Do you or someone you love suffer from hearing loss? Hearing loss can be frustrating and debilitating. It can seriously impact a person's quality of life and is some cases, even become life-threatening.
Dr. Jed Kwartler, board-certified otologist/neurotologist and director of Summit Medical Group's Ear Specialty Center, talks about the signs and symptoms and diagnosis and treatment of hearing loss.
Selected Podcast
Hearing Loss
Featured Speaker:
Past President of the New Jersey Academy of Otolaryngology, Dr. Kwartler is a member of the American Academy of Otolaryngology-Head and Neck Surgery, New Jersey State Hearing Evaluation Council, North American Skull Base Surgery Society, American Neurotology Society, and New Jersey Speech, Language, and Hearing Association. He has been an advisor to the organization, Hearing Education Awareness for Rockers (HEAR).
Ear Specialty Center - Summit Medical Group: Dr. Kwartler
Jed Kwartler, MD
Jed A. Kwartler, MD, is Director of Summit Medical Group Otology/Neurotology. Recognized as a leading ear surgeon in the New York metropolitan area, Dr. Kwartler performed New Jersey's first cochlear implant in a child in 1993. He is an advocate for adults and children who are hard of hearing and he supports hearing testing for newborns. In addition to his position at Summit Medical Group, he is Clinical Associate Professor of Otolaryngology at the University of Medicine and Dentistry of New Jersey in Newark.Past President of the New Jersey Academy of Otolaryngology, Dr. Kwartler is a member of the American Academy of Otolaryngology-Head and Neck Surgery, New Jersey State Hearing Evaluation Council, North American Skull Base Surgery Society, American Neurotology Society, and New Jersey Speech, Language, and Hearing Association. He has been an advisor to the organization, Hearing Education Awareness for Rockers (HEAR).
Ear Specialty Center - Summit Medical Group: Dr. Kwartler
Transcription:
Hearing Loss
Melanie Cole (Guest): Do you suffer from hearing loss? Do you know someone, a loved one, who suffers from hearing loss? You might not realize it, but it can be one of the most frustrating and debilitating conditions out there. It frustrates your loved ones, it frustrates yourself. It can make you a bit disoriented. It can be quite complicated. My guest is Dr. Jed Kwartler. He’s Director of Group Otology and Neurotology at Summit Medical Group. Welcome to the show, Dr. Kwartler. Let’s speak about hearing loss. First of all, what do you see as the main cause of hearing loss?
Dr. Jed Kwartler (Guest): I believe, Melanie, the main cause of hearing loss is just getting older. We all do lose a little bit of hearing as we age. In fact, over age 65, about one out of three people have hearing loss. I would say age is the most common thing. If I were to give a second thing, it would probably be exposure to noise, either chronic exposure to noise or what we’ll call acoustic trauma, something like a firecracker or a gunshot or some type of explosion. Those would probably be the two biggest things that cause hearing loss.
Melanie: Well, I know that every parent listening, Dr. Kwartler, would just like the answer to the question, “If we watch and wait with ear infections, can that cause hearing loss?”
Dr. Kwartler: First of all, most ear infections are middle ear problems. They cause hearing loss because you got fluid in the ear and in general, it’s not going to cause a permanent nerve or inner ear type of hearing loss. So watching and waiting, particularly if you’re just waiting to see if fluid goes away, is really actually not a problem.
Melanie: Okay, so back to age-related hearing loss. It starts to happen, maybe you’re in your 70s, maybe you’re lucky and it doesn’t start to happen until you’re in your 80s or beyond, you go to see a man such as yourself or an auditory specialist. Now we see these popping up in various medical practices. How can you categorize the amount of hearing loss? Is it still sort of what we used to picture as the old-fashioned hearing test with the beeps in our ear? Is it much more sophisticated now? How can you tell the degree?
Dr. Kwartler: Great question. It is still that way that you characterized it, sort of older fashioned way of the things with the beeps and raising your hand or pressing a button to indicate that you’ve heard it or not heard it. That’s one part of a hearing test called a pure toned threshold that does determine how much you hear and what volume you hear at a particular frequency. There are other parts of a complete audiometric evaluation that assess how the nerves are actually functioning within the inner ear, something called an otoacoustic emission. There are other parts of the test also in terms of just testing your intelligibility, your ability to repeat back words. Taking all of that information together, you can characterize hearing loss into hearing loss as mild to moderate to moderately severe to more severe types of hearing loss. Based on that set of tests also, you can kind of predict pretty reasonably how well someone’s going to do with something like amplification, some type of hearing aid device, or whether they need some other kind of treatment.
Melanie: Now, really when you see people that are starting to lose their hearing, how frustrating do they feel that this is? Because people think, “Oh, well, being blind would be much worse.” But for someone who is losing their hearing, anything, crossing a street, walking through an airport, anything can be a little disorienting as you’re missing the sounds of someone running by you or anything.
Dr. Kwartler: Well, you’re absolutely right. The impact of hearing loss is tremendous. In fact it’s interesting that you led with part of the question about choosing deafness or blindness. Helen Keller actually would prefer to be blind rather than deaf. She said that the blindness only cuts you off from your immediate surroundings whereas deafness cuts you off from interactions with people.
Melanie: How interesting.
Dr. Kwartler: Hearing is really important. If you just think for two seconds how sound dependent our life is. Here we are talking on the telephone, people are listening on the radio; communication is oral, using our mouth, not our hands, not sign. We don’t read teleprompters. We talk to people although I guess, at least my kids, probably text to each other when they’re sitting even next to each other, in this day and age of smartphones. But speech is really critical. The ability to communicate orally is very important and therefore, hearing is really important. There are all sorts of impact on income. In fact, if you have hearing loss, there is a decrease in your income over time, particularly as hearing loss becomes more severe. In the older population, there are studies that look at depression. It is a great source of social isolation and depression in older patients. If they could just hear better, they just interact more. And lastly, there are really some interesting studies going on now out of Johns Hopkins to link hearing loss and dementia, dementia being a growing problem in our aging population. And while there’s not good answers, there is certainly some kind of linkage between that.
Melanie: Why do you think it is so frustrating, Dr. Kwartler, for the people that you love when you are someone who is hard of hearing? Because I have heard adult children yelling at their parents in frustration at restaurants and places. “Didn’t you hear what I said, mom?” That kind of thing. If somebody was in a wheelchair, they would never yell at that person, “Why can’t you walk?”
Dr. Kwartler: I don’t know the answer to that.
Melanie: But you know what I mean, right?
Dr. Kwartler: Absolutely. If someone had a vision impairment, you wouldn’t stick your foot out and trip them. And yet, when you talk to someone with a hearing loss and aren’t looking at them, or have something in your mouth, or are looking down, it’s as if you’re tripping them. I don’t know why there’s that lack of sensitivity and taking responsibility for changing the way you communicate with those people. But you’re absolutely right, it does happen. Big problem.
Melanie: It’s an interesting thing. Is there a dizziness or balance-associated problem with hearing loss?
Dr. Kwartler: Yes, there can be. Again, the inner ear has two parts to it. There’s a hearing side of your inner ear and there is a balance receptor side of your inner ear. While we can measure fairly directly and see the effects of age on the inner ear in terms of hearing, we also do autopsy type studies, laboratory studies, where we’ve looked at older patients and what the balance side of their inner ear looks like. There is some decrease in function on that side, too. And again, not just age but many other things can cause a balance-related problem. Not all dizziness or balance issues are ear related but certainly they can be.
Melanie: When we’re talking about prevention of hearing loss, give us some of your best tips for prevention.
Dr. Kwartler: The number one thing in terms of noise exposure is ear protection. If you work around power tools, if you have hobbies that expose you to loud sound, wearing some type of earplugs or earmuffs is really critical because noise-induced hearing loss is preventable but not reversible. If you start to have nerve hearing loss, we can’t do anything except say, “Sorry, get a hearing aid.” But if you’re careful, you can prevent it. Now, the big question that comes up with kids, and in particular in teenagers is, “What about all these headphones and loud music?” And noise-induced hearing loss doesn’t discriminate by age. If you are playing music loudly, wearing headphones or ear buds so that the person next to you can hear the sound, you’re potentially injuring your ear.
Melanie: Then you are playing that too loud and certainly that’s going to be an issue with the younger people and the loud music. Of course, we used to get that from our parents. Thank you so much, Dr. Jed Kwartler. You’re listening to SMG Radio. If you would like more information on Summit Medical Group, you can go to summitmedicalgroup.com. And right here on SMG Radio, we have so many great programs with great information. Scroll around and learn something with us. This is Melanie Cole for Summit Medical Group and SMG Radio. Have a great day.
Hearing Loss
Melanie Cole (Guest): Do you suffer from hearing loss? Do you know someone, a loved one, who suffers from hearing loss? You might not realize it, but it can be one of the most frustrating and debilitating conditions out there. It frustrates your loved ones, it frustrates yourself. It can make you a bit disoriented. It can be quite complicated. My guest is Dr. Jed Kwartler. He’s Director of Group Otology and Neurotology at Summit Medical Group. Welcome to the show, Dr. Kwartler. Let’s speak about hearing loss. First of all, what do you see as the main cause of hearing loss?
Dr. Jed Kwartler (Guest): I believe, Melanie, the main cause of hearing loss is just getting older. We all do lose a little bit of hearing as we age. In fact, over age 65, about one out of three people have hearing loss. I would say age is the most common thing. If I were to give a second thing, it would probably be exposure to noise, either chronic exposure to noise or what we’ll call acoustic trauma, something like a firecracker or a gunshot or some type of explosion. Those would probably be the two biggest things that cause hearing loss.
Melanie: Well, I know that every parent listening, Dr. Kwartler, would just like the answer to the question, “If we watch and wait with ear infections, can that cause hearing loss?”
Dr. Kwartler: First of all, most ear infections are middle ear problems. They cause hearing loss because you got fluid in the ear and in general, it’s not going to cause a permanent nerve or inner ear type of hearing loss. So watching and waiting, particularly if you’re just waiting to see if fluid goes away, is really actually not a problem.
Melanie: Okay, so back to age-related hearing loss. It starts to happen, maybe you’re in your 70s, maybe you’re lucky and it doesn’t start to happen until you’re in your 80s or beyond, you go to see a man such as yourself or an auditory specialist. Now we see these popping up in various medical practices. How can you categorize the amount of hearing loss? Is it still sort of what we used to picture as the old-fashioned hearing test with the beeps in our ear? Is it much more sophisticated now? How can you tell the degree?
Dr. Kwartler: Great question. It is still that way that you characterized it, sort of older fashioned way of the things with the beeps and raising your hand or pressing a button to indicate that you’ve heard it or not heard it. That’s one part of a hearing test called a pure toned threshold that does determine how much you hear and what volume you hear at a particular frequency. There are other parts of a complete audiometric evaluation that assess how the nerves are actually functioning within the inner ear, something called an otoacoustic emission. There are other parts of the test also in terms of just testing your intelligibility, your ability to repeat back words. Taking all of that information together, you can characterize hearing loss into hearing loss as mild to moderate to moderately severe to more severe types of hearing loss. Based on that set of tests also, you can kind of predict pretty reasonably how well someone’s going to do with something like amplification, some type of hearing aid device, or whether they need some other kind of treatment.
Melanie: Now, really when you see people that are starting to lose their hearing, how frustrating do they feel that this is? Because people think, “Oh, well, being blind would be much worse.” But for someone who is losing their hearing, anything, crossing a street, walking through an airport, anything can be a little disorienting as you’re missing the sounds of someone running by you or anything.
Dr. Kwartler: Well, you’re absolutely right. The impact of hearing loss is tremendous. In fact it’s interesting that you led with part of the question about choosing deafness or blindness. Helen Keller actually would prefer to be blind rather than deaf. She said that the blindness only cuts you off from your immediate surroundings whereas deafness cuts you off from interactions with people.
Melanie: How interesting.
Dr. Kwartler: Hearing is really important. If you just think for two seconds how sound dependent our life is. Here we are talking on the telephone, people are listening on the radio; communication is oral, using our mouth, not our hands, not sign. We don’t read teleprompters. We talk to people although I guess, at least my kids, probably text to each other when they’re sitting even next to each other, in this day and age of smartphones. But speech is really critical. The ability to communicate orally is very important and therefore, hearing is really important. There are all sorts of impact on income. In fact, if you have hearing loss, there is a decrease in your income over time, particularly as hearing loss becomes more severe. In the older population, there are studies that look at depression. It is a great source of social isolation and depression in older patients. If they could just hear better, they just interact more. And lastly, there are really some interesting studies going on now out of Johns Hopkins to link hearing loss and dementia, dementia being a growing problem in our aging population. And while there’s not good answers, there is certainly some kind of linkage between that.
Melanie: Why do you think it is so frustrating, Dr. Kwartler, for the people that you love when you are someone who is hard of hearing? Because I have heard adult children yelling at their parents in frustration at restaurants and places. “Didn’t you hear what I said, mom?” That kind of thing. If somebody was in a wheelchair, they would never yell at that person, “Why can’t you walk?”
Dr. Kwartler: I don’t know the answer to that.
Melanie: But you know what I mean, right?
Dr. Kwartler: Absolutely. If someone had a vision impairment, you wouldn’t stick your foot out and trip them. And yet, when you talk to someone with a hearing loss and aren’t looking at them, or have something in your mouth, or are looking down, it’s as if you’re tripping them. I don’t know why there’s that lack of sensitivity and taking responsibility for changing the way you communicate with those people. But you’re absolutely right, it does happen. Big problem.
Melanie: It’s an interesting thing. Is there a dizziness or balance-associated problem with hearing loss?
Dr. Kwartler: Yes, there can be. Again, the inner ear has two parts to it. There’s a hearing side of your inner ear and there is a balance receptor side of your inner ear. While we can measure fairly directly and see the effects of age on the inner ear in terms of hearing, we also do autopsy type studies, laboratory studies, where we’ve looked at older patients and what the balance side of their inner ear looks like. There is some decrease in function on that side, too. And again, not just age but many other things can cause a balance-related problem. Not all dizziness or balance issues are ear related but certainly they can be.
Melanie: When we’re talking about prevention of hearing loss, give us some of your best tips for prevention.
Dr. Kwartler: The number one thing in terms of noise exposure is ear protection. If you work around power tools, if you have hobbies that expose you to loud sound, wearing some type of earplugs or earmuffs is really critical because noise-induced hearing loss is preventable but not reversible. If you start to have nerve hearing loss, we can’t do anything except say, “Sorry, get a hearing aid.” But if you’re careful, you can prevent it. Now, the big question that comes up with kids, and in particular in teenagers is, “What about all these headphones and loud music?” And noise-induced hearing loss doesn’t discriminate by age. If you are playing music loudly, wearing headphones or ear buds so that the person next to you can hear the sound, you’re potentially injuring your ear.
Melanie: Then you are playing that too loud and certainly that’s going to be an issue with the younger people and the loud music. Of course, we used to get that from our parents. Thank you so much, Dr. Jed Kwartler. You’re listening to SMG Radio. If you would like more information on Summit Medical Group, you can go to summitmedicalgroup.com. And right here on SMG Radio, we have so many great programs with great information. Scroll around and learn something with us. This is Melanie Cole for Summit Medical Group and SMG Radio. Have a great day.