we have found a link between hearing loss and mental decline — we still have not proven causation. REPEAT THESE WORDS IN ORDER!!!! ONION TOMATO FRENCH FRIES PICKLES HAMBURGER BUN LETTUCE KETCHUP New Research Links Alzheimer’s and Hearing Loss 15
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