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Manalapan Office Walk Through

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Here is a link to a walkthrough of our new Manalapan Office! Check it out, and reach out to us to schedule your appointment! Manalapan Office Walkthrough Video

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Why do hospitals, schools and pediatricians screen for hearing loss

What are school hearing screenings?

Screening programs are developed and used to identify individuals who are likely to have a specific condition.

• In this case, we are talking about hearing screenings!

• School-age hearing screenings are an integral tool in identifying children with hearing loss who were not identified at birth, lost to follow-up, or who developed hearing loss later.

• A hearing screening is a simple “pass” or “fail” test. 

• Its purpose is to determine if a child has normal hearing or not. 

• It consists of a series of beeps or tones, played through headphones, at the limit of normal range to see if the child is able to hear them.

• The child responds by raising their hand if the tone was heard across different pitches, and for each ear.

Purpose of a school hearing screening:

• A hearing screening can detect potential hearing loss

• The screening places a child into either a “normal hearing” group or “possible hearing loss group”

• This would lead to a recommendation for further testing to rule out presence of hearing loss

• School hearing screenings can pick up hearing losses that are missed at birth

• Newborn hearing screenings that are done at the hospital do not reliably rule out potential mild hearing losses

When should we screen?

• School districts have timelines set in place for when students will be screened: 

• Children who are entering school (Kindergarten, 1st grade in some places)

• Children in K-3 (annual evaluations at these ages)

• Children in 7th grade

• Children in 11th grade

• Children who have failed a grade

• Children with speech/language delay

• Children entering a special education program

Who Else Should We Screen?

However, there are other times outside of routine school hearing screenings when a child should have their hearing screening: 

• Concerns about hearing, speech language or learning

• Family history of delayed or late onset hearing loss

• Signs of syndromes that include hearing loss

• Craniofacial/ear abnormalities

• Persistent ear infections for more than 3 months

• Head trauma and loss of consciousness

• Ototoxic drug exposure (harmful to hearing)

•  Noise exposure

What is Considered a “Pass”?

• Each tone is presented to the child 3 times at 20 dB HL, which is the cutoff loudness level to be considered within the range of normal hearing. 

• If a child hears it at least 2 out of 3 times, he/she passes at that frequency, or pitch. 

• If the child passes at all frequencies, then the child passes the screening.

What is Considered a “Fail”?

• If a child does not respond to one or more of the tested frequencies at a level greater than 20  dB HL, it is considered a “failed” hearing screening

• The child “fails” the screening even if only one ear did not hear the tones at this level

If the Child Fails the Screening, What Happens Next?

• The child should be re-screened, either:

• On the spot

• On another date (should be within 24-48 hours after the first screening)

• Another type of screening tool may be used to compare to results from the first screening

• The child may be referred to an Ear, Nose & Throat doctor (ENT) or an Audiologist for a full hearing test

• Parents should be notified about results from the screening either by mail or over the phone

Consequences of Missed Hearing Loss:

• Impaired hearing is a primary health condition, just as impairment of any sense organ.

• Sensory deprivation results in restricted or non- development of the central auditory nervous system.

• Communicative: Compromised speech-language development.

• Social/Emotional: Family will use ineffective communication behaviors, experience frustration, and misinterpret the child’s behaviors and might experience guilt and anxiety when the hearing loss is diagnosed.

• Cognitive/Academic: Negative effects on vocational and economic potential and contributions to society.

What is EVA Enlarged Vestibular Aqueduct

What is an Enlarged Vestibular Aqueduct (EVA)?

 The vestibular aqueduct is a bony canal that begins inside the temporal bone and travels

within the inner ear to deep inside the skull

 Running through the aqueduct is a fluid-filled tube called the endolymphatic duct, which

connects the inner ear to the endolymphatic sac

 The role of these two structures is to maintain a normal ion concentration

 Some believe that the vestibular aqueduct is mature at birth, while others believe it

continues to grow postnatally until about age 3-4

A vestibular aqueduct is considered enlarged if it is greater than 1-1.5mm. Usually, when the

aqueduct is enlarged, the endolymphatic duct and sac are large too. This causes the regulation of

cochlear fluid and ion concentration to be disrupted

EVA & HEARING LOSS

 EVA can occur in isolation, but also can co-occur with congenital disorders such as

Pendred syndrome, CHARGE syndrome and Branchiootorenal syndrome

 EVA can lead to both hearing loss (most likely sensorineural) and balance issues

 It can be identified with a CI Scan or an MRI

 There is no “cure” for EVA, but hearing aids are most commonly used to manage hearing

loss associated with it

 Vestibular therapy can be beneficial to those who have balance problems due to EVA

EVA & CONTACT SPORTS

 Those with EVA may be at risk for progressive hearing loss, in which the hearing can

gradually or rapidly decrease or fluctuate over time

 Head injury or barotrauma increase the likelihood of progressive hearing loss

 People with EVA are *strongly advised* to avoid contact sports such as football and

soccer, as well as wear helmets when engaging in activities that put them at risk for head

injury

Contact us for more information on EVA!

What are vestibular disorders

Vestibular Disorders

How does my ear affect my balance?

 The Organ for Balance, or the vestibular system, lies within the inner ear

 It consists of three fluid-filled loops call the semicircular canals

 The fluid within the canals changes in response to head motion

 Our vestibular system, eyes and proprioceptive system help us move our bodies within

space and maintain our balance

Vestibular conditions can be caused by:

 Changes in medication

 Poor circulation of the ear

 Movement of “ear crystals” within the semicircular canals

 Infections

 Debris in the semicircular canals

 Traumatic brain injury

Symptoms of a vestibular disorder:

1. Falling, swaying or tilting

2. Vertigo

3. Floating feeling

4. Feeling off-balance

5. Leaning to one side

How do I test for a vestibular disorder?

An audiologist may perform a videonystagmography (VNG) to test for certain vestibular

conditions. This gives the audiologist information about how the vestibular portion of the inner

ear is functioning. The patient wears goggles to monitor eye movements. The patient will

perform several tasks, including following a moving target on a screen, moving their head and

body in various positions, and having warm and cool air put into the ear canal. During these

tasks, the audiologist monitors eye movements and attempts to simulate dizziness to determine

the potential source of symptoms.

What happens next?

Depending on the results of the testing, an audiologist may refer for vestibular therapy.

Sometimes, the audiologist may refer to a specialist, such as an Ear, Nose and Throat physician

or a neurologist to determine if additional testing is warranted. In certain cases, home exercises

may be recommended to alleviate dizziness symptoms.

Who benefits from using custom musician ear plugs

WE MAKE CUSTOM MUSICIAN MONITORS!!

Q: What are musician monitors?

A: Musician earplugs and in-ear monitors are used for musicians and sound engineers to protect

their ears when performing or when exposed to high levels of sound pressure

Q: How do custom musician plugs differ from conventional ear plugs?

A: Conventional earplugs muffle speech and music; additionally, conventional earplugs reduce

more sound in the high frequencies than low and mid frequencies, which makes speech and

music sound unnatural and distorted. Custom earplugs allows for speech and music to sound

natural, preserving the distinct quality and richness of speech and music, but it is ensured to be at

a safer volume level.

Wearing in-ear monitors allows for musicians to hear themselves play music while still

protecting their hearing.

Musicians are not the only professionals who use musician plugs or in-ear monitors:

Aircraft:

 Crew

 Flight instructors

 Passengers

 Pilots

Athletics:

 Athletes

 Coaches

 People at sporting events

Construction:

 Carpenters

 Equipment operators

 Road builders

 Steel workers

Emergency vehicles:

 EMTs

 Highway patrol

 Firefighters

Industrial:

 Factory workers

 Shop teachers

 Students

 Supervisors

Leisure:

 Concerts

 Nightclubs

 Noisy restaurants

Medical-Dental:

 Dentists

 Hygienists

 Technicians

 Surgeons

Motor Sports:

 Motorcyclists

 Pit crews

 Race car drivers

 Spectators

Music:

 Concerts

 Marching bands

 Musicians

 Night clubs

Others:

 Delivery drivers

 Markey traders

 Night club staff

 Truck drivers

Celebrities with Hearing loss

CELEBRITIES WITH HEARING LOSS

1) Stephen Colbert: Colbert is deaf in his right ear as a result of surgical removal of a tumor

when he was a child. Colbert initially wanted to be a marine biologist, but the damage to

his ear would not allow him to scuba dive.

2) Steve Martin: The actor utilizes hearing aids to manage hearing loss and tinnitus. Martin

reportedly has hearing damage as a result of noise-induced hearing loss after being too

close to a loud gunfire on the set of “The Three Amigos” without wearing hearing

protection.

3) Katie Leclerc: The actress, who played a deaf teenager on the TV show Switched at

Birth, was diagnosed with Meniere’s disease, which causes fluctuating hearing loss,

ringing in the ears, aural fullness, and vertigo.

4) Whoopi Goldberg: The TV personality reportedly has low-frequency hearing loss, which

creates difficulty hearing vowel sounds like “a” and “e” that produce the energy of sound.

Goldberg has attributed her hearing loss to many years of listening to loud music without

hearing protection. She currently wears two hearing aids and is vocal about her hearing

journey.

5) Halle Berry: Berry has stated that she has a significant degree of hearing loss as a result

of a head injury.

6) Lou Ferrigno: The bodybuilder and actor has had profound hearing loss since the age of

three. He wore many hearing aids over the years, but due to his impaired word

understanding, was ultimately a Cochlear Implant recipient. Ferrigno has stated that the

CI has helps him hear “s” sounds and ambient noises that he was previously not able to

hear.

7) Derrick Coleman Jr: The football player has had known hearing loss since the age of

three due to a hereditary condition. He reportedly wears pantyhose underneath his helmet

to keep his hearing aids protected from moisture and prevent feedback!

Protecting your hearing aids in the Summer time

The summer is the riskiest time of year for hearing aids!

Hearing aids can:

• Get lost on days at the beach

• Be forgotten about when jumping into the pool

• Clogged with sand

• Moist from sweat

Here are some tips to protect your hearing aids during these summer months!

1) Keep up with daily cleaning!

 Use the brush to clean hearing aid microphones

 Wipe down the hearing aids using a microfiber cloth

 Change wax filters when necessary

2) Use a drying kit or desiccant to place next to your hearing aids at night

3) Place your hearing aids inside nylon sleeves to protect them from moisture

4) Remember to place your hearing aids in a portable pouch before going in the pool or onto

the sand. Don’t put them in your pocket!

5) Use an otoclip to clip your hearing aids to your shirt while playing sports

6) Visit your provider to have your hearing aids cleaned and checked to make sure they are

working properly for those summer activities!

Enjoy your summer!

Updated hours week of 04/18/2022-04/22/2022

We will have limited staff and limited hours this week. It may take a bit longer to receive a call back. If there is an urgent issue, please email Dr. Sandler at ES@thcaudiology.com

Hearing Assistive Technology

What is Hearing Assistive Technology?

Many individuals with hearing loss struggle in noisy environments. Hearing aids or cochlear implants alone may not be enough to overcome effects of noise, background conversation, reverberation and distance.

Hearing Assistive Technology (HATS) are devices that connect to hearing aids and/or cochlear implants to allow for a cleaner sound signal and facilitate clearer understanding and communication.

FM System:

• An FM system consists of a microphone that is placed close to a speaker, such as a teacher.

• The microphone transmits the speech signal directly into the hearing aids, which minimizes effects of distance, noise and reverberation.

• An FM system is particularly useful in settings such as a classroom, which can be a challenging environment for children.

• Utilizing an FM system has been shown to facilitate language development, reduce listening fatigue and allow a child to have a greater degree of independence at school.

Loop System:

• A loop system works with hearing aids or cochlear implants that have a telecoil.

• A copper wire is placed within a large room or theater that connects to a loop driver to a public sound system.

• The sound is then wirelessly transmitted into the hearing aids or cochlear implant to allow for cleaner and more direct signal.

Remote Microphone:

• Remote microphones wirelessly transmit speech signals directly into the hearing aids.

• They allow for a direct audio input that helps to overcome effects of distance, noise and reverberation.

• Remote mics have been shown to improve speech understanding in the presence of noise.

• They can be clipped to a talker’s clothes or placed on a table to pick up a speech signal.

TV Streamer:

• This device allows for TV signal to stream directly into hearing aids.

• It helps the individual with hearing loss to listen at a volume that is comfortable without disturbing those around them.

• The volume can be adjusted on the TV and on the hearing aids independently.

Amplified/Captioned Telephones:

• These allow for individual to use captioning in addition to hearing a speaker on the other end of a phone call.

• When an individual makes a phone call (either landline or cell phone), the phone connects to a Captioned Telephone Service (CTS), which uses voice recognition to transcribe what the person on the other end of the line is saying.

• These captions appear in almost real-time, allowing the individual utilizing closed captions to follow along without falling behind.

For more information about HATS, call our office!

Facts about Meniere's Disease

What is Meniere’s Disease?

• Meniere’s Disease is an inner ear disorder than can affect one’s hearing and balance systems

• It typically affects one ear but sometimes can affect both

• The onset of Meniere’s can be at any age, but most often starts between younger and middle adulthood

What Causes Meniere’s Disease?

• Meniere’s is thought to develop as a result of an abnormal amount of endolymph fluid in the inner ear

• While its cause is unknown, though it is thought to be due to genetics, viral infection, autoimmune response, or a combination of these

Four Main Symptoms of Meniere’s:

• Hearing loss

• Tinnitus (ringing in the ears)

• Aural fullness (clogged sensation)

• Vertigo

The severity of Meniere’s symptoms can fluctuate.

How Do These Symptoms Manifest?

1. Hearing loss is most commonly low frequency, though it can vary

2. Tinnitus is often described as a “roaring” or humming sound, which is also low frequency

3. Aural fullness typically occurs in the ear that is affected, and is most likely a byproduct of hearing loss

4. Perhaps the most debilitating symptom is vertigo, a spinning sensation that can last for a few hours and may lead to nausea and vomiting

While there is no “cure” for Meniere’s, there are several ways to manage symptoms:

• An Ear Nose & Throat physician may recommend a diuretic and/or low sodium and caffeine diet

• Motion sickness and anti-nausea medications may be prescribed to reduce effects of a vertigo episode

• An Audiologist may recommend a hearing aid if there is hearing loss and tinnitus present

• Vestibular rehabilitation may be useful if one has balance difficulties in between episodes of vertigo

• Surgical options may be considered in severe cases in which symptoms are not relieved with traditional management strategies for Meniere’s

For more information, contact our office!

Facts about hearing loss

Surprising Facts About Hearing and Hearing Loss

1. Noise exposure is a common cause of hearing loss

2. Newborns can have fluid in their ears that can impair their hearing temporarily

3. Approximately 32 million people with hearing loss are under the age of 15

4. Sitting close to loudspeakers at a concert can damage someone’s hearing in just 7.5 minutes

5. Sitting close to loudspeakers at a concert can damage someone’s hearing in just 7.5 minutes

6. Approximately 25,000 people in the U.S. have cochlear implants; about half of them are children

7. For people who have hearing loss in both ears, wearing two hearing aids is better than wearing one. Wearing two hearing aids helps the individual localize where sound is coming from

For More Information About Hearing Loss and Hearing Aids, Schedule an Appointment With Us Today!

Single Sided Deafness

Treating Single-Sided Deafness

A Unilateral Hearing Loss (UHL) is when one ear has normal hearing, while the other ear has some reduction in hearing. Hearing loss in the one ear can range in severity from mild to profound. Single Sided Deafness (SSD) is a type of unilateral hearing loss that is so severe that the ear is considered non-functional or deaf. Those with single sided deafness may not benefit from a hearing aid on that ear.

Causes of UHL and SSD may include:

• Congenital hearing loss

• Trauma or head injury

• Acoustic neuroma

• Viral or bacterial infections

• Vascular insults that damage the auditory pathway

• Ototoxicity

Unilateral hearing loss and single sided deafness can have a variety of consequences. 

These may consist of: difficulty with speech in noise, being accused of having selective hearing, trouble finding the location of sound in space, a tendency to misconstrue the intended message in group interactions, feelings of rejection/ridicule when an individual cannot follow a conversation, speech and language delays, reduced academic performance, fatigue and appearing disinterested.

There are a number of options to manage single sided deafness:

1. Contralateral Routing of Signals (CROS) Hearing Aid

This hearing aid device has a microphone placed on the impaired ear and a receiver on the better ear. The signal is wirelessly routed from the microphone on the poorer ear to the receiver on the better ear. CROS devices can lead to clearer conversations, improved speech understanding, and a more comprehensive listening experience.

2. Bone Anchored Hearing Apparatus (BAHA)

This consists of a metal abutment that is implanted into the patient’s skull, and an external piece that snaps on. A BAHA bypasses the outer and middle ear and stimulates both cochleae via bone conduction. A BAHA is beneficial for those with SSD due to outer and middle ear abnormalities.

Soft band BAHAs are an appropriate option for children under the age of 5 or for those who do not wish to undergo the surgical procedure.

1. Osia Implantable Device

The Osia implantable device is similar to that of a BAHA, as it bypasses the outer and middle portions of the ear to stimulate the cochlea via bone conduction.

With the Osia device, an internal implant is drilled into the mastoid bone, and an external processor connects to the internal piece via magnet to stimulate both cochleae.

Both BAHA and Osia devices have shown to lead to improved understanding of speech listening in both quiet and noise.

1. Cochlear Implant

Hearing aids make sound louder but do not make sound clearer. When an individual who is fit with a hearing aid continues to struggle with understanding speech, a cochlear implant can be considered.

A cochlear implant is a small electronic device that stimulates the auditory nerve electrically.

An internal component is surgically placed under the skin behind the ear. A thin wire with a magnet and an electrode array is inserted into the cochlea within the inner ear. An external piece sits behind the ear and connects to the internal component via magnet.

The external piece picks up sound with a microphone. The sound is then transmitted along the electrode array, which sends electrical stimulation up to the brain.

For individuals with SSD, cochlear implants are the only devices that can allow for “binaural hearing”.

Contact us to learn more about what device is right for you!

Signs of Hearing Loss

Signs That You Suffer from Hearing Loss

1. Speech sounds muffled or as though someone has marbles in their mouth

2. Asking people to repeat themselves, or frequently asking “what did you say?”

3. Difficulty and frustration when speaking on the phone

4. Experiencing ringing, buzzing, humming or chirping in one or both of your ears

5. Finding that you withdraw from social gatherings or participating less because you cannot understand others in noisy surroundings

6. Feeling that your ears are clogged or full

7. Struggling to follow conversations in noisy places such as restaurants, theaters, stadiums or lecture halls

8. Raising the television volume higher, even when others note that the TV is loud

If you feel you may suffer from hearing loss, schedule an appointment with us today!

Hearing Loss from Noise Exposure

Noise Induced Hearing Loss

When an individual is exposed to loud sound, the inner ear can become permanently damaged. This is known as Noise Induced Hearing Loss (NIHL). The longer one is exposed to loud noise, the greater likelihood of permanently damaging one’s hearing. The louder the sound, the less time it takes to cause damage to the inner ear.

Risks for NIHL include but are not limited to:

• Working in noisy environments, such as industrial factories, musician venues, warehouses, military bases, or transportation vehicles (trucks, airplanes, ambulances,

• Participating in activities such as shooting firearms or attending concerts

• Listening to music at an extremely loud volume level for extended periods of time

Signs that may indicate NIHL include: 

• Gradual or sudden hearing loss

• Difficulty understanding people, especially in noisy environments

• Sensitivity to noise (hyperacusis)

• Ringing/humming in the ears (tinnitus)

• Perception that pitch is off

• Changes in heart rate

• Disturbed sleep

• Cognition and learning disorders

How might you prevent NIHL?

Limit exposure to noise! Be sure to wear hearing protection devices such as earmuffs, earplugs or musician plugs. You may also consider using sound-isolating earphones when listening to music to decrease background noise and avoid needing to make the volume louder

A term that has been widely surfacing in the Audiology world is known as Hidden Hearing Loss. This term has been applied to cases in which the patient reports difficulty with speech in noise, tinnitus and hyperacusis, though tests reveal normal hearing. Exposure to loud sounds for extended periods of time can lead to functional deficits before hearing loss is displayed on hearing tests. Even if hearing is normal, these symptoms could be a precursor to hearing loss when exposed to loud sound!

If you think you may suffer from noise induced hearing loss, schedule an appointment with us today!

When should you see an Audiologist?

The Difference Between Ear, Nose & Throat Physicians (ENTs) and Audiologists

Q: What is an ENT?

A: An ENT specializes in medical or surgical treatment of the ear, nose and throat. Some ENTs perform ear surgeries such as PE tube placement, stapedectomies, mastoidectomies and implant devices such as BAHA, Osia, or Cochlear Implants.

Q: What is an Audiologist?

A: An Audiologist is a healthcare professional that specializes in the diagnosis and treatment of auditory (hearing) and vestibular (balance) disorders. An Audiologist uses technological solutions such as hearing aids to manage chronic hearing loss.

Q: When does one need to see an ENT?

A: One should visit an ENT if he or she has medical conditions that may affect the ear, nose or throat. 

Q: When does one need to see an Audiologist?

A: One should see an Audiologist if he or she notices increased difficulty with hearing, such as turning the television volume higher or struggling to follow conversations in noisy environments.

Q: Do ENTs and Audiologists work together?

A: Sometimes Audiologists will refer to ENTs to inquire about the underlying cause of a patient’s hearing loss or for medical management of the hearing loss. Similarly, ENTs may refer to Audiologists for management of a patient’s hearing loss when they determine it is not due to an underlying medical condition and can be managed under an Audiologist’s care.

Contact us to learn more about what we do as Audiologists!

Jabra OTC hearing devices

You may be hearing about over the counter hearing devices in the news. There is a lot of excitement about how they will help individuals with hearing loss. We will be offering Jabra Enhance plus as an option in our practice. These are limited self-fitting devices, likely limited to mild to moderate hearing loss. They will be suitable options for some patients, and they are definitely not for everybody. Here is some information about what is included with Jabra devices.

Jabra Enhance $800 for the set

Fitting Formula: Estimation via app

Fitting Range: mild to moderate hearing loss

Follow up service: All via app or Jabra, NOT from TheHearing Center

Warranty terms: 1 year service obtained direct from manufacturer

Streaming Connectivity: Limited to iphone 11 or never with iOS 15 via app and Jabra

Loss and Damage Coverage: None

Expected lifespan: 1 to 2 years

If you think these may be a fit for you, or you would like to better understand the differences between our more traditional hearing aids, and these devices, please contact our office.