What Do a Leather Pouch and a Fruit Fly Have in Common?

By Yishane Lee

What is the utricle? Merriam-Webster defines it as “a small anatomical pouch; the part of the membranous labyrinth of the inner ear into which the semicircular canals open.” But to you and me, it may help provide the solution to hair cell regeneration in the inner ear.

Like the cochlea, the utricle is located in the inner ear and it contains hair cells that are used to detect gravity (versus the sound waves that the cochlear hair cells detect). In a major step forward, Hearing Restoration Project scientist Dr. Jennifer Stone and her colleagues at the University of Washington pioneered the technique of isolating the utricle from the adult mouse and growing it in a dish in the lab.

Why is this important? It is providing for the first time the ability to directly access and experimentally manipulate hair cells and support cells in a lab setting. In other words, we can grow and do experiments on the utricle (a word derived from the Latin for leather bag). The cochlea has proven to be too delicate to isolate and grow in a dish.

As Dr. Andy Groves, Baylor College of Medicine, and an HRP colleague writes in the Winter 2014 issue of Hearing Health:

“Dr. Stone’s lab found that within a few days after hair cells are killed in the utricle, the surrounding supporting cells take the very first genetic steps to activate the program to make hair cells—but then they stop before the hair cells actually form. It is as though the supporting cells have received a signal to regenerate new hair cells, but they cannot ‘seal the deal’ and complete the regeneration program. This situation is very different from the cochlea, where absolutely no hair cell regeneration steps occur in adults.”

Drs. Grove and Stone, along with Dr. Neil Segil of the University of Southern California, are working together to figure out why regeneration takes the first steps and then stops. One area they are focusing on is the Notch signaling pathway, an evolutionarily determined method of cell communication. Notch signaling, among other things, determines the mosaic patterns of various cell types, including the mosaic that organizes the inner ear’s hair cells and supporting cells. The dysfunction of Notch signaling (a name that comes from a notch found in the wings of a fruit fly) has been linked to various cancers and diseases, and as a result it has become a focus of drug intervention.

Read about all of our HRP projects here, and stay tuned for more HRP updates throughout the year.

Royal Arch Masons Renew Investment in HHF and CAPD Research

By Tara Guastella

I am thrilled to report that for the third year HHF has received a generous gift of $100,000 from the Royal Arch Masons in support of of our 2013 Emerging Researchers studying central auditory processing disorder (CAPD).

CAPD is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. The outer, middle, and inner ear of individuals who have CAPD are usually normal in structure and function (peripheral hearing). But they aren’t able to fully process the information they hear, which leads to difficulties in recognizing and interpreting sounds, especially those that compose speech. It is thought that these difficulties arise from a dysfunction in the central nervous system—the brain.

Individuals who have CAPD have difficulty concentrating when in an environment that is not perfectly quiet or has some "controlled" noise in the background. Understanding a verbal message will also be a problem when trying to listen to a speaker if someone else is talking or if ambient noise is present in the background.

People with CAPD often have to work harder than others just trying to receive auditory information in a meaningful way. It is a very frustrating situation for individuals when they can hear "perfectly" but cannot process auditory speech information in a meaningful way.

One of our Royal Arch Masons–funded researchers, Ross Maddox, Ph.D., is beginning a line of research investigating the specific behavioral effects of audio-visual binding and its processing in the brain. Behavioral tests with brain imaging will be used to investigate the importance of combining information across the visual and auditory senses, and establish relationships in brain activity and behavior, an effort that could inspire new audio-logical therapies.

For over 30 years, the Royal Arch Masons have supported CAPD research efforts, making it a priority to increase funds to this much needed area of research. We are honored that the Royal Arch Masons have chosen HHF as a recipient of this support, and we are inspired by the progress of our Royal Arch Masons–funded Emerging Researchers.

We are incredibly grateful for the continued support of the Royal Arch Masons and thank them for their annual contribution.

The Stealth Purpose of Earwax (in Humans and Whales)

By Yishane Lee

Consider the humble earwax. Much maligned, earwax is generally something that people want to get rid of—hence the cotton swab industry.

But in fact, earwax in humans has a purpose, and it may surprise you. Earwax, also known as cerumen, protects the ear by keeping water, dust, and other harmful particles such as bacteria out of your ear canal. Its waxy texture serves to keep your ear sufficiently lubricated to function properly. It also contains antibacterial and antifungal properties.

So the number one thing to remember about earwax is to leave it alone so it can do its job. “The ears are one of God’s great self-cleaning devices,” says William H. Slattery, M.D., an otolaryngologist at House Research Institute in Los Angeles, in a Hearing Health magazine story “Stop That Swab!”

Earwax is supposed to move out of the ear canal, taking debris with it. Blocking this natural (albeit slow) motion of the earwax out of the spiral of the canal—and not the earwax itself—is usually what causes problems.

Injuries from people inserting cotton swabs too far into the ear canal are a common reason people go see a doctor. If it’s bigger than your elbow, it doesn’t belong in your ear. Earwax removal was even a squirm-inducing plot point in an episode of the hit HBO series “Girls.”

Over 14 years of practice, Phoenix otolaryngologist Jerald Altman, M.D., never ceased to be amazed by the range of items that ended up in kids’ ears, so much so that he wrote a board book for kids explaining why sticking things in your ears (or up your nose) is a bad idea.

And finally, earwax also has significant scientific merit—at least among whale researchers. Scientists successfully retrieved and studied the earwax of the endangered blue whale when one was hit by a ship and its body washed up onto a Santa Barbara, Calif., beach.

Baleen whales like the blue whale start accumulating earwax as soon as they are born. As a result, this whale “earplug” (since it doesn’t seem to get expelled over time, like ours does) records how old the whale is. Scientists can count its rings, much like counting rings to determine the age of a felled tree.

Scientists at Baylor University, in Waco, Texas, analyzed the 10-inch earplug that was retrieved in California to figure out the level of toxins the male blue whale accumulated. What they found was far from good news in terms of exposure to pesticides, mercury, and other contaminants—some transferred directly from the mother. The whale’s stress levels as measured by cortisol were also double the average.

But in a bit of good news, the novel analysis (published in the Proceedings of the National Academy of Sciences in August) of this blue whale from birth to death holds huge promise for understanding various whale species and our effects on them over time. Whale earplugs have been saved as part museum displays for decades, offering a timeline of environmental and other stressors the whales may have undergone.

Undercover Noise Cop

By Kathi Mestayer

New Year, New You? If you’re planning to hit the gym as part of a New Year’s resolution, don’t forget that being healthy includes protecting your hearing. Look for “No Pain, No Gain?” this January in Hearing Health magazine.

To write my story, I had to do some sleuthing. I’ve been doing undercover noise data collection for a few months. My instruments range from two virtually invisible smartphone apps (SoundMeter+ and AudioTools) to a very visible, unwieldy, professional sound meter. Everyone can see it, but nobody knows what it is.

Picture me in my bathing suit (be kind), walking around a huge, cavernous, swimming pool area at a community recreation center. I’m cradling the professional sound meter like a baby in my arms, its 3-inch-diameter sponge microphone cover sticking out like a huge Tootsie Roll. In my other hand is my smartphone, its decibel app meter flying back and forth at a rate so fast I can barely see it.  

The folks in the aquatics class at my end of the pool are working out, following the instructor’s movements. The boom box is barely audible due to the extremely resonant sound bouncing off of the glass and steel.

The teacher, who knows me from classes I’ve taken, gives me a “what on earth are you doing?” look, and then quickly goes back to her teaching. The lifeguard, on the other hand, is taking the liberty of really staring at me. I’m feeling pretty conspicuous.  

I take a few readings with both meters, and get a range of 74 to 78 dBA (the unit dBA measures sound levels as perceived by humans). Then, I skulk along the side of the pool to the aquatics boom box, to see how much it is adding to the din. It adds about 4 dBA, which is a significant jump in decibel terms.

As I note in my story on noisy gyms (coming up in the Winter 2014 issue of Hearing Health, out in January):

“Remember that decibel increases are magnified: 80 dBA is twice as loud as 77 dBA—the sound energy doubles with each 3 dBA increase. So while 4 dBA doesn’t seem like much on a linear scale, it’s a big difference in dBA terms.”

On my way out, I slink over to the lifeguard and tell her what I’m doing. She doesn’t ask what readings I’m getting but luckily for her, it’s within Occupational Safety & Health Administration (OSHA) limits for her as a worker. Fortunately, she doesn’t have to worry about hearing damage, at least at this sound level.

LEARN MORE:

• Be sure to read our guide to hearing aids for an active lifestyle in “Get Active” by staff writer and audiologist Barbara Jenkins, Au.D.

• If you have a hearing loss, here’s how you can hear better in the workplace in “Office Space.”

• See what steps one busy Northern California restaurant is taking so its patrons can hear one another while dining.

Hearing Health magazine staff writer Kathi Mestayer serves on advisory boards for the Virginia Department for the Deaf and Hard of Hearing and the Greater Richmond, Va., chapter of the Hearing Loss Association of America.

Cue the Music

By Yishane Lee

Along with wrapping up holiday gifts, we are also busy wrapping up the Winter 2014 issue of Hearing Health, available in January.

Our cover story is about legendary guitar great Les Paul, and the launch of the Les Paul Ambassadors. The Les Paul Ambassadors are an exciting partnership between HHF and the Les Paul Foundation to support our search for a cure for hearing loss and tinnitus as well as educate consumers about this topic. We’re thrilled that Lou Pallo, a longtime friend of Les Paul and a talented musician in his own right, is our first Ambassador helping to spread the word.

Les Paul, who had a hearing loss and tinnitus, is the inspiration for our special music issue. Enjoying music can be a challenge for people who have a hearing loss, partly because hearing aids favor the voice of one speaker above background noise, and what is music if not many speakers and a lot of so-called noise?

As staff writer and audiologist Barbara Jenkins more eloquently explains:

“Hearing aids have been developed to maximize clarity of speech understanding, but to do this they must reduce non-speech sounds—which are the very elements that enhance musical or environmental sounds. Even though you may hear music better with your hearing aids than without them, most speech enhancement programs by necessity end up distorting music.”

Jenkins has plenty of helpful tips for optimizing your hearing aids to enjoy listening to music, and beyond merely engaging the music program in your hearing aid. Look for “The Sounds of Music” in our Winter issue.

You have probably heard of the cochlear implant (CI), but what about the hybrid CI? It can also help users enjoy music. The hybrid makes use of—and aims to preserve—residual hearing. Particularly in age-related hearing loss, residual hearing is usually in the low frequencies. So by combining this residual, low frequency hearing with high frequency hearing that has been amplified by the implant, the hybrid CI user has a fuller, rounder hearing experience.

Look for our story about hybrid CIs, written by Lina Reiss, Ph.D., a 2013 Second-Year HHF Emerging Research Grant (ERG) recipient, along with an ERG alumnus, Christopher Turner, Ph.D., who has published more than 20 papers on the topic. In addition, researchers at the University of Washington recently announced a new harmonic algorithm that allows CI users to better hear music, which we will detail in “Hearing Headlines.”

Finally, we have contributions from musicians who have hearing loss. Wendy Cheng started an association of amateur musicians with hearing loss, now 10 years old, and Nancy Williams is a member of HHF’s board and a pianist who has performed at New York City’s Carnegie Hall. Underscoring all these stories is the work our Hearing Restoration Project, which is working toward a cure for hearing loss and tinnitus—and the ability to once again enjoy music to its fullest.

Don’t miss out on all this and more - subscribe  to Hearing Health magazine for free today!

Support a Cure for Hearing Loss and Get Your Tax Deduction Before 2013 Ends!

By Tara Guastella

What’s a better way to take part in the season of giving than by making a tax deductible donation and showing your support for a cure for hearing loss and tinnitus? I can’t think of any!

This time of year, charities always see an influx in gifts with many donors waiting until the last minute to write their check or go online to donate. Last year, we broke records in the amount of charitable gifts that came in during the fourth quarter and this year we hope to do so yet again!  Will you help us break records by making a year end, tax deductible gift?

Why should you donate to HHF this year? Kille, a mother of three sons (two have hearing loss), recently shared: "When I stumbled upon HHF's free magazine, Hearing Health, I said to myself 'Thank goodness there is an organization out there working on offering a cure for hearing loss for those who want it. And I want to be part of making that a reality.'"

We hope you will join Kille. There are many ways you can support HHF and a cure for hearing loss and tinnitus this giving season:

• Make an online donation (before December 31).

• Mail in a donation (remember it must be postmarked and the check date must be no later than Dec. 31); see our mailing address in the footer below.

• Contribute to an item on our Wish List and give our researchers the tools they need to conduct their studies.

• Create a giving page or fundraising event where you can raise funds from family and friends.

• Make a donation in honor of or in memory of someone special to you.

• Give a gift of appreciated stock from an IRA or a gift of life insurance.

Which way will you show your support? Share in the comments!

The Perfect (Powerful) Stocking Stuffer

By Yishane Lee

Hearing aid batteries are the perfect little stocking stuffer for the hearing aid wearers on your list—or if you’re a hearing aid wearer yourself, you should request from Santa!

Hearing aids use miniature zinc air button cells, which represent a huge improvement over their mercury predecessors—not least because the mercury ones were toxic! They also last twice as long, are environmentally friendly, and are less expensive.

The battery is activated when the sticker tab is removed, and exposing the cell to air oxidizes the zinc and powers the battery. Wait 30 to 60 seconds for the cell to become fully activated before placing the new battery into the hearing aid. This helps maximize the battery’s life.

The size of these button cells are universally standardized and the sizes are color coded for convenience, whether they are disposable or rechargeable. Common sizes are size 10 (yellow) and size 312 (brown). How long they last depends on use, but generally size 10s last three to five days, and size 312 about 10 to 15 days.

The key is making sure the seal that activates the battery remains intact. If it becomes damaged and air reaches the cell, activating the zinc, the battery will eventually drain. (And then you may find yourself in a foreign country looking for a pharmacy that sells hearing aid batteries—always bring spares when traveling!) Besides pharmacies, your hearing healthcare provider, warehouse stores, and online retailers all sell batteries.

Battery shelf life is several years, provided you store them at room temperature and keep them away from heat and humidity, which can affect the seal. Always store and transport in their original packaging. Carrying batteries around in your pocket or handbag can also damage the seal, and your keys or other metal objects can inadvertently short-circuit them.

Open up the battery compartment when you remove them and shut them off (newer models do this automatically for you), so they are aired out overnight. Exposure to moisture is another risk for zinc air batteries.

Remember: All batteries pose a serious health risk for children and pets if swallowed. Keep them out of reach and contact poison control immediately at (202) 625-3333 if they are ingested. Get more safety tips from the National Capital Poison Center.

And a note about recycling: Zinc is hazardous to the environment. So while many states do not require that hearing aid batteries be recycled, if you throw the batteries out with the trash, over time the harmful chemicals will be released. Look for battery recycling bins at large grocery stores and drugstores. Hearing aid retailers and hearing providers also may accept used batteries as well. The Big Green Box and Battery Solutions will recycle your batteries (and other electronics) for a fee. See Earth911 and Call2Recycle for battery dropoff locations and other resources.

Read more about batteries, including rechargeable and proprietary options, as well as choices for cochlear implants.

Are You Wireless Enabled?

By Paul Harrison, Guest Author

This is the first in a two part series on wireless technology and hearing aids.

With the introduction of wireless technology, hearing aids are now able to do more than ever before. Just making things louder is a thing of the past with new devices containing more and more advanced features with each new generation of hearing aid.

Wireless technology in hearing aids means that they are able to connect both with each other and with a number of different devices using a signal that is similar to the Bluetooth in mobile phones. When the hearing aids work together it is known as binaural technology. With this feature, they can communicate with each other and work together to improve your hearing. There are some binaural features that will analyze your environment, detect which hearing aid is receiving the clearer signal and then transmit this superior signal to the other side. This ensures that you are always getting the best sound available, whatever your environment may be. Binaural microphone applications work in the same way to ensure you hear sounds from all directions clearly but can give priority to speech over background noises.

When most people mention wireless technology in hearing aids, they are referring to their ability to connect to other things. This signal allows the hearing aids to be paired with different accessories that in turn can be connected to your various audio devices.

Each manufacturer has their own range of accessories which can only be used with their own hearing aids. Some require a device called a streamer to be used in addition to the other accessories. This streamer is used to relay the signal from each device into the hearing aids and is often the point of control as well. Some manufacturers use a different or more powerful signal which can send the sounds directly without the need for this additional device.

So what can you connect to?

Television

Many manufacturers now have a device that can be easily connected to most televisions. It is usually a discreet little box that sits by the TV and picks up the sound coming from it. It then transmits the sound into the hearing aids, either directly or through the additional streamer. This can give you the effect of wearing headphones without the inconvenience of actually wearing them. It also allows you to control the volume by adjusting the hearing aids rather than the television. This can be particularly useful if you are not the only person watching, as it means you can watch at your own level without affecting the listening comfort of others. In most cases, if an additional streamer is required, this unit will also act as a charger for it.

Telephone

Many hearing aid users struggle when using their home telephone for several reasons. Some people find that the conversation sounds muffled and some even report that they often don’t hear it ring. There are now wireless accessories that can help with this by connecting you directly to the telephone. An alert will sound in your hearing aids when the phone rings so you never miss a call and then you don’t even have to get up to answer it. You can answer the call by simply pressing a button on your device and you will then hear the conversation through your hearing aids. This gives you the benefit of a clearer sound and also means that you hear the conversation in both of your ears at the same time. The built in microphone in the device then allows you to enjoy your conversation without having to go to the phone.

Mobile Phone

These work in a very similar way to the home phone accessories. They allow you to receive alerts when calls come through and then answer the phone without having to remove it from your pocket or bag.

According to YourHearing Wireless, technology is advancing all the time, making it easier for hearing aid users to enjoy things that they previously found difficult or frustrating. Each manufacturer has a different range of accessories so you would need to check to see what is available for your particular hearing aids. There are so many options available today it is possible for everyone to get themselves and their hearing aids wireless enabled.

Stay tuned for part two to be posted in early 2014 which will highlight other types of devices that can connect to your hearing aid and help you hear better.

Author Bio:

Paul Harrison has been in the Hearing aid industry for 20 years and in that time has worked at both manufacturer and retailer level before managing his own online hearing aid business www.yourhearing.co.uk which is a national network of local hearing aid audiologists who offer the main hearing aid brands at less than the high street but with the same quality aftercare and warranty.

"Listen to Me, Right Now!"

By Yishane Lee

As a parent, I constantly think that my children aren’t listening. The number of times I repeat myself endlessly (usually accompanied by an escalation in volume) before I get an answer is enough to drive me bonkers. But a child who isn’t listening to you can be a sign of something more than a clash of wills.

If you find that your child doesn’t respond to repeated entreaties—especially when you’re not facing her—it could be a sign of a hearing loss.

It is one sign that Hearing Health magazine staff writer Barbara Jenkins, Au.D., BCABA, includes in her list of the most common signs of hearing loss in children of different ages, from infants to teenagers.

Despite universal newborn hearing screening in hospitals—an effort that HHF spearheaded in the 1990s that has been critical for early intervention treatment—hearing loss can be progressive and appear in children after you go home from the hospital and into the school years.

For instance, a baby who doesn’t react to a sudden noise, such as a toy dropping to the floor, may have a hearing loss. Evolutionarily speaking, humans (and all animals) make sounds in reaction to hearing sounds, so a hearing loss can be indicated when a baby does not make word-like sounds, such as “gaga” or “dada” by 10 months of age.

In fact, speech milestones are critical for making sure your child’s development—and hearing—are on track. (Also important is talking directly to your toddler, too, according to a new Stanford University study.) Talk to your pediatrician if you have any concerns, no matter how slight. A study in JAMA Otolaryngology-Head and Neck Surgery found that parental concern and school hearing screens helped diagnose hearing loss after passing the newborn hearing screening.

As your child ages, there’s more opportunity for social interaction as well as picking up illnesses. Ear infections (otitis media, or infection of the middle ear) are one of the most common childhood infectious diseases requiring antibiotics. In young children the Eustachian tube has not fully developed, leaving the middle ear more likely to retain fluid that in the ears of older children gravity flushes out.

Since infections can last one to three months, with fluid blocking the ear, during that time hearing and speech both become impaired.

This can delay language acquisition and lead to learning issues. Left untreated, children who are prone to chronic ear infections are at risk of permanent hearing loss. Some of our 2013 Emerging Research Grant recipients (Ravinder Kaur, Ph.D.; Ani Manichaikul, Ph.D.; and Merri J. Rosen, Ph.D.) are working on developing a vaccine, identifying genetic predispositions, or otherwise mitigating the effects of this serious health issue in children.

Placing ear tubes in the ear are a common remedy for children with chronic ear infections. It’s a simple surgery, but requires general anesthesia, and repeated surgeries may be required if the tubes fall out. Our otolaryngologist recommended that my son, then just over a year old, get tubes to help with chronic fluid in the ear (without infections). But I couldn’t bring myself to do surgery when the ailment was something he would eventually grow out of. That said, it is a common, safe surgery that many children have benefited from.

Ear infections can be an obvious sign of potential hearing loss. So can needing the TV or stereo volume turned up, tilting the head forward, or having difficulty at school. Your child may even tell you straight out that he can’t hear you. As Jenkins writes, “This may seem obvious, but many parents assume that their children are not paying attention when in fact there may be an unidentified hearing loss.”

Review the signs your child may have a hearing loss here, and share your experience parenting a child with hearing loss below.

"Hear Today, Gone Tomorrow," says the NYC Department of Health

By Tara Guastella

Last week, the New York City Department of Health announced the launch of a new public health awareness campaign. Rather than targeting oversize soft drinks or styrofoam containers, this ad campaign focuses on a very important issue: noise-induced hearing loss. The campaign warns that listening to headphones at a high volume can lead to both hearing loss and tinnitus.

The health department collected data on levels of hearing loss and found that nearly one out of four adults ages 18 to 44 who report heavy headphone use say they have hearing problems. This group was also more than twice as likely to report hearing problems than those who report light-to-moderate use or no use of headphones.

“Listening to headphones at a high volume for too long can damage your hearing,” says Health Commissioner Thomas Farley, M.D. “If you want to continue to enjoy music in the future, you’ll turn down the volume today.”

The hearing loss is permanent. Unlike birds, fish, and reptiles, humans and all mammals cannot restore their own hearing because we don’t have the ability regenerate inner ear hair cells. So when those hair cells are damaged by chronic exposure to loud sounds, our ability to hear is irreversibly compromised.

HHF’s Hearing Restoration Project (HRP) is working toward a cure for hearing loss and tinnitus. Our HRP consortium members are working collaboratively and sharing data on their findings in bird, zebrafish, and mouse studies. By doing so, they are able to assess how birds and zebrafish show regeneration while a mouse does not, after a very early developmental time. Other HRP research examines which cell types we are likely to need to target in damaged human ears to induce regeneration.  

As our HRP researchers work toward a cure, it is important to take precautionary steps to prevent further loss of hearing. Follow this advice from the NYC Department of Health:

• Reduce the volume, limit listening time, and take regular breaks.

• Never listen at maximum volume and do not turn the volume up to drown out external noise.

• Use volume limiting features of personal listening devices.

• Know the early signs of hearing loss and ask a doctor for a hearing test if you have trouble hearing conversation, need to turn up the volumes on TV, radio, or personal music players or experience ringing in the ear.

Safe listening!