Questions and Answers on Hearing Loss & Hearing Aids

Verbal communication is the primary means of interaction for many. Hearing loss impedes that communication.

Audiologist Dr. Rutendo Chikuku discusses hearing loss and how hearing aids can help.
Questions and Answers on Hearing Loss & Hearing Aids
Featuring:
Rutendo Chikuku, AuD Palouse ENT & Audiology
Rutendo Chikuku, AuD, is an audiologist with Palouse ENT & Audiology in Pullman.  Dr. Chikuku completed her graduate externship year at the Medical University of South Carolina working mainly on an ongoing study investigating age-related hearing loss. Dr. Chikuku works with both the adult and pediatric population and performs most follow-up testing for the pediatric population from birth to three years old. Her special interests include electrophysiological testing, hearing conservation and she is passionate about hearing health awareness in the community.
Transcription:

Bill Klaproth: So, what happens during hearing loss and when are hearing aids necessary? You have questions, Pullman Regional has answers. Here to answer those questions on hearing loss and hearing aids is Rutendo Chikuku of Paluse ENT and Audiology and doctor of Audiology with Pullman Regional Hospital. Dr. Chikuku, thank you for your time. So what causes hearing loss?

Rutendo Chikuku, AuD, CCC-A: Yeah, so that’s a great question. So, a lot of things can cause hearing loss. Here at our facility, we’ll see people who come in with noise induced hearing loss. So maybe they haven’t been very good at wearing their hearing protection and they work with really loud power tools. Or in our community, we have a lot of people who do hunting and some recreational shooting. So, if people don’t wear protective devices, that will cause permanent hearing loss. So that’s noise induced hearing loss. We also have what we call age related hearing loss. As we get older, we tend to lose those higher pitches. So that’s just age-related hearing loss. There’s also what we call ototoxic hearing loss, which just means we’ll take medications. Sometimes people who have chemotherapy particularly or certain antibiotics that are detrimental or cause damage to hearing. We’ll catch those sometimes after they go through chemotherapy because that’s the most important thing to get the cancer away. But then some of those side effects will be hearing loss. So, there’s a gamut of things that can potentially cause hearing loss.

Bill: So, noise reduced, age reduced, and ototoxic. When it comes to age reduced, is it generally when someone gets over 50 or 60 that hearing loss occurs?

Dr. Chikuku: Yeah. So that’s a great a question. I mean for most of the time, it’s really good to get a baseline hearing test when people reach about age 50. So, age 50 is that kind of age demographic that people start to get all of these other checkups. They schedule their colonoscopies and all of that kind of testing. We want people to have a baseline hearing test at about 50 also. Then we can schedule either annual tests or every other year test to monitor what’s going with their hearing. If it’s remaining stable or if it’s getting worse over time.

Bill: So, when someone does lose hearing, is it generally in one ear that’s exposed to the noise if its noise reduced? Then when it comes to age reduced hearing loss, is it generally both ears at the same time?

Dr. Chikuku: So, age related hearing loss most of the time, the vast majority of age related hearing loss is in both ears. Sometimes we’ll get people come in with unilateral losses, but that’s a small percentage. Most of the time, the loss is in both ears.

Bill: At what point should someone see the doctor?

Dr. Chikuku: Yeah. I mean when people are having concerns. So, if people are hunters, if people are musicians—particularly a musician because that’s their livelihood that they have good hearing—it’s good to get a baseline at any time just to see what your hearing looks like so that we’re able to monitor that over a period of time. If people are just wondering how am I doing with my hearing, that’s also good to get a baseline. Most people will start noticing that they have trouble with speech understanding, particularly in background noise. Understanding phone conversations. If they go out to eat at restaurants, understanding just the conversation in the midst of that background noise starts to be challenging. So yeah. When you start noticing some of those symptoms. You know tinnitus also sometimes can be an indicator of hearing loss. So those are good tell-tale signs for people to come into our office and get a baseline hearing test and we can see what’s going on with their hearing.

Bill: So how do you diagnose hearing loss? Then at what point are hearing aids necessary?

Dr. Chikuku: Yeah. So, when people come in for a hearing evaluation, we go ahead and test different frequencies or pitches of their hearing. We want to test to see whether or not they're coming into our normal range. Or if they're outside our normal range, then they're falling in different degrees of hearing loss. So that’s how we’re testing the hearing aspect. When people have a hearing loss and they're a candidate for hearing aids, we recommend that they go ahead and at least go through a hearing aid trial. Sometimes people will come in and say well, if I go ahead and tell them that they are a candidate for hearing aids, people sometimes may be hesitant. They're like well I still feel like I'm doing okay, but the idea is you want to treat hearing loss with hearing aids sooner rather than later. People sometimes forget that they listen with their brain. So, you hear with your ear then you listen with your brain. That’s what I tell my patients.

So, the ear captures sound and then it goes to the brain for processing. When you have hearing loss, your brain isn’t getting the input from those particular pitches. Because of things like brain plasticity, your brain kind of reallocates that real estate for something else. Most of the time, it’s for the vision center. So maybe fast forward 10 years and then you decide to get hearing aids. You try to stimulate that part of the brain, it no longer is responding well to those tones because it’s reallocated to something else. So, the thing that suffers is your ability to understand speech, using those particular areas that have not been stimulated for long periods of time. So yeah. That’s why I always tell people to treat hearing loss sooner rather than later.

I’ll see a lot of patients. My youngest little kid in hearing aids was fit at 6 months. Then I have a patient who’s 101. Then I see everything in between. So, when people get hearing aids as soon as they're diagnosed—on average maybe young 50s people get their hearing aids—they do really well for the most part. Just the longer people wait. Sometimes I’ll see people maybe 85 and that’s their first set of hearing aids, but they’ve had hearing loss for 20 years. I mean they’ll still do well, but probably not as well as they would have done if they had gotten the hearing aids a little bit sooner. So yeah. The goal of hearing aids, I’ll tell patients, is that they do better with hearing aids, but they will not restore normal hearing. I always want to throw that in there also.

Bill: So, once it’s gone, it’s gone then. So better to get those hearing aids sooner as well. Well, that’s great advice Dr. Chikuku. Do hearing aids help with tinnitus? I hear a lot about that and the ringing in the ears. Tell us about that.

Dr. Chikuku: Yeah, that’s a great question. It’s a question that quite a few patients come in wondering. With tinnitus, we have people who once they wear hearing aids, it resolves that situation. It resolves that ringing or that buzzing that people perceive in their ear, but there really isn’t a good rhyme or reason if I can put it that way. The research is still in progress with that because it’s literally a coin toss. I’ll have 50% of my patients that say, “Oh yeah that feels a lot better. Whenever I have my hearing aids on, I don’t hear the ringing.” But then I’ll also have the other 50% that says, “Well, it’s awesome. I hear better. I can understand speech a lot better, but I can still hear the ringing.”

So, it really depends. From the research is still working on finding better answers for that. So, it’s really… Until you try the hearing aids and see, I don’t really have an answer for a general question like that. So, it’s pretty patient specific.

Bill: Right. So, depending on the person, it may help, it may not. It’s all individualized like you say. Then what is the connection between hearing loss and dementia?

Dr. Chikuku: So yeah. That is very recent research. Probably the core researcher of that, they started looking at that maybe 10 years ago where they were noticing more correlation. I like that word better. If people with dementia also had hearing loss, then they were finding that those people deteriorated faster. So, the essential discussion or the take home message was for people to remain engaged. When people can't hear, they're detached. This is for anybody whether or not they have dementia. You retract because you aren’t able to hear what other people are saying and communicate effectively. So, the social health or well being of your life is affected in that way. So, when people have dementia, you’re retracted anyway, and hearing loss contributes to that. So, they find that that deterioration goes down a little bit quicker. The take home message was if you have dementia and hearing loss, it’s strongly encouraged to be able to treat that so that dementia doesn’t deteriorate as rapidly.

Bill: So just another reason to get those hearing aids, to stay engaged.

Dr. Chikuku: Exactly right. Exactly right.

Bill: Well that makes sense. Dr. Chikuku, thank you so much for your time today. For more information, visit pullmanregional.org. That’s pullmanregional.org. This is the Health Podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.