Dr. Wright's Blog

Hear better ALL summer

Broadmead Hearing Widex Moment Summer 6-week Trial
 
Wind in the trees, birdsong, children's voices, trickling water. This is what natural sound is about.
 
Hearing aid manufacturer Widex has introduced an exciting new rechargeable hearing solution called Moment™ that offers natural sound, even in noisy situations. 

Moment doesn't sound like a hearing aid

Widex says that Moment delivers the most pure, natural sound ever. This is because of the way hearing aids typically process sound. 
 
If sound processed in a hearing aid reaches the eardrum later than sound heard directly, when the two signals mix they can be ‘out of sync'. This lag is what can create an artificial sound in hearing aids. The Moment is equipped with ultra-fast processors that remove the delay, resulting in pure and natural sound like you heard before hearing loss.

Widex Moment also features:

  • Audio streaming from all of your devices, including smartphones & your TV
  • A nano coating that resists moisture
  • Light weight, easy-to-use charger
  • mRIC R D - the smallest lithium-ion receiver-in-canal hearing aid 
  • Fingertip control from your smartphone with the Moment app

Broadmead Hearing Widex Moment man sitting at desk

Try Moment for 6 weeks (at no cost) this summer

We're receiving positive feedback on the Moment from clients who are trying it. If you want to hear more about the features of this new hearing aid - and hear the difference for yourself - request an appointment. We'd be happy to show you how Moment can improve your hearing.
 
Broadmead Hearing Widex Moment 6-week Trial
If you prefer to call to schedule an appointment please do! Broadmead Hearing Clinic: 250.479.2969 or Oak Bay Hearing Clinic: 250.479.2921. We look forward to hearing from you.
 
 

 

Audiology case files: the rogue right ear

Audiologist detectives magnifying glass and footprints

 

In many ways an Audiologist is a detective. Much like solving a case, an Audiologist puts together clues—symptoms and test results—to uncover what is affecting a client’s hearing or balance. Today we’re running through a case with you that puts audiological diagnostic skills and knowledge to the test.

The case history

The case history allows an Audiologist to get to know each client and listen to their perspective on their hearing and/or balance issues. This conversation provides the first clues that will help determine the best course of action.

 

By asking specific questions, the Audiologist gets a better idea of what might be causing the client’s symptoms, and which tests to administer during the evaluation. 

Audiologist: What brings you into the clinic today?

Patient: I've noticed that my voice sounds louder in my right ear. I’ve always been a loud talker. Others have mentioned that in the past, but in the last couple of months, I've noticed it too.

Audiologist: Is there a feeling of fullness or pressure in either ear?

Patient: Yes, my right ear feels a bit full. I have allergies too so I’m not sure if it’s related to that. 

Audiologist: Has the sensation of fullness and your voice being loud in your right ear been constant since it started, or does it go away when your head is in a certain position, like lying down?

Patient: I have noticed that it tends to go away when I’m lying down.

Audiologist: Have you noticed any hearing difficulties?

Patient: No, my hearing seems fine.

Audiologist: Sometimes these symptoms are related to balance issues, which can involve the inner ear. Have you had any episodes of dizziness or vertigo, where it feels like the room is spinning or your head is spinning?

Patient: No, I haven’t had anything like that.

The first set of clues:

From the case history, the Audiologist has a few important clues to help with these decisions:

  • Voice sounds louder in the right ear (autophony)
  • The feeling of fullness in right ear that goes away when lying down
  • No hearing difficulties or balance issues

The diagnostic hearing evaluation

The Audiologist begins the hearing evaluation by looking into the client’s ears. Both ear canals are clear and the eardrums appear normal. 

Next, the Audiologist conducts pure tone audiometry, a test to determine the softest sounds across a range of pitches that the client can hear. An interesting result emerges: the client has a mild hearing loss for low-pitched sounds. When the test is repeated by having the client listen to a special headset that sends the sounds directly to her inner ear, through the bone, the result is normal. When there is a difference in hearing between listening through the ear canal (outer ear) and the bone behind the ear (inner ear), it suggests that something is blocking the sound along the way (typically in the middle ear). 

The second set of clues:

Middle ear testing is performed next, with two interesting results: 

  1. Both middle ears are functioning normally.
  2. The client felt dizzy during the pressure-changing portion of the middle ear test.

Closing in on the answer

The Audiologist now has an idea of what might be causing the client’s symptoms: 

Superior Semicircular Canal Dehiscence (SSCD). SSCD is a disorder that takes place in the vestibular, or balance portion of the inner ear. The semicircular canals of the vestibular system are typically covered by a thin layer of bone. The thin layer of bone may not thicken properly during maturation and can become even thinner as a person ages. As a result, events such as minor head trauma or forced pressure changes (like on a plane descent or diving when you plug your nose and blow to unplug your ears) can cause a small section of the bone to split or separate. This is referred to as a dehiscence. 

The extra opening at the top of the superior semicircular canal can cause the following symptoms

  • Dizziness with changes in pressure, exposure to loud sounds, or physical straining
  • Voice echoes in one ear or in the head (autophony)
  • The person can hear internal sounds like eyes blinking or moving, bones creaking, or heart beating
  • Footsteps sound loud

Solving the case

The Audiologist now has evidence from the diagnostic hearing evaluation to go along with the client’s case history. She counsels the client on the results and writes a report to the client’s family physician, recommending a referral to an otolaryngologist (an Ear, Nose, and Throat doctor, or ENT). The ENT will often perform a CT (computerized tomography) scan to confirm whether a dehiscence is present. If so, the ENT will discuss management and treatment options with the client. 

Most of the time, an Audiologist can wrap up the detective work with a recommendation for a solution. However, part of the Audiologist’s role in unravelling a hearing or balance mystery is understanding when to bring in experts in special cases, much like a detective consulting forensics. 

If you or someone you know is experiencing issues with hearing or balance call to schedule an appointment with a professional detective ahem, Audiologist at the Broadmead Hearing Clinic: 250-470-2926 or Oak Bay Hearing Clinic: 250-479-2921.

 

Why musicians and music lovers need ear plugs

Broadmead-Hearing-Musician-Ear-Plugs

 

Musicians depend on hearing for their craft—composing, conducting, and performing. But research shows that professional musicians are four times as likely to develop noise-induced hearing loss. Musicians such as Phil Collins, Eric Clapton, and our client, Randy Bachman, have all developed permanent hearing loss after years of exposure to “noise”. Even though music is enjoyable, if the volume is too high, for too long, the sound will cause hearing damage for the musician and the audience.

Music can leave ears ringing…and more

Musicians are also 57% more likely to experience tinnitus (pronounced tih-NITE-us or TIN-ih-tus), a perceived sound with no external source. Most often tinnitus is associated with ringing, but sounds can also include including buzzing, chirping or hissing. While not life threatening, tinnitus usually goes hand-in-hand with hearing loss and should be evaluated by an Audiologist for a treatment plan.

Prolonged exposure to loud music can result in other hearing disorders including trouble hearing pitch (diplacusis) and sensitivity to loud sounds (hyperacusis). Right now, there is no cure for hearing loss, tinnitus or other associated hearing disorders so the best thing to do is be proactive by protecting your hearing. 

Hearing protection isn’t only for musicians

You should use musician plugs:

  • As a professional musician.
  • If you play music for fun.
  • Any time music is amplified.
  • If you enjoy concerts.
  • Listening to loud music at home.

Standard hearing protection

Standard hearing protection like foam ear plugs or mouldable wax that are available at the pharmacy will attenuate (decrease) the intensity of the sound reaching the cochlea; however, it also creates a "hollow" sound that singers in particular report to be unnatural. If you’re attending a concert or other activity with amplified sound foam ear plugs can help block harmful noise levels.

One-size-fits-all

One-size-fits-all musician ear plugs such as Etymonic ER20xS are available in a standard, large and universal fit on Amazon for approximately $20.00 CDN a pair. They have a lower profile to fit the ear canal (which can vary greatly in size and shape) so while snug, won’t offer the same comfort level as custom-made ear plugs. They do reduce sound levels and deliver a clear, crisp sound while protecting your hearing. One-size-fits-all musician ear plugs can be useful for amateur musicians and at concerts.

Custom musician ear plugs

The best way to protect your hearing while practicing with the band or performing gigs is with custom musician earplugs. 

A musician's earplug has a filter which will allow for high frequency sounds to pass through, eliminate the "hollow" sound, and will provide the adequate attenuation needed to protect your hearing. 

 

Broadmead-Hearing-Custom-Ear-Plugs

 

There are four different filters available: 

  1. ER – 9: for vocalists where less attenuation is needed.
  2. ER - 15: appropriate for most rock, blues and classical instruments.
  3. ER - 25: recommended for drummers.
  4. Vented/tuned earplugs recommended for the bass, cello (instruments without much treble), or for clarinets (instruments that are not damaging but play near louder instruments like the drums).

Here's a chart we refer to when discussing which ear plug is right for each instrument:

Broadmead-Hearing-Musician-Ear-Plugs

We can fit you for the right custom musician's ear plugs. Your Audiologist will take an impression of your ear canal, send the impression away and have musician plugs made with the appropriate filter (additional filters can be ordered and can be exchanged in the plug). The cost of custom-made musician's earplugs using the ER 15 or 25 filter is approximately $240.00 for a pair. Custom ear plugs last 4-5 years and are well worth the investment.

Rehearsing safely

Even with hearing protection, it’s important that musicians think about where they practice and play and the impact of sound. 

Dr. Frank Wartinger offers the following tips:

  • Consider overall sound exposure when planning a rehearsal schedule
  • Think about sound exposure and acoustics of your rehearsal venue 
  • Do you have proper monitor equipment at your rehearsal venue?
  • Vary how long you practice
  • Mix in unplugged sessions that limit amplification
  • Hold smaller, sectional rehearsals
  • During conversation between songs discourage playing

Get a comfortable, custom fit musician’s ear plugs

If you’re a budding musician, a garage band group, a professional, or simply enjoy listening to music, our Audiologists will ensure you get the right kind of custom ear plugs for the perfect fit. Protect your hearing and enjoyment of music. Call to schedule an appointment at Broadmead Hearing Clinic: 250.479.2969 or Oak Bay Hearing Clinic: 250.479.2921.

 

What is an Audiologist?

Broadmead Hearing What is an Audiologist?

 

When someone asks me, “What is an Audiologist?” I often find the answer involves more than a brief description because the term Audiologist—when compared to other health professionals such as physiotherapists, optometrists, and dentists—is not well known. To help explain what an Audiologist does (hint: they don’t record music), I have answered the most commonly asked questions that I receive about Audiologists and what Audiology means.

Audiology, hearing and balance

An Audiologist is a health professional who specializes in the detection, diagnosis, and management of hearing and balance disorders.

They specialize in hearing and balance? Are those two things even related?

Yes! The inner ear, which is one part of the ear that an Audiologist will test, has two main components:

  1. The cochlea, which is our hearing organ
  2. The vestibular system, which plays an important role in balance

Certain conditions can affect both systems. By conducting a thorough case history and diagnostic evaluation, an Audiologist can determine if one or both systems are affected and what the next appropriate step is. 

Broadmead-Hearing-Anatomy-of-the-Ear 

You mentioned the inner ear. Do Audiologists ever test other parts of the hearing system?

Yes, Audiologists routinely test other parts of the hearing system, which extends from the outer ear, all the way to the brain. 

Can you explain a bit more about the different parts of the pathway?

Absolutely.
 
Let’s start with the outer ear. The outer ear begins with the pinna, which is the only part of the ear that can be seen without specialized equipment. A visual examination of the pinna will tell an Audiologist if there are any abnormalities that require a medical referral.
 
An otoscope, which is a visual device used to illuminate and magnify, is used to examine the rest of the outer ear, which includes the ear canal and stops before the eardrum. If a person has significant wax in the ear canal, it can often be removed by the Audiologist. 
 
The next part of the ear that an Audiologist will test is the middle ear. The middle ear includes the eardrum and the 3 tiny bones (malleus, incus, and stapes) that connect the eardrum to the inner ear. Testing the middle ear does not require active participation by the person being tested, which means it can be performed on people of all ages. If a hearing loss is caused by a middle ear issue, the person will often be referred to their physician or to an Ear, Nose, and Throat (ENT) specialist, who may be able to treat the hearing loss with medication or surgery. 
 
Testing of the inner ear involves multiple components. A basic screening test will determine what the softest sounds are that a person can detect. A diagnostic evaluation will also involve a person’s ability to understand speech in quiet and in background noise. These speech tests have important implications on how well a person will hear with hearing aids and what technology is appropriate for them.

You’ve gone over the outer ear, middle ear, and inner ear. Does the testing end there?

It depends on each person.
 
If somebody needs a hearing test as part of an application for a job, such as the RCMP, and does not report any hearing difficulties, a hearing screening will often suffice.
 
If the person reports tinnitus (more on that later) or sound sensitivity, a different test battery as well as evidence-based questionnaires will be used. 
Sometimes, a person will report significant hearing difficulties and will have a normal result on a diagnostic hearing evaluation. In these cases, the person is often referred for auditory processing testing, which is a thorough audiological test that determines how the brain processes sound.

That sounds complicated. What is the minimum education required to become an Audiologist?

In Canada, the minimum education required to become an Audiologist is a master’s degree in Audiology, which includes at least 350 hours of supervised clinical practicum. To practice Audiology and dispense hearing aids in BC, Audiologists must pass a written and practical exam. They must also accumulate continuing education credits on a regular basis. 

Do all Audiologists do the same work?

Good question! Like most healthcare professions, Audiology has become increasingly specialized over the years. While many Audiologists routinely perform diagnostic hearing evaluations, fit hearing aids, and provide aural rehabilitation, some will focus on a particular specialty. For example, there are Audiologists who specialize in tinnitus, the ringing/buzzing/hissing sound that some people get. Others focus on vestibular (balance) or sound sensitivity issues. 

Where do Audiologists work?

  • Hospitals and health units
  • Private practice
  • Schools
  • Universities
  • Hearing aid and cochlear implant manufacturers
  • Professional associations and regulatory bodies

When should I see an Audiologist?

  • If you or others have noticed a change in your hearing
  • If your hearing is affecting your ability to participate, or how you participate, in day-to-day activities
  • If things are not sounding as clear or sharp as they used to
  • If you have tinnitus, especially if it is bothersome
  • If you are sensitive to sounds that do not bother the average person
  • If you have been unsuccessful with hearing aids or other amplifying devices
  • If you want to better understand and manage your hearing loss, tinnitus, or sound sensitivity issues

 

Now you know what a professional Audiologist does! If you or someone you know is experiencing any of the symptoms described above – or if you are over the age of 60 and have not had your hearing tested in the last 3 years - call to schedule an appointment with one of our professional Audiologists at the Broadmead Hearing Clinic: 250-470-2926 or Oak Bay Hearing Clinic: 250-479-2921. Your hearing and balance will thank you!

How Concussions Impact Hearing and Balance

Brain made of little colourful blocks hearing loss concussions

By Martine Schlagintweit, M.Sc., AUD, Aud(C), RHIP

Why you should see your Audiologist after experiencing a concussion.

While the media spotlight has focused on sport-related concussions in recent years, Audiologists have been treating changes in hearing and balance resulting from concussions for the past three decades. From our experience, anyone with a concussion—including veterans, athletes, seniors, workers, and children—must treat it as an important health concern.

Concussions are a form of traumatic brain injury, which happens when the brain is shaken around inside the skull, usually following a direct blow to the head, an acceleration injury (e.g. whiplash), or exposure to a blast. Brain Injury Canada reports 160,000 Canadians experience a brain injury annually, and there are currently 1.5 million Canadians living with the effects of traumatic brain injury. 

According to Speech-Language and Audiology Canada, 40-85% of individuals who sustain concussions report some balance and hearing issues following their injury. The Ontario Neurotrauma Foundation recommends that any individual who reports changes to their hearing or balance related to a concussion should be referred to an Audiologist for evaluation. Further to this, “It is the position of Speech-Language and Audiology Canada that Audiologists are essential to quality, client-centered, interprofessional concussion care across the lifespan.”

Common hearing and balance complaints with concussions

It is common for people who have had a concussion to report consequent changes to their hearing and balance.
 
Hearing and balance symptoms of concussion include: 
  • Decreased hearing
  • Quality of sound is ‘different’ 
  • Difficulty hearing speech when other sounds are present
  • Tinnitus 
  • Sensitivity to loud sounds or certain types of sounds 
  • Feeling off balance 
  • Dizziness
  • Nausea with quick motion
  • Falls 

How do concussions affect hearing and balance? 

The initial trauma to the head, the cause of the concussion, can also cause structural damage to the organs responsible for hearing and balance, the outer middle and inner ear; this usually happens with more severe head trauma. 
 
More commonly, structures inside the brain and brainstem are impacted by the trauma, causing an array of symptoms that relate to the specific structures that have been injured. Parts of the brain that are often injured by concussion include: 
  • Corpus Callosum 
  • Thalamus & Internal Capsule 
  • Temporal Lobe 
  • Brainstem
 
Each of these regions in the brain has cells that are dedicated to supporting auditory functions like hearing speech in noise, recognizing sound patterns, localizing sounds in space, and associating a sound with a linguistic label (e.g. hearing a noise and labeling it as a ‘beep’ or a ‘boop’). Damage to these structures can make it difficult for people to make sense of sound, follow conversations, or identify where sounds are coming from, which can make participating in daily activities difficult.
 

How can Audiologists help with concussion management? 

Audiologists are key members of concussion management teams. By providing specialized diagnostic services that extend beyond the basic hearing test, Audiologists can assess the functional impact the concussion is having on a person’s hearing, auditory processing, and balance. This information is essential to evaluate the overall wellbeing of the individual after they have experienced a concussion and can be used in collaboration with other professionals including physiotherapists, occupational therapists, speech-language pathologists to develop a client-centered recovery strategy. 
 
If you or a family member are experiencing hearing or balance related issues resulting from a concussion, call us to schedule an appointment with an Audiologist. Broadmead: 250.479.2969 or Oak Bay: 250.479.2921.