The Importance of Over-the-Counter Hearing Aids to the Future of Hearing Health Care

Hearing loss has often been perceived as an inevitable, and hence, relatively inconsequential part of aging. In other words, if hearing loss is so common, how could it be important?

https://www.flickr.com/photos/bazzadarambler/5380504422/

Image source: bazzadarambler – Flickr // CC BY 2.0

Over the past seven years, epidemiologic research from Johns Hopkins University, as well as from other institutions around the world, has demonstrated that hearing loss, while being a usual aspect of aging, is not without consequence. For example, these studies have shown that individuals with hearing loss are at a greater risk of developing dementia, falling, and being hospitalized.

These links are not purely by correlation or chance, but likely the result of mechanisms through which hearing loss increases the risk of these adverse outcomes. These mechanisms include the “load” that hearing loss puts on the brain, reduced auditory stimulation contributing to faster brain aging over time, and the loss of social connectedness that comes with not being able to easily communicate.

These research findings have served as a wake-up call to policymakers given that addressing hearing loss could potentially lead to real and tangible benefits that would
help reduce the risk of dementia and other important costly health outcomes.

Full reference: Lin, F.R. (2017) Where We Are and Where We’re Headed: The Importance of Over-the-Counter Hearing Aids to the Future of Hearing Health Care. Hearing Loss Magazine. May/June 2017 p.18-23

Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma

Outcomes for endoscopic ear surgery (EES) for pediatric cholesteatoma at a tertiary pediatric hospital.

Methods: Retrospective case series of 65 pediatric cholesteatoma cases in 38 ears. Subgrouping based on cholesteatoma type and EES type. Surgical findings, outcomes, and demographic data were evaluated.

Results: Endoscopes were used in 65 pediatric cholesteatoma cases in 38 primary ears (34 patients), followed for an average of 2.6 years (9 months to 4.6 years). The endoscope was used as the primary visualization tool in 31 (81.6%) ears (EES 2 or 3), and as an adjunct to the microscope in seven ears (EES 1). Twenty-two (57.9%) ears and 35 (53.4%) cases were transcanal endoscopic ear surgery (EES 3 or TEES). Overall, there was recurrence in five (13.2%) ears and residual in four (10.5%) ears. Cholesteatoma was acquired in 27 ears, with average age 10.9 years; and congenital in 11 ears, with average age 3.8 years. Surgical time was longer for acquired cases (226 vs. 154 minutes). Hearing outcomes were comparable for both cholesteatoma types. Residual disease was seen in three (11.1%) acquired ears and one (9.1%) congenital ear. Overall, the lowest rates of recurrent and residual disease were seen in EES 3 cases, and relatively low rates in EES 2 and 3 ears, including four (12.9%) recurrences and two (6.5%) ears with residual disease.

Conclusion: The endoscopes are a viable tool for resection of pediatric cholesteatoma and provide excellent visualization of the middle ear and associated recesses.

Full reference: Ghadersohi, S. et al. (2017) Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma. The Laryngoscope. Published online: 23 May 2017

Hearing Impairment and Incident Frailty in English Community-Dwelling Older Adults

Hearing impairment is common in later life and is estimated to affect 20% of adults in Great Britain aged 60 and older. Age-related hearing impairment has been associated with comorbidity, disability, and poor quality of life, affecting independent living and overall well-being

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Image source: Franck Michel – Flickr // CC BY 2.0

Objectives: To examine the association between hearing impairment and incident frailty in older adults.

Design: Cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing.

Participants: Community-dwelling individuals aged 60 and older with data on hearing and frailty status (N = 2,836).

Measurements: Hearing impairment was defined as poor self-reported hearing. Having none of the five Fried frailty phenotype components (slow walking, weak grip, self-reported exhaustion, weight loss and low physical activity) was defined as not frail, having one or two as prefrail, and having three or more as frail. Participants who were not frail at baseline were followed for incident prefrailty and frailty. Participants who were prefrail at baseline were followed for incident frailty.

Conclusion: Hearing impairment in prefrail older adults was associated with greater risk of becoming frail, independent of covariates, suggesting that hearing impairment may hasten the progression of frailty.

Full reference: Liljas, A.E.M. et al. (2017) Self-Reported Hearing Impairment and Incident Frailty inEnglish Community-Dwelling Older Adults: A 4-YearFollow-Up Study. The Journal of the American Geriatrics Society. 65(5) pp. 958–965,

The Action Plan for Hearing Loss in Wales

This framework sets out what NHS Wales wants to achieve in an integrated health and social care system for D/deaf/people living with hearing loss.

The Framework is in three parts:

  • Part 1 introduces the overarching vision and the outcomes the authors want to achieve for people who are D/deaf or living with hearing loss.
  • Part 2 sets out specific actions that will help to improve and deliver sustainable and equitable integrated health and social care services nationally.
  • Part 3 specifies the leadership and monitoring arrangements.

Full document: Integrated Framework of Care and support for people who are D/deaf or living with hearing loss

Improving Deaf people’s access to mental health services

As many as two in three Deaf people in the UK struggle with mental health problems, but most find it too difficult to access psychological therapy.

Guidance for commissioners of primary care mental health services for deaf people from the Joint Commissioning Panel for Mental Health (JCPMH) and Deaf health charity SignHealth, calls for improvement to deaf people’s access to mental health services.

Despite having poorer mental health than the rest of the population, the 60,000 people across the UK who use sign language as their main language often come up against barriers when seeking mental health services.

The guide’s recommendations for commissioners of primary mental health services could make a dramatic change to the mental health of many Deaf people.

Audiometer apps: reliability & potential

Megan Corry, Michael Sanders, and Grant D. Searchfield. The accuracy and reliability of an app-based audiometer using consumer headphones: pure tone audiometry in a normal hearing group.  International Journal Of Audiology.  Published online: 09 May 2017.

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Objective: To undertake a preliminary evaluation of the test–retest reliability, and accuracy of an iPad audiometer app using commercial earphones as a low-cost alternative to a clinical audiometer in a restricted sample of normal hearing participants.

Design: Twenty participants self-reporting normal hearing undertook four pure-tone audiometry tests in a single session. Two tests were performed with a 2-channel Type 1 audiometer (GSI-61) using EAR insert earphones and two tests with an iPad based app (Audiogram Mobile) using Apple earbud headphones.

Study sample: Twenty normal hearing participants (13 female and seven male participants, aged 21–26 years) were recruited for the test–retest and accuracy evaluations. Results: The app resulted in different thresholds to the audiometer (F(1, 19) = 16.635, p < 0.001). However test–retest reliability was similar. The app froze or quit unexpectedly over 25% of times used.

Conclusions: Audiometer apps have great potential for clinical settings, especially in resource scarce environments, but reliability should not be assumed. While a low cost-alternative to standard transducers, issues of accuracy and calibration of consumer headphones need to be addressed before such combinations can be used with confidence.

Changes in Psychosocial Measures after a 6-Week Field Trial

Jamie L. Desjardins and Karen A. Doherty. Changes in Psychosocial Measures after a 6-Week Field Trial American Journal of Audiology. Published online 9th May 2017
Purpose

The purpose of this study was to assess the extent to which intervention with hearing aids, namely, a 6-week hearing aid field trial, can minimize the psychosocial consequences of hearing loss in adults who have previously not sought treatment for their hearing loss.

Method

Twenty-four adults with mild to moderate bilateral sensorineural hearing loss, who had never worn hearing aids or sought help for their hearing loss, participated in this study. Participants were fitted with receiver-in-canal hearing aids, bilaterally, and wore them for 6 weeks. Participants completed subjective measures of hearing handicap and attitudes about hearing loss and hearing aids before, during, and after the hearing aid trial. A control group of age-matched participants followed the same experimental protocol, except they were not fitted with hearing aids.

Results

Using hearing aids for 6 weeks significantly reduced participants’ perceived stigma of hearing aids, personal distress and inadequacy due to hearing difficulties, and hearing handicap.

Conclusions

A hearing aid trial can have a positive effect on a person’s attitudes toward wearing hearing aids and decrease hearing handicap.