A Primer on Swimmer’s Ear – Its Origins, Signs and Symptoms and Treatments

Swimmer’s ear, technically known as acute external otitis or otitis externa, is an infection that develops in the outer ear canal (the area outside your eardrum). The common name swimmer’s ear comes from the fact that the problem is frequently linked to swimming. Anytime water collects in the outer ear it results in a moist atmosphere where bacteria may grow. This condition is also caused by scratching or damaging the sensitive skin lining the ear canal by using your fingertips, cotton swabs, or other objects in an attempt to clean them. Fortunately swimmer’s ear is easily treated. If untreated, swimmer’s ear may cause serious complications therefore it is important to identify the signs and symptoms of the condition.

If the ear’s innate protection mechanisms are overloaded, the end result may be swimmer’s ear. Moisture in the ears, sensitivity reactions, and scratches to the ear canal lining can all promote the growth of bacteria, and cause infection. Activities that increase your likelihood of developing swimmer’s ear include swimming (especially in untreated water such as lakes), overly aggressive cleaning of the ear canal with cotton swabs, use of in-ear devices such as “ear buds” or hearing aids, and allergies.

Itching inside the ear, mild pain or discomfort that is worsened by pulling on the ear, redness and an odorless, clear fluid draining from the ear are all signs and symptoms of a mild case of swimmer’s ear. Moderate symptoms include more severe itching and pain and discharge of pus-like liquids. Extreme cases of swimmer’s ear are accompanied by symptoms such as fever, severe pain which may radiate into other parts of the head, neck and face, swelling redness of the outer ear or lymph nodes, and possibly blockage of the ear canal. If left untreated, complications from swimmer’s ear can be quite serious. Complications might include short-term hearing loss

, long-term ear infections, deep tissue infections which may spread to other areas of the body, and cartilage or bone loss. The potential for severe complications implies that you should visit a doctor as soon as you suspect swimmer’s ear.

Swimmer’s ear can be diagnosed in an office visit after a visual exam

. They will also check at the same time to see if there is any damage to the eardrum itself. If swimmer’s ear is the problem, it is typically treated first by cleaning the ears very carefully, and then prescribing antibiotic or antifungal eardrops to fight the infection. If the infection has become widespread or serious, the physician may also prescribe oral antibiotics.

To prevent swimmer’s ear, dry your ears thoroughly after showering or swimming, avoid swimming in untreated water resources, and do not place foreign objects into your ears to clean them.

Chickens, Fish and Human Hearing Loss – New Research Into Regenerating Inner Ear Hair Cells

As hearing professionals, one of the frustrations we encounter in our practice is that the conditions that have caused hearing loss in our patients cannot be reversed. One of the primary causes of hearing loss, for example, is damage to the tiny hair cells in our inner ears that vibrate in reaction to sounds. These vibrations are then translated by the brain into what we think of as hearing.

The sensitivity of these tiny hair cells allows them to vibrate in such a manner, and thus makes it possible for us to hear, but their very sensitivity makes them very fragile, and prone to damage. The hair cells of the inner ear can sustain damage from exposure to loud noises (causing noise-induced hearing loss, or NIHL), by certain medications, by infections, and by aging. Once these hair cells are damaged in human ears, science has to date not found any way to repair or “fix” them. Since we can’t reverse the damage, hearing specialists and audiologists look to technology instead. We compensate for hearing loss due to inner ear hair cell damage with hearing aids and cochlear implants.

Things would be a lot simpler if we humans were more like chickens and fish. That may seem like a peculiar statement, but it’s true, because – unlike humans – some fish and birds can regenerate the hair cells in their inner ears, thereby regaining their hearing once it has become lost. Chickens and zebra fish are just 2 examples of species that have the capacity to spontaneously replicate and replace their damaged inner ear hair cells, thus permitting them to fully recover from hearing loss


While it is vital to state at the outset that the following research is in its beginning stages and that no practical benefits for humans have yet been achieved, sizeable advancements in the treatment of hearing loss may come in the future as the result of the innovative Hearing Restoration Project (HRP). Funded by a not-for-profit organization called the Hearing Health Foundation, this research is presently being conducted in 14 different labs in Canada and the United States.Working to isolate the molecules that allow the replication and regeneration in some animals, HRP researchers hope to find some way to enable human inner ear hair cells to do the same.

This research is painstaking and challenging. Researchers need to sift through the many molecules involved in the regeneration process – some of which facilitate replication while others inhibit it. Researchers are hoping that what they learn about hair cell regeneration in fish or avian cochlea can later be applied to humans. Some of the HRP researchers are pursuing gene therapies as a way to promote such regrowth, while others are working on using stem cells to accomplish the same goal.

Our entire staff extends to them our well wishes and hopes for their success, because absolutely nothing would thrill us more than being able to someday completely cure our clients’ hearing loss.

Should You Fix Your Old Hearing Aid or Should You Replace It?

One of our most frequently asked questions is, “My hearing aid is broken or is no longer working – should I replace it with a new one, or have it repaired?” The honest answer needs to be, “Depends.” It is really an individual choice, and the “correct answer” is as individual as the individuals who ask it.

The first thing to take into account is that all hearing aids – no matter how high-end they were or how well they were built – will sometimes start to function less effectively, or fail. They operate, after all, in an atmosphere (your ear canals) that is inhospitable to them because it contains moisture and ear wax. Ear wax is normal and essential because it guards the delicate lining of the outer ear, but it can be tough on hearing aids; moisture that stays in the ears after bathing or swimming can be even harder on them. Add to these 2 issues breakage (from unintentionally dropping the aids and natural wear and tear (as inner tubing or components degrade), and you can safely bet that at some point your hearing aid will require either replacement or repair.

One of the things that should most influence your choice to “replace or repair” is whether you like your current hearing aids. If you do, or you have gotten accustomed to the sound they produce( as many wearers of older analog hearing aids do), it might make more sense to have them repaired than to replace them with newer digital aids which could produce a very different sound or wearing experience.

A further thing to consider, obviously, is cost – brand new hearing aids may cost thousands of dollars, but fixing your present aids might cost only a few hundred dollars dependent on what is wrong with them. The part we cannot answer for you is the influence of insurance. Some insurance plans include replacements, but not repairs or have varying policies on partial or full coverage.

If you opt to have your hearing aids fixed, another question that arises is, “Should I take them to the store I purchased them from, or send them to one of the numerous repair labs who advertise on the Internet?” While you could decide to deal with a far off repair laboratory directly, your local audiologist is a tremendous resource. To begin with, they can determine if repairs are in fact necessary. Second, they may be able to get the repairs completed on site decreasing the length of time you do not have your hearing aid. For hearing aids which do need laboratory or manufacturer repairs, the clinic will coordinate all the communications and paperwork for you. Don’t assume the price will be higher for these added services, because audiologists deal with repair facilities in bulk.

Far more choices are available to those who elect to replace their existing hearing aids. You should be open-minded about new designs and technology understanding that anything new takes some getting used to. Newer hearing aids are more compact and provide enhanced programability to achieve the sound quality you prefer. The answer to the “replace or repair” question is still your responsibility, but we hope that the information we have provided will help you.

A Look at the Relationships Between Hearing Impairment and Reduction in Cognitive Function

If you suffer from some form of hearing impairment, do you ever find that listening to people speak is work, and that you have to try really hard to understand what people say? This is a phenomenon that happens even to people wearing hearing aids, because in order for them to perform well you have to have them fitted and tuned correctly, and then get used to using them.

Regrettably, the repercussions of this sensation may not be restricted to hearing loss; it may also be linked with declines in cognitive abilities. The latest studies have indicated that there is a solid association between hearing loss and your risk of developing dementia and Alzheimer’s.

A 16-year study of this relationship from the Johns Hopkins School of Medicine included 639 participants ages 36 to 90. The data indicated that 58 study volunteers – 9% of the total – had developed dementia and 37 – 6 percent – had developed Alzheimer’s. The degree of hearing loss was positively correlated with the likelihood of developing either condition. For every 10 decibel further hearing loss, the risk of developing dementia went up by 20 percent.

A different research study of 1,984 people, also sixteen years in duration, demonstrated comparable results connecting hearing loss and dementia. In this second study, investigators also found decline of cognitive capabilities among the hearing-impaired over the course of the project. When compared with individuals with normal hearing, those with hearing loss developed memory loss 40% faster. An even more startling finding in both studies was that the link between hearing loss and dementia held true even if the individuals wore hearing aids.

A number of hypotheses have been proposed to explain this seeming connection between hearing loss and loss of cognitive performance. One hypothesis is based on the question at the beginning of this article, and has been given the name cognitive overload. Some researchers think that if you are hearing impaired, your brain exhausts itself just trying to hear that it has a reduced capacity to understand what is being said. The resulting lack of comprehension may cause social isolation, a factor that has been demonstrated in other studies to lead to dementia. Another idea is that neither dementia nor hearing loss cause the other, but that they’re both related to an as-yet-undiscovered disease mechanism – possibly vascular, possibly genetic, possibly environmental – which causes both.

However dismal these study results may sound, there are things to be learned from them. For those of us who wear hearing aids, these results serve as a reminder to see our hearing specialists on a regular basis to keep the hearing aids properly fitted and programmed, so that we aren’t constantly straining to hear. The less work expended in the mechanics of hearing, the more brain power available for comprehension. Also, if hearing loss is related to dementia, knowing this may lead to interventional techniques that can delay its onset.

Preventing Future NIHL in Professional and Amateur Musicians

What do Neil Young, Brian Wilson, Eric Clapton, and Pete Townshend have in common, besides all being musicians? All of these musicians experienced – as a result of playing the music they love – permanent hearing loss.

When I treat musicians, I have to tell them a sad but unavoidable fact of life – the very music they love to play may be damaging their hearing. When a musician is exposed to loud music they can suffer from noise-induced hearing loss (NIHL) which produces ringing in the ears, sometimes referred to as tinnitus. With similar ongoing exposure permanent hearing loss can result.

The hearing loss can happen to any musician, whether they play in a rock band, in a symphony orchestra, in a chamber music group, or just play at home when rehearsing. Any sound with an amplitude (volume) of over 85 decibels (dB) can cause hearing loss if you are exposed to it for long periods of time. While 85dB may sound like a high level of sound, even rehearsal situations can produce these levels. Rock musicians and classical alike are both exposed to excessive amplitude of sound; an unamplified violin reaches 103dB and an electric guitar produces 120dB. It has been estimated that musicians do more damage to their ears during the hours that they rehearse alone than they do in the short times they spend on stage.

Musicians can take steps to protect their hearing despite this unavoidable exposure to sound that exceeds acceptable levels, even in seemingly quiet rehearsal settings. When investing in high-quality ear protection beyond what can be had from drug-store Styrofoam ear plugs, performers can trust their hearing is protected. Manufactures of ear protection today still use the original and proven design first invented by Etymotic Research over 20 years ago. These musicians earphones are better for your purposes because they allow you to hear the full frequency range of both music and speech, but at lower volumes that don’t damage hearing.

Stores that sell musical instruments and supplies carry what are called universal-fit earplugs for about $15 per pair. Whether you are a professional musician or just someone who plays for fun, I recommend a better form of protection – custom-molded musicians earplugs with the Etymotic filter in place. Comfortable even with extended wear for long periods of time, custom-molded earplugs block undesirable sound allowing the music to come through undistorted and without damaging hearing. Yes, they’re more expensive than the earplugs sold in music stores, but since hearing damage is irreversible, how much is your ability to hear the music you play worth to you?

Why Hearing in Crowded Situations Might be Particularly Challenging for You

Our patients frequently ask us why they seem to have significantly greater difficulty hearing in busy spaces as compared to other situations. They report that they don’t seem to have any problem hearing people and understanding what they say when they are speaking to them one-on-one, or even in small groups. But in a crowd, such as a noisy party or in large public gatherings, suddenly it becomes difficult to understand what the person speaking to them is saying, or to distinguish the speaker’s voice from the background sounds. People who complain of this condition often report that they have difficulty distinguishing between consonants such as the letters “S,” “F,” and “H.”

If these challenges sounds familiar to you, it is possible that you have a degree of hearing loss in the high-frequency range. When describing human speech, audiologists define the 3000 to 8000 Hertz range as high-frequency. This is the range that the F, S, and H sounds typically fall into. In crowds, there is a mix of frequencies, ranging from the low frequencies of background music or people walking or dancing to the higher frequencies of human speech. People with high-frequency hearing loss tend to perceive the lower frequencies – in this case, the noise – as sounding louder than the higher frequencies, which they are now having more trouble hearing.

At least 18 percent of the population suffers from some form of high-frequency hearing loss. One of the possible causes for this condition is aging, but high-frequency hearing loss has in recent years been increasing in teenagers and younger adults as well, possibly as a result of being exposed to overly loud music, and suffering noise-induced hearing loss. Other factors that can cause hearing loss include genetics, exposure to toxic drugs (including some chemotherapy agents), diabetes, and other diseases.

If you have indeed suffered some high-frequency hearing loss, it can be treated. We can prescribe hearing aids that have been adjusted to reduce the volume of low-frequency sounds and boost the volume of the higher frequencies, so that you can hear better in crowds.

If you have trouble hearing in crowds, your first step should be to make an appointment with one of our specialists, so that we can determine whether you have suffered some form of hearing loss. Our audiologist can perform a variety of tests to identify the underlying cause of the problem and recommend the best treatment options for your specific situation.

Choosing a Cell Phone that will be Compatible with Your Hearing Aids

Hearing aids and cellular phones haven’t always gotten along as well as they do now. The complex electronics in both devices often caused static, dropped words or squealing interference noises. Fortunately, improvements in technology and new government regulations have made the issue “Will this cell phone work with my hearing aid?” simpler to answer. To help consumers shop for the right hearing aid compatible cell phone, the new regulations include a standard rating system and labeling requirement.

Understanding the rating system requires a bit of knowledge about the modes that hearing aids can operate in. There is an M mode (which stands for microphone) and a T mode (which stands for telecoil). In M mode, your hearing aid uses its built-in microphone to pick up audible sounds from the environment and amplify them so that you can hear them. In T mode, the hearing aid uses telecoil technology instead. The hearing aid is able to pick up the electromagnetic signals from inside the phone directly. Roughly 60 percent of all cell phones sold in the United States have a telecoil (T) mode.

The two modes – M and T – are each rated on a scale of 1 to 4 where 1 is the lowest sensitivity and 4 is the highest. No mobile phone or cordless handset sold in the United States can be sold as hearing aid compatible (HAC) unless it has a rating of at least M3 or T3.

In addition, many hearing aids (and cochlear implants) have a similar M and T rating to measure their sensitivity and their resistance to radio frequency interference. When shopping for a phone, to determine its compatibility with your hearing aid, simply add its M and T ratings together with those of the phone to create a combined rating. A sum of 6 or more makes a solid pairing. That hearing aid and cell phone combination should work well for you. If the combined rating is 5, this combination is considered normal and suitable for most regular phone use. A combined rating of 4 is considered usable for brief calls, but may not be suitable for extended phone use.

If you are shopping for a mobile phone online, you can usually use this combined rating to determine how compatible the phone you are interested in buying will be with your hearing aid. If you are able to shop in a store that allows you to “try before you buy” and actually use the phone you want while wearing your hearing aid, that is of course a better idea.

Averting Typical First Time Hearing Aid Buyer Mistakes

The selection and purchase of a first hearing aid can be an overwhelming task for anyone. When Consumer Reports did a comparative report on hearing aids, they followed consumers for six months as they tried to figure out which one to buy. What they found was less than satisfying, because they found that two-thirds of the aids were either improperly fitted or that they provided either too much or too little volume. Even within this small group of people the price range for these hearing aids was huge and they were not always provided the best information by the retailers.
To spare you this experience, in this article we’ll try to provide a few tips to help you when shopping for your first hearing aid. This article is too short to provide all the tips that would be useful, so to supplement it we recommend Your Guide to Buying Hearing Aids. It is an article provided by a non-profit corporation called the Better Hearing Institute (BHI), which provides educational materials about hearing loss and how to correct it. Here are our suggestions:

    1. Consult a professional hearing specialist – Make an appointment with us or with another certified hearing specialist in your area, and read the information in the BHI guidelines before you go. The BHI guidelines will walk you through what you can expect at your first appointment and what questions you may need to ask your specialist.
    2. Select the hearing aid that best suits your needs and lifestyle – This depends on the type and severity of your hearing loss, and should have been determined by tests performed by specialists during Step 1. Settling on the perfect hearing aid for you will take into account the type of hearing loss you are experiencing as well as your budget.
    3. Research hearing aids of this type – Once you know which type of aid is bested suited for you, go to the Internet. Your research should focus on any reports of problems or repairs, consumer reviews on comfort and reliability, as well as price comparisons.
    4. Search for and select a vendor you can rely on – The vendor may be the specialist you saw in Step 1, or can be someone recommended by them. The vendor should be able to make molds of your ears and fit the aids properly. While it is possible to buy hearing aids on the Internet, this is not recommended because most models have to be custom-fitted.
    5. Make sure the aids fit and work properly – Your first fitting should include tests by your vendor to ensure comfortable fit and good function of your new hearing aid. Most reputable vendors will do this, and provide a “satisfaction guaranteed” warranty, complete with free followup fittings or adjustments, if necessary.

We wish you good luck with selecting your first hearing aid, and want you to know that we are here to provide help if you need it.

Hearing Loss Early Warning Symptoms

Hearing loss may appear in many forms, and can appear either suddenly, as the result of injury or trauma, or over time, due to the aging process. Hearing loss may range between mild instances of not hearing conversations correctly to severe periods of total deafness, and may be either permanent or temporary. Either a single ear can be affected by hearing loss, or both ears.

You will find many symptoms linked to hearing loss, one of the most common of which is a growing difficulty hearing or understanding conversations. You may experience other’s speaking voices as if they were speaking too softly or are too distant to be heard properly, or their voices may seem to be muffled and indistinct. Or alternatively, you might be able to hear folks speaking but discover that you are having trouble distinguishing individual words; this could become more noticeable when multiple people are speaking simultaneously, or when you are in noisy locations.

Other common signs of hearing loss include increasing the volume on your TV or radio, having more difficulty hearing women’s voices than men’s, and not being able to differentiate sounds such as ‘th’ and ‘s’ from one another. If you experience pain, irritation, or itching in your ears, have instances of vertigo or dizziness, or hear a constant buzzing or ringing sound, these symptoms may also be indications of hearing loss.

Because it can occur gradually, many people with hearing impairment don’t realize it. This can sometimes lead to habits or behaviors intended to hide their hearing loss from other people. Examples of these types of symptoms include having to ask people to repeat themselves often, avoiding dialogues and social situations, pretending to have heard stuff that you really didn’t, and emotions of isolation or depression.

If any of these symptoms sound familiar to you, it’s time to make an appointment with one of our hearing specialists. They will give you a hearing test to determine if you have experienced hearing loss, and if so, can help you do something about it.

Being Safe at Home when a Family Member is Hearing Impaired

One subject that is rarely discussed with regards to hearing loss is how to keep people who have it safe in their own homes. For instance, imagine that a fire starts in your home; if you’re like most people you have smoke detectors to sound a warning so that you and your family can evacuate the premises before a fire spreads too far and traps you. But now imagine that this fire begins at night, when you’re sleeping, and you have taken off your hearing aids.

The smoke detectors standard in almost all homes and those required by city and local governments emit a loud warning sound at a frequency between 3000 to 4000 Hz. And while the majority of people can hear these sounds easily, these frequencies are among those most impacted by age-related hearing loss and other kinds of auditory impairment. So if you’re among the more than 11 million people in America with hearing problems, there’s a possibility that you simply would not hear your smoke alarm even if you were awake.

Fortunately, there are home safety products which are specifically designed for the needs of the hearing impaired. For instance, there are smoke alarms that emit a low-frequency (520 Hz) square wave tone that a majority of hearing-impaired people can hear. For those who are totally deaf, or who are unable to hear whatsoever when they remove their hearing aids or turn off their cochlear implants (CIs) at night, there are alert systems that combine exceedingly loud noises, blinking lights, and vibrators that shake your mattress. Several of these systems are designed to be incorporated into more complete home security systems to alert you to intruders or people thumping furiously on your door in the event of an emergency.

To hear other sounds which might signal danger, many hearing-impaired individuals have installed induction loops in their homes for boosting the efficiency of their hearing aids or cochlear implants. These systems are basically long strands of wire placed in a loop around your living room, kitchen, or bedrooms. These serve to activate the telecoils embedded in your hearing aid or cochlear implant that increase the volume of sound; this can be useful in emergencies.

And of course there is the humble telephone, which many of us often ignore until we need one, but which may become crucial in any sort of emergency situation. Thankfully, many modern mobile and home telephones are now telecoil-compatible, to allow their use by those wearing hearing aids or cochlear implants. Moreover, there are phones made for the hearing impaired which incorporate speakerphones that operate at high volumes, and which may be voice-activated. So if you were to fall and hurt yourself out of reach of the telephone, you could still voice-dial for help. Other manufacturers make vibrating wristbands that interact with your cell phone to awaken you or advise you if you get a phone call.

Naturally, some home safety suggestions for the hearing impaired are the exact same as for people who can hear well, such as trying to keep lists of your health care providers, emergency service providers, and hospitals close at hand. We are as concerned about your safety as we are about your hearing, so if we can be of assistance with any further tips or recommendations, feel free to call us.

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