Do You Have Rocks Loose In Your Head?

August 15, 2016

There are several different reasons why you might experience spinning sensations or what is more often called “dizziness” or “vertigo.”  One form of dizziness in particular can occur at any age to anyone, although it seems to occur more often to those over 60.  The good news is that it can be treated quite successfully.

This relatively common balance error occurs when a person puts his or her head in a particular position, which sets in motion a series of events that to some, can have quite debilitating results. It can occur with just lying down in bed, turning in bed from one side to the other, lying back in the dentist’s chair or at the hair salon for a shampoo. The vertigo can make you very nauseated and if you happen to be standing, it can cause you to fall and hurt yourself.

When a person’s head is in the “trigger position” for a short period of time, a quick spinning sensation occurs that can come on quite violently or if you’re lucky, only mildly. This lasts for 10-20 seconds as long as the position is maintained. If the person changes position, the dizziness will begin to subside but returns again when turning back to the offending position.  The clinical name for the disturbance is, “Benign Paroxysmal Positioning Vertigo” or BPPV. It can also be described as, “having rocks loose in your head”! This is true because the error that occurs in the balance system is produced by small crystals landing in areas of the inner ear where they shouldn’t be.

The inner ear balance system or vestibular system is a matched pair, one in each ear and is made up of two different sensory mechanisms. One system is made up of 3 semi-circular canals that are full of fluid with a gate at the end of each canal.  It gives your brain information about the direction your head is moving. As your head moves, the fluid in the semi-circular canals moves as well.  This causes the gates to swing open triggering a signal that is then transmitted to your brain. The brain responds by sending a signal to the muscles in your eyes to make a corrective eye movement in concert with the head movement.  This is an automatic response and cannot be voluntarily shut down.

Another system located in your inner ear is called the otolith organ and it can be simply described as a bed of jello with small calcium carbonate crystals embedded into it.  At the base of this jello-like material are sensory trigger cells. This system tells your brain about the speed of your head movement in space.  Each system works to tell your brain and then your eyes about the direction and speed of your head movements. They work at a very high speed and are sensitive to miniscule body movements.

The problem comes when the crystals are disturbed and begin to slough off in great numbers. The crystals then migrate over time and end up piling up against one of the gates in the semi-circular canals. This is where the fun begins. When these rocks are in the wrong spot and you happen to put your head in the “trigger position,” the crystals hold the gate open too long and tell your brain that you are still moving when in fact, you’ve stopped. The brain believes your vestibular system over everything else and tells your eyes to make a corrective movement based upon bad information.  This causes the eyes to keep moving and therefore create a spinning sensation. This can create quite a stir, literally, as 80% of sufferers report experiencing nausea and disorientation.

The good news is that this disturbance can be fixed by performing a very specific physical therapy maneuver. Research tells us that 75% of patients report no further symptoms after one treatment. Of those who continue to have spinning sensations after the first treatment, 85% are cured after the second treatment. It is rare that BPPV cannot be cured by physical therapy.

If you think that you or a loved one might be experiencing BPPV, we can help! A simple test in our office can identify which canal is causing the problem and then we will refer you for treatment. Call our office if you have questions about this or other balance disturbances.

What Causes Tinnitus?

August 8, 2016

Tinnitus itself is not a disease process but a symptom of an underlying issue. A number of health conditions can cause or worsen tinnitus, an annoying ringing, buzzing or hissing sound that occurs in the ears of nearly 50 million Americans. In many cases, an exact cause is never found. If you experience tinnitus, you shouldn’t worry. Very rarely is tinnitus caused by something that is dangerous to your health. Understanding what tinnitus is and what could possibly cause it or exacerbate it can help alleviate some of the stress and irritation that most tinnitus sufferers report experiencing.

A common cause of tinnitus is damage to the inner ear hair cells of the cochlea, a spiral-shaped cavity in the bone of the skull just behind the ear that resembles a snail shell and contains nerve endings essential for hearing. These tiny, delicate hairs sit in a fluid and move in relation to the pressure of sound waves through the fluid. This movement triggers an electrical signal through the auditory nerve that travels from the ear to the brain. The brain then interprets these signals as sound. If the hairs inside the cochlea are bent or broken, they can produce random electrical impulses to the brain, which are then interpreted as sound. This sound is what we call tinnitus.

Other causes of tinnitus include middle ear problems, chronic health conditions and injuries to or conditions that affect the auditory nerve or the hearing center of the brain.

Common causes of tinnitus
In most instances, the exact cause of tinnitus is unknown. There are some health conditions, however, that are known to cause tinnitus:

Exposure to loud sounds: Long-term noise exposure on the job is a leading cause of hearing loss, especially in men. Loud noises from industrial equipment, construction sights and from the use of firearms by our military are common sources of noise-related hearing loss. Personal music players, such as MP3 players or iPods can cause noise induced hearing loss over time as well. Tinnitus can also occur with short-term exposure to loud noise. For instance, you may experience a ringing in the ears after attending a loud concert. This type of tinnitus usually goes away within hours while long-term exposure to loud sound can cause permanent damage.
Excessive earwax: Earwax protects your ear canal by trapping dirt or other intruders and by helping to slow the growth of the bacteria and fungus that naturally occur in the ear. When too much earwax accumulates, however, it can be difficult for the ear to rid itself of the wax, which occurs naturally with time. Excessive wax accumulation can cause hearing loss and a low pitched ringing or roaring in the affected ear.
Changes in the bones of the middle ear: Stiffening of the joints between the bones of the middle ear, the smallest bones of the body, is called otosclerosis. This stiffness happens gradually and may affect hearing as well as cause tinnitus. This condition, often referred to as arthritis of the middle ear tends to run in families.
Age-related hearing loss: Accumulation of birthdays happens to the best of us. For many people, hearing worsens as those birthdays accumulate. Hearing loss in the high frequencies is the most common cause of tinnitus. The medical term for hearing loss due to the aging process is presbycusis.
Stress: It is suggested that stress increases pressure on the nerves that run up the back of the neck, increasing the likelihood of tinnitus. The exact source is unknown but increased tension in the muscles of the neck and shoulders is common in those who are exposed to situations of excessive long-term stress.

Less common causes of tinnitus
Some causes of tinnitus are less common and in most cases, the causes of the tinnitus are a more important focus than the tinnitus itself.

Meniere’s disease: This disorder of the inner ear balance system causes an excessive accumulation of fluid in the inner ear. The tinnitus experienced by those with Meniere’s disease is often described as a low-pitched roar.
Jaw disorders: The temperomandibular joint (TMJ) juts up into the ear canal when the mouth is opened widely. In some instances, disorders of this joint can cause ringing in the ears.
Traumatic injury to the head or neck: Most commonly caused by sudden trauma, injuries to the head or neck can cause neurological disorders that can affect the organs of the inner ear or the auditory nerve itself. In some instances, traumatic injury can cause dysfunction in the area of the brain that processes sound. These type of injuries most commonly cause ringing in only one ear.
Tumor: An acoustic neuroma, a non-cancerous tumor that develops on the auditory nerve, can cause tinnitus in the ear that has the tumor.
Blood flow issues: With the aging process, it is not uncommon to develop a buildup of deposits, called plaque in the major blood vessels of the body. If a buildup happens close to the middle or inner ear, the blood vessels lose the ability to flex or expand optimally with each heartbeat. This can cause blood flow to become more forceful, making it easier for the ear to detect the beats. This type of tinnitus is called pulsatile tinnitus.
Medications: Take a look at the side effects of most prescription medications and you might be surprised at how many have the possible side effect of tinnitus. In general, a physician isn’t as concerned with causing tinnitus as treating the symptoms of a disease or condition. Generally speaking, the higher the dose of a medication, the worse the tinnitus becomes. Often the unwanted noise disappears when the medication is stopped. If you experience tinnitus, talk to your doctor about other alternatives. If your curious about the medications you are currently taking, visit for the side effects associated with the most commonly prescribed medications.

If you have tinnitus, talk to your doctor or hearing healthcare provider. He or she will make sure to pursue every avenue to determine what is causing the ringing in your ears. Although tinnitus is not often curable, talking with your healthcare provider can start you down the right path toward finding a solution or, in the least, increasing your understanding of what may be causing it and what you need to do to relieve the stress and irritation that tinnitus often causes. Call today and make an appointment for a tinnitus evaluation. We’ll be happy to help.

Using Sound in Tinnitus Management

August 1, 2016

Tinnitus is a common problem. In fact, more than 50 million Americans suffer from tinnitus, the experience of sound, noise or ringing in the ears in the presence of sound in the environment. These sounds can vary from loud to soft, high pitch to low pitch and from constant to periodic. Tinnitus is very common in those who have hearing loss.

For most people, tinnitus is not a significant problem, but more of an irritation. For others, the tinnitus they experience can become a substantial disruption in their lives, affecting sleep and causing anxiety, stress and even depression. With a combination of counseling and sound therapy, the effects of tinnitus can be minimized.

The use of sound to minimize the effects of tinnitus is meant to help the brain habituate or become accustomed to the tinnitus. The type of sounds used can be amplified sound from hearing aids, environmental sounds, noise or music. A new type of sound used to help the brain habituate is called Zen fractal music and comes from a hearing aid manufacturer called Widex. Based on what is known as “fractal technology,” Zen music is a series of chime-like tones that play randomly but with a rhythm that is meant to mimic the resting heart rate. Each Zen program can be adjusted for tempo, pitch and volume.

The goal of Zen technology is to aid in relaxation in order to decrease the wearer’s aggravation and stress from continuous tinnitus and thus improve overall quality of life. The Zen music can be played by itself with no amplification of outside sounds or in addition to conventional amplification. A program that incorporates a low-level white noise along with the Zen music can also be programmed into the hearing aid. Each program is accessed through a push button on the hearing aid or by remote control. A survey performed by researchers at Widex revealed that the use of Zen fractal music as a way to decrease the severity of tinnitus is very successful. In fact, 85.7% of patients surveyed reported a reduction in tinnitus severity1.

The Zen fractal technology is found in all of the Widex Mind family of hearing aids. If tinnitus is a constant barrage of sound that causes stress or aggravation in your daily life, ask your adiologist today if Zen is right for you.

1 The Efficacy of Fractal Music Employed in Hearing Aids for Tinnitus Management, Francis Kuk, PhD; Heidi Peeters, MA; and Chi Lau, PhD; Hearing Journal Sept 2010

Tinnitus: Did you hear that?

July 25, 2016

Have you ever heard a high-pitched ringing or buzzing sound in your ears? Some describe it as a whooshing sound or something that resembles a hissing sound, like air escaping a tire. Still others hear it as a roaring or pulsing sound. However you describe it, you’re not alone. In fact, the Centers for Disease Control estimate that nearly 50 million Americans experience some sort of head noise to some degree at least occasionally. 1 Of the 50 million sufferers of tinnitus, nearly 16 million experience it severely enough to seek medical attention. So, what is the ringing? Where does it come from? Is there a cure? Over the next several posts, I’d like to answer some of the most frequently asked questions about that annoying ringing sound, called tinnitus, and provide some insight into possible causes. And, if you’re one of the unlucky millions to suffer with tinnitus, take heart. Research into a long-term cure continues and several innovative treatments are available that are proving successful in decreasing the effects of tinnitus.

The word “tinnitus” comes from a Latin word meaning “to tinkle like a bell.” It is the perception of sound when there is no actual sound present. The word itself is pronounced TIN –i-tus by some and tin-ITIS by others. The correct pronunciation is debatable. In my opinion, it’s a case of To-MAE-to/To-MAH-to. However you say it, tinnitus is annoying for most and can interrupt sleep, affect mood and disrupt productivity at work and relationships at home. Even stress and depression are known to be associated with tinnitus. If you experience tinnitus, have your hearing checked by an audiologist. It’s the first step toward understanding a possible cause and to finding some relief.

A thorough evaluation can give insight into the possible cause of the ringing sound you experience in your ears, but there is no known cure. Tinnitus is not a condition in itself but a symptom of something else occurring in the body, such as hearing loss in the high frequencies, circulatory issues, jaw problems or a medical issue like a head or neck injury. Once you know the probable cause, your audiologist can discuss lifestyle modifications to improve the tinnitus and review the options for reducing the noise or at least the effects of the noise.

It’s also helpful to spend some time researching tinnitus; its causes and treatments. Sometimes, just having a bit of knowledge about what’s happening to you can decrease the aggravation and stress that not knowing can cause. In the next several posts, I hope to help you on that journey. We’ll begin with the two most common questions: What is Tinnitus and What Causes Tinnitus?

1 Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention (CDC).

Want an Invisible hearing aid? We’ve got one!

July 18, 2016

If you’ve been doing any sort of research on hearing aids, you’re bound to have come across the lnSound Lyric extended-wear hearing aid. This little technology marvel stays in the ear canal for up to 4 months. It’s gotten rave reviews from audiologists and from wearer’s alike and has been featured on TV shows like Dr. Oz and The Doctors. But Lyric isn’t for everyone. In fact, research says that about 43% of those who could wear the Lyric (they’re hearing loss is appropriate, they’ve never had chemotherapy or radiation treatment to their head or neck, they aren’t diabetic, the ear canal is large enough) end up not being compatible with Lyric for some reason. Often, the reason is just the fact that the ear canal won’t accept it. So, what do you do if your ear isn’t right for Lyric or your budget won’t allow for it (subscriptions range from $3200 to $3600 a year)? There is a new alternative called the Invisible In The Canal (IIC) hearing aid. If you’re looking for small and Lyric isn’t an option, the IIC may be your answer.

The Starkey SoundLens is the first Invisible in-the-canal hearing aid that can be removed daily by the wearer. The size and invisibility may be the largest consideration for the majority of its wearers, but the SoundLens also offers exceptional sound quality. Using Starkey’s Voice IQ technology, the SoundLens improves hearing in the presence of background noise. It also incorporates Starkey’s industry-leading feedback management system while digital programming allows the instrument to be fully tailored to your listening needs
The SoundLens is the ideal instrument for the active individual who requires a discreet hearing aid. Its sound quality and technology features are best-in-class and the size make it an ideal choice for those looking for a discreet alternative to the typical hearing aid. There are some drawbacks to the SoundLens to consider: because of its size, dexterity is a consideration. It also uses a small battery, which necessitates changing of the battery often. Starkey reports a typical battery life of 5 to 7 days with a 16-hour per-day wear time. Finally, the SoundLens won’t work for every ear. Starkey reports that roughly 60% of people with hearing loss can be fit with the SoundLens. The most common issue is size of the ear canal but it also works best for the mild to moderate hearing loss. Given these few drawbacks, the Starkey SoundLens is a great alternative for those who are looking for an invisible everyday-wear hearing aid.