Q: How can genetics affect hearing loss?
A: As of 2006, researchers have identified 145 different genetic loci that cause hearing loss in humans. Recent studies have revealed that approximately 50-60% of moderate to profound, congenital, or early-onset hearing loss is genetic. The remaining 40-50% of hearing loss is due to non-genetic effects, such as maternal infection (CMV or rubella), prematurity, postnata infection (meningitis, otitis media), ototoxic drugs, or acoustic/ cranial trauma.
Q: What is BPPV?
A: Benign paroxysmal positional vertigo (BPPV) is a disorder that causes vertigo, dizziness, and other symptoms due to debris that has collected within a part of the inner ear. This debris, called otoconia, is made up of small crystals of calcium carbonate (sometimes referred to colloquially as “ear rocks”). With head movement, the displaced otoconia shift, sending false signals to the brain.
Q: What are symptoms of BPPV?
A: Symptoms of BPPV are almost always precipitated by a change in head position. Getting out of bed and rolling over in bed are two common “problem” motions. Some people feel dizzy and unsteady when they tip their heads back to look up. An intermittent pattern of these symptoms is usual.
Q: How can BPPV be treated?
A: Particle-repositioning maneuvers, including the Epley maneuver and the Semont-liberatory maneuver, are very effective in treating BPPV and can be performed in the doctor’s office in about 15 minutes. The goal of these maneuvers is to move the detached otoconia out of one of the semicircular canals. Treatment may also include individualized vestibular physical therapy exercises designed to help “retrain the brain.” The Brandt-Daroff habituation exercises are sometimes recommended and can be done at home. Canal-plugging surgery may be another option.
Q: What is otosclerosis?
A: Otoscelrosis is the abnormal growth of bone of the middle ear. This bone prevents structures within the ear from working properly and causes hearing loss. For some people with otosclerosis, the hearing loss may become severe.
Q: What are symptoms of otosclerosis?
A: Hearing loss is the most frequent symptom of otosclerosis. The loss may appear very gradually. Many people with otosclerosis first notice that they cannot hear low-pitched sounds or that they can no longer hear a whisper. In addition to hearing loss, some people with otosclerosis may experience dizziness, balance problems, or tinnitus.
Q: What causes otoscelrosis?
A: The cause of otosclerosis is not fully understood, although research has shown that otosclerosis tends to run in families and may be hereditary, or passed down from parent to child. People who have a family history of otosclerosis are more likely to develop the disorder. On average, a person who has one parent with otosclerosis has a 25 percent chance of developing the disorder. If both parents have otosclerosis, the risk goes up to 50 percent. Research shows that white, middle-aged women are most at risk. Some research suggests a relationship between otosclerosis and the hormonal changes associated with pregnancy. While the exact cause remains unknown, there is some evidence associating viral infections (such as measles) and otosclerosis.
Q: How is otosclerosis treated?
A: In many cases surgery is an option for treatment of otosclerosis. In an operation called a stapedectomy, a surgeon (otolaryngologist or otologist) bypasses the diseased bone with a prosthetic device that allows sound waves to be passed to the inner ear. It is important to discuss the risks and possible complications of this procedure, as well as the benefits, with the surgeon. In rare cases, surgery can worsen the hearing loss. If the hearing loss is mild, surgery may not be an option. Also, on occasion, some hearing loss persists after surgery. A properly fitted hearing aid may help some people with otosclerosis in situations that include persistent hearing loss. A hearing aid is designed to compensate for a hearing loss by amplifying sound. An audiologist can discuss the various types of hearing aids available and make a recommendation based on the specific needs of an individual.
Q: What is tinnitus?
A: Tinnitus is a sensation of ringing, roaring, buzzing, or hissing in the ears or head that accompanies many forms of hearing loss.
Q: How can tinnitus be treated?
A: It is important to keep in mind that tinnitus is a symptom, not a disease. As such, the optimal treatment strategy should be directed toward eliminating the disease, rather than simply alleviating the symptom. Also, because tinnitus may be symptomatic of a more serious disorder, it is important to try to find the medical cause before deciding on treatment. preventing and minimizing tinnitus. Here are a few things patients can do to help prevent and minimize tinnitus:
· Reduce exposure to extremely loud noise
· Avoid total silence
· Decrease salt intake
·Monitor one’s blood pressure
· Avoid stimulants such as caffeine and nicotine
· Exercise
· Reduce fatigue
· Manage stress
· Educate yourself
While there is no known cure for most forms of tinnitus, there are many management options available and most tinnitus sufferers can find varying degrees of relief from one or a combination of the following. Medications. There is no single medication that works on all tinnitus patients. Some of the antidepressants and anti-anxiety medications available are helpful for certain tinnitus patients, however more research is needed in this area.
Q: What is Menier’s Disease?
A: Meniere’s disease is a vestibular disorder that produces a recurring set of symptoms as a result of abnormally large amounts of a fluid called endolymph collecting in the inner ear.
Q: What causes Menier’s Disease?
A: The exact cause of Meniere’s disease is not known. Theories include circulation problems, viral infection, allergies, an autoimmune reaction, migraine, and the possibility of a genetic connection. Experts also aren’t sure what generates the symptoms of an acute attack. Some people with Meniere’s disease find that certain triggers can set off attacks, including stress, overwork, fatigue, emotional distress, additional illnesses, pressure changes, certain foods, and too much salt in the diet.
Q: What are symptoms of Menier’s Disease?
A: Spontaneous, violent vertigo, fluctuating hearing loss, ear fullness, and/or tinnitus. Following the attack, a period of extreme fatigue or exhaustion often occurs, prompting the need for hours of sleep. The periods between attacks are symptom-free for some people and symptomatic for others. Attacks can last from 20 minutes to 24 hours. They can occur many times per week; or they can be separated by weeks, months, and even years. The unpredictable nature of this disease makes it difficult to tell how it will affect a person’s future. Symptoms can disappear one day and never return, or they might become so severe that they are disabling.
Q: How is Menier’s Disease Treated?
A: The most conservative long-term treatment for Meniere’s disease (aimed at reducing the severity and number of attacks) involves adhering to a reduced-sodium diet and using diuretics, or “water pills.” The goal of this treatment is to reduce inner ear fluid pressure. Some physicians, more commonly outside of the United States, also weigh the potential efficacy of using betahistine HCl (Serc) as a vestibular suppressant for Meniere’s disease. Medications that are used during an attack to reduce the vertigo, nausea, and vomiting include diazepam (Valium), promethazine (Phenergan), dimenhydrinate (Dramamine Original Formula), and meclizine hydrochloride (Antivert, or Dramamine Less Drowsy Formula). Vestibular rehabilitation therapy is sometimes used to help with the imbalance that can plague people between attacks. Its goal is to help retrain the ability of the body and brain to process balance information.
Q: What types of drugs or medications cause hearing loss or dizziness?
A: The following link to Ototoxic Medications, which is maintained by Timothy C. Hain, M.D. provides updated information on ototoxic drugs.
