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Veterans Affairs Auditory Vestibular Research

 

Akin and colleagues recently launched a new study designed to comprehensively measure the effect of loud noise on all five organs of the vestibular system – the three semicircular canals, which are sensitive to rotations of the head, and the two otoliths that sense gravity and linear acceleration – in animals and humans. “One of the things that’s been disturbing about the dizziness related to head injury or blast exposure,” she said, “is that it can last for a long time, sometimes years. Typically inner-ear balance-related symptoms resolve in weeks to months.” Having a clearer sense of how loud noise affects all of the balance organs, and how each organ recovers from noise exposure, may one day help clinicians figure out ways to help patients improve their balance after a head injury or blast exposure.

Though nearly everyone with hearing loss can be helped with hearing aids, only about 1 in 5 people use them, and their reasons for not using them vary widely. AVREAP’s Audiologic Rehabilitation Laboratory is directed by Sherri Smith, AuD, PhD, who studies rehabilitation strategies specific to veterans with hearing loss. Much of her work is devoted to exploring ways to make existing interventions more effective and increasing their appeal to veterans.

inner-ear-balance-test

U.S. Rep. Phil Roe, R-Tenn., watches as Dr. Ashley Clark demonstrates a new test of inner ear balance function on Owen Murnane, PhD, during a visit with the staff of the Auditory Vestibular Research Enhancement Award Program. Murnane, along with AVREAP Director Faith Akin, PhD, has been studying how exposure to loud noise affects the vestibular system. VA photo

One such study, currently underway, is evaluating the effectiveness of using a “test box,” a small, sound-treated enclosure that allows accurate measurements of a hearing aid, to determine the level of sound in a person’s ear when the hearing aid is worn. Smith is comparing outcomes for veterans whose hearing aids are fitted and verified using this approach – which doesn’t require veterans to leave their homes – to outcomes for veterans who have their hearing aids fitted and verified by in-person visits to VA hearing clinics, which are busy and often far from where many veterans live.

“If the data show that this method is an effective way to fit a hearing aid accurately,” Smith said, “it will give us a way to meet the needs of the veteran and save them a face-to-face visit.”

Smith is also evaluating an experimental technology for reducing background noise – the ambient sound one might encounter in a crowded restaurant, or at a sporting event – that often deters many people from using hearing aids. The study is comparing two hearing aids programs: one with standard programming, and the other programmed with an experimental noise reduction algorithm. “If there’s a difference between the programs,” Smith said, “it might help people who are highly intolerant of background noise get more benefit from their hearing aids while wearing them in noise.”

Studies like this one may ultimately help grow the percentage of veterans who choose to wear hearing aids. Health researchers refer to this choice as a “health behavior,” and VA’s auditory investigators understand that people’s health behaviors directly affect their quality of life. Hearing loss impairs the exchange of information; it can lead to loneliness, isolation, dependence, and frustration – and most of this can be easily avoided with the use of hearing aids and other interventions.

It’s not the treatments that are lacking in the fight against hearing loss among veterans. The most successful interventions simply require early recognition and rehabilitation, but unfortunately, as with many chronic health conditions, relatively few people with hearing loss seek treatment immediately, if at all. Eighty percent of hearing-impaired adults fail to treat their hearing loss in the first five to 10 years after its detection.

It’s not the treatments that are lacking in the fight against hearing loss among veterans. The most successful interventions simply require early recognition and rehabilitation, but unfortunately, as with many chronic health conditions, relatively few people with hearing loss seek treatment immediately, if at all. Eighty percent of hearing-impaired adults fail to treat their hearing loss in the first five to 10 years after its detection.

It’s one thing to know this – and another thing to know why, and to be able to do something about it. NCRAR’s associate director, Gabrielle Saunders, PhD, is leading an effort to examine the most changeable of variables influencing hearing health care behaviors: the attitudes and beliefs of veterans with hearing loss. The findings of Saunders’ group may help to guide the development of strategies that will lead more hearing-impaired veterans to seek intervention, to reduce the secondary negative effects of hearing loss, and ultimately, as they’re better able to communicate and understand speech, to improve their quality of life.

This article was first published in the Veterans Affairs & Military Medicine Outlook magazine

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Craig Collins is a veteran freelance writer and a regular Faircount Media Group contributor who...