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Researchers from Uppsala University have been able to document and visualise hearing loss-associated genes in the human inner ear, in a unique collaboration study between otosurgeons and geneticists. The findings illustrate that discrete subcellular structures in the human organ of hearing, the cochlea, are involved in the variation of risk of age-related hearing loss in the population. The study is published in BMC Medicine.

Hearing loss is a potentially debilitating condition that affects more than 1.23 billion people worldwide. The most common form of hearing loss, which represents 90% of all cases, is related to the degenerative effects of aging on hearing, i.e., age-related hearing loss or presbycusis. However, the molecular mechanisms that underlie the development of age-related hearing loss and individual variation in risk are poorly elucidated.

In the current study, a unique collaboration was established between otologists and geneticists at Uppsala University, which allowed for functional follow-up studies of candidate genes from genome-wide association studies (GWAS) using immunohistochemistry in the human cochlea.

“The cochlea, and in particular the hearing organ, the organ of Corti, is a highly vulnerable structure that is difficult to analyse since it is surrounded by the hardest bone in the body,” says Helge Rask-Andersen, MD and Senior Professor at the Department of Surgical Sciences. “We have been able to study some of the molecular components of human hearing that are critical for the conversion of sound to nerve electric impulses.”

Genetic variants at 67 genomic regions were found to contribute to increased risk of age-related hearing loss. Genome-wide association studies (GWAS) on hearing-related traits were performed in the UK Biobank, which has half a million participants from the United Kingdom. Genetic associations are difficult to interpret by themselves and follow-up experiments are often required before causal genes can be inferred.

“It is an amazing opportunity to be able to follow up our findings in human cochlear samples, since there are molecular differences between the hearing organ of humans and other mammals,” says Mathias Rask-Andersen, Associate Professor at the Department of Immunology, Genetics and Pathology.

Candidate proteins from GWAS were visualized with immunofluorescent antibodies and super-resolution structured illumination microscopy (SR-SIM) by Dr Wei Liu, MD and Associate Professor at the Department of Surgical Sciences. Several proteins were observed within the spiral ganglion, which contains the neuronal cell bodies that innervate the hair cells in the organ of Corti and carry neuronal impulses to the brain via the cochlear nerve.

The researchers could also visualize hearing loss-associated proteins in discrete subcellular domains in the hair cells for the first time in humans, such as TRIO and F-actin-binding protein (TRIOBP) in the hair tufts (stereocilia) and LIM domain only protein 7 (LMO7) in the cuticular plate, which is an actin-rich structure that anchors stereocilia to the cell body. The stereocilia are the microscopic or nano-sized ‘hairs’ that protrude from the hair cells of the organ of Corti. They respond to mechanical vibrations from sounds that reach us and are transferred and amplified from the ear drum to the inner ear by the small middle ear bones.

Taken together, the findings from the current study demonstrate that common genetic variations associated with age-related hearing loss affect the structures of the cochlea, in particular the neuronal processes of the spiral ganglion, but also structures directly involved in the transduction of mechanical stimuli to neuronal impulses. This knowledge may help to better understand the biological mechanisms that lead to age-related hearing loss and generate strategies for prevention such as novel pharmacological treatments.

Article originally appeared on Science Daily

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A 12-week music program is helping deaf and hard-of-hearing children learn to optimize their hearing aids and cochlear implants, by teaching them to better understand the sounds they detect.

The program, developed by Dr. Chi Yhun Lo from Macquarie University, helps the children to extract meaningful information, such as separating noise from what they want to hear, a skill that is critical to their education and emotional development.

“Deafness is often seen as a barrier to engagement with music,” says Chi. “On the contrary, music actually is an excellent way to improve the problems associated with hearing loss.”

For children with recently acquired cochlear implants or hearing aids, the world can be a confusingly noisy place. The devices do not teach them how to pick out the signal in the noise—their teacher’s voice in the classroom, or their friend’s voice in a noisy playground.

But group music lessons and app-based home activities in which children sing, dance, play instruments and become involved in games like “guess the instrument” helps them sort out different types of sounds.

Chi’s research, published earlier this year, found that such music groups boosted the children’s general capacity to learn, as well as their emotional health.

Originally a musician and audio engineer for events like the Sydney Festival, Chi now uses his skills to understand speech and hearing better.

“Professional musicians are excellent listeners,” says Chi. “We’re trained to identify subtle changes in tone, pitch and timbre, all the things which make up the rich character of a sound.”

The program was inspired by Chi’s previous research, which found that music training helps people with cochlear implants understand “prosody” or the rhythms of stress and intonations which are critical to detecting emotion in voice, or figuring out whether something is a question or a statement.

“My study shows that music training is particularly helpful, as it teaches kids to pick up quick and detailed changes in sound,” says Chi. “It was heartening to see rapid improvements in our students’ social wellbeing—improved peer relationships and emotional regulation, as well as a drop in anxiety and depression.”

The development of the program was supported by the Shepherd Centre, a specialist service for children with hearing loss. Ingrid Steyns, principal manager of clinical learning, says the Centre recognizes the value of music in intervention and listening skill development.

“The benefit of music for children with hearing loss is such a valuable and important area for research, and the evidence-based information that comes from the development of tools such as these helps us to support the full development of each deaf child,” says Ingrid.

“The Shepherd Centre has supported the translation of the outcomes from this project into clinical practice and building knowledge of the importance of these skills in training programs for professionals working with children and young people with hearing loss.”

Trudy Smith from NextSense Institute, which offers continuing professional education in sensory disability, says the program affirmed for her that music is a necessary part of every child’s program—not just those with hearing.

“The scientific rigor of the program gives us confidence in the effectiveness of music therapy on speech perception skills and social development for children who are deaf or hard of hearing,” says Trudy.

Article originally appeared on Medical Xpress

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Tinnitus was significantly associated with pre-existing primary open-angle glaucoma, researchers reported in the Journal of Glaucoma.

“The underlying mechanism relating glaucoma and tinnitus is not exactly clear,” Tung-Mei Kuang, MD, PhD, of the department of ophthalmology at Taipei Veterans General Hospital in Taiwan, and colleagues wrote. “Vascular dysregulation is one possible common pathway. Although POAG [primary open-angle glaucoma] is multifactorial, and a clear pathophysiology is not established, it has been suggested that the glaucomatous ganglion cell damage is caused, at least in part, by chronic impairment of blood supply to the optic nerve head.”

Seeking to better understand the association between POAG and tinnitus, Kuang and colleagues conducted a population-based, case-control study using data from the Taiwan National Health Insurance Research Database. Participants were predominantly of Han-Chinese ethnicity and included 542,682 with tinnitus (mean age, 55 years; 43% men) and 1,628,046 controls.

Of 2,170,728 total participants, 85,257 had POAG before the index date of tinnitus, 25,506 were patients with tinnitus, and 56,761 were controls (P < .001). Overall, researchers determined that about 30% of patients with tinnitus were more likely to have pre-existing POAG than controls.

The study also showed tinnitus was significantly associated with hearing loss (P < .001), hyperlipidemia (< .001), rheumatoid arthritis (P = .005) and idiopathic intracranial hypertension (< .001).

“[Eye care providers] should be aware of this association, and further studies are needed to understand the underlying mechanisms,” the authors concluded.

Article originally appeared on Healio

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Air bubbles trapped in a woman’s inner ear caused her to develop severe dizziness, seemingly out of nowhere, and she required surgery to make the disorienting, spinning sensation go away.

The 51-year-old woman initially went to the doctor after experiencing this strange spinning sensation for about 24 hours, according to a report of the case published Thursday (April 21) in the journal JAMA Otolaryngology–Head & Neck Surgery. In addition to feeling as though the room were spinning around her, the woman reported that she felt an unusual blockage or pressure in her right ear and was also experiencing right-sided hearing loss.

The doctors performed a physical examination of the woman’s right ear, but they found no abnormalities. The team then ran the patient through a common test for vertigo, called the Dix-Hallpike test, and found that she exhibited the telltale twitchy eye movements that are often associated with such dizziness.

As an initial treatment, the doctors led the patient through an exercise designed to treat one of the most common forms of vertigo, known as “benign paroxysmal positional vertigo” (BPPV). This condition occurs when tiny crystals inside the inner ear become dislodged from their normal position, according to Johns Hopkins Medicine. These crystals, or “ear stones,” typically sit inside a sac-like organ in the ear that detects changes in the head’s orientation, but when the ear stones detach from this organ, they can trigger sensations of dizziness. An exercise called the Epley maneuver can move the ear stones back into their proper place, but in the woman’s case, the exercise didn’t help.

Article originally appeared on Live Science

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For patients with vestibular migraine (VM), the mean age of headache and vertigo onset is 25 and 39 years, respectively, according to a study published in the April issue of Clinical Neurology and Neurosurgery.

Neşe ÇelebisoyM.D., Ph.D., from Ege University in Izmir, Turkey, and colleagues examined demographic and clinical features of VM in 415 patients using structured questionnaires and clinical examination.

The researchers found that the mean age was 25 and 39 years for headache and vertigo onset, respectively. Benign paroxysmal positional vertigo was detected during the interictal period in 12.3 percent of participants. On audiometry, 10 percent had hearing loss; in 8.7 percent, it was one-sided low-frequency sensory-neural hearing loss <2,000 Hz, and the history was typical for Meniere disease (MD) as well as VM. Of the patients with MD and VM, 94.4 percent had tinnitus, 83.4 percent had aural fullness, 72.2 percent had nausea, and 30.5 percent had vomiting. On a visual analog scale measured from 0 to 10, median attack severity was 8 and 7 for headache and vertigo, respectively, for the entire group. Severe headache correlated with age 43 years and younger, while severe vertigo correlated with age 41 years and older (odds ratios, 6.831 and 7.073, respectively). Patients with family history of migraine (72.5 percent) had a lower age of onset of both migraine headaches and vertigo.

“The clinical presentation in VM shows great variability,” the authors write. “The mean age at headache onset was 28 ± 9 years and the period between onset of migraine headaches and vertigo attacks was around 10 years.”

Article originally appeared on HealthDay.

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The biotechnology company Frequency Therapeutics is seeking to reverse hearing loss — not with hearing aids or implants, but with a new kind of regenerative therapy. The company uses small molecules to program progenitor cells, a descendant of stem cells in the inner ear, to create the tiny hair cells that allow us to hear.

Hair cells die off when exposed to loud noises or drugs including certain chemotherapies and antibiotics. Frequency’s drug candidate is designed to be injected into the ear to regenerate these cells within the cochlea. In clinical trials, the company has already improved people’s hearing as measured by tests of speech perception — the ability to understand speech and recognize words

“Speech perception is the No. 1 goal for improving hearing and the No. 1 need we hear from patients,” says Frequency co-founder and Chief Scientific Officer Chris Loose PhD ’07.

In Frequency’s first clinical study, the company saw statistically significant improvements in speech perception in some participants after a single injection, with some responses lasting nearly two years.

The company has dosed more than 200 patients to date and has seen clinically meaningful improvements in speech perception in three separate clinical studies. Another study failed to show improvements in hearing compared to the placebo group, but the company attributes that result to flaws in the design of the trial.

Now Frequency is recruiting for a 124-person trial from which preliminary results should be available early next year.

These two images show that one of Frequency’s lead compounds, FREQ-162, drives progenitor cells to turn into oligodendrocytes. The control is on the left and the right has been treated. Credit: Frequency Therapeutics

The company’s founders, including Loose, MIT Institute Professor Robert Langer, CEO David Lucchino MBA ’06, Senior Vice President Will McLean PhD ’14, and Harvard-MIT Health Sciences and Technology affiliate faculty member Jeff Karp, are already gratified to have been able to help people improve their hearing through the trials. They also believe they’re making important contributions toward solving a problem that impacts more than 40 million people in the U.S. and hundreds of millions more around the world.

“Hearing is such an important sense; it connects people to their community and cultivates a sense of identity,” says Karp, who is also a professor of anesthesia at Brigham and Women’s Hospital. “I think the potential to restore hearing will have enormous impact on society.”

From the lab to patients

In 2005, Lucchino was an MBA student in the MIT Sloan School of Management and Loose was a PhD candidate in chemical engineering at MIT. Langer introduced the two aspiring entrepreneurs, and they started working on what would become Semprus BioSciences, a medical device company that won the MIT $100K Entrepreneurship Competition and later sold at a deal valued at up to $80 million.

Frequency Therapeutics co-founders Will McLean, PhD recipient at the Harvard-MIT Division of Health Sciences and Technology (HST), David Lucchino MBA ’06, Jeff Karp, PhD, HST affiliate faculty and Professor at Brigham and Women’s Hospital, and Chris Loose, PhD ’07. Frequency went public on the Nasdaq on October 3, 2019. Credit: Courtesy of Frequency Therapeutics

“MIT has such a wonderful environment of people interested in new ventures that come from different backgrounds, so we’re able to assemble teams of people with diverse skills quickly,” Loose says.

Eight years after playing matchmaker for Lucchino and Loose, Langer began working with Karp to study the lining of the human gut, which regenerates itself almost every day.

With MIT postdoc Xiaolei Yin, who is now a scientific advisor to Frequency, the researchers discovered that the same molecules that control the gut’s stem cells are also used by a close descendant of stem cells called progenitor cells. Like stem cells, progenitor cells can turn into more specialized cells in the body.

“Every time we make an advance, we take a step back and ask how this could be even bigger,” Karp says. “It’s easy to be incremental, but how do we take what we learned and make a massive difference?”

Progenitor cells reside in the inner ear and generate hair cells when humans are in utero, but they become dormant before birth and never again turn into more specialized cells such as the hair cells of the cochlea. Humans are born with about 15,000 hair cells in each cochlea. Such cells die over time and never regenerate.

In 2012, the research team was able to use small molecules to turn progenitor cells into thousands of hair cells in the lab. Karp says no one had ever produced such a large number of hair cells before. He still remembers looking at the results while visiting his family, including his father, who wears a hearing aid.

“I looked at them and said, ‘I think we have a breakthrough,’” Karp says. “That’s the first and only time I’ve used that phrase.”

The advance was enough for Langer to play matchmaker again and bring Loose and Lucchino into the fold to start Frequency Therapeutics.

The founders believe their approach — injecting small molecules into the inner ear to turn progenitor cells into more specialized cells — offers advantages over gene therapies, which may rely on extracting a patient’s cells, programming them in a lab, and then delivering them to the right area.

“Tissues throughout your body contain progenitor cells, so we see a huge range of applications,” Loose says. “We believe this is the future of regenerative medicine.”

Advancing regenerative medicine

Frequency’s founders have been thrilled to watch their lab work mature into an impactful drug candidate in clinical trials.

“Some of these people [in the trials] couldn’t hear for 30 years, and for the first time they said they could go into a crowded restaurant and hear what their children were saying,” Langer says. “It’s so meaningful to them. Obviously more needs to be done, but just the fact that you can help a small group of people is really impressive to me.”

Karp believes Frequency’s work will advance researchers’ ability to manipulate progenitor cells and lead to new treatments down the line.

“I wouldn’t be surprised if in 10 or 15 years, because of the resources being put into this space and the incredible science being done, we can get to the point where [reversing hearing loss] would be similar to Lasik surgery, where you’re in and out in an hour or two and you can completely restore your vision,” Karp says. “I think we’ll see the same thing for hearing loss.”

The company is also developing a drug for multiple sclerosis (MS), a disease in which the immune system attacks the myelin in the brain and central nervous system. Progenitor cells already turn into the myelin-producing cells in the brain, but not fast enough to keep up with losses sustained by MS patients. Most MS therapies focus on suppressing the immune system rather than generating myelin.

Early versions of that drug candidate have shown dramatic increases in myelin in mouse studies. The company expects to file an investigational new drug application for MS with the FDA next year.

“When we were conceiving of this project, we meant for it to be a platform that could be broadly applicable to multiple tissues. Now we’re moving into the remyelination work, and to me it’s the tip of the iceberg in terms of what can be done by taking small molecules and controlling local biology,” Karp says.

For now, Karp is already thrilled with Frequency’s progress, which hit home the last time he was in Frequency’s office and met a speaker who shared her experience with hearing loss.

“You always hope your work will have an impact, but it can take a long time for that to happen,” Karp says. “It’s been an incredible experience working with the team to bring this forward. There are already people in the trials whose hearing has been dramatically improved and their lives have been changed. That impacts interactions with family and friends. It’s wonderful to be a part of.”

Article originally appeared on SciTechDaily

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No association was found between COVID-19 vaccination and the occurrence of sudden sensorineural hearing loss (SSNHL), according to a cross-sectional, population-based study published in JAMA Otolaryngology–Head & Neck Surgery.

Previous research from Israel found cases where SSNHL occurred within weeks of patients receiving their first dose of the Pfizer COVID-19 vaccine between December 2020 and April 2021. However, the benefits of the COVID-19 vaccine outweigh its potential link to SSNHL, the researchers stated. These findings prompted the current study researchers to explore whether this potential association does, in fact, exist. Additionally, they examined whether emerging patterns in incident reports of the Centers for Disease Control and Prevention (CDC) Vaccine Adverse Events Reporting System (VAERS) during the initial 7 months of the US SARS-CoV-2 vaccination campaign — between December 14, 2020, and July 16, 2021— imply a link between COVID-19 vaccination and SSNHL.

The current analysis was carried out in 2 phases. In the initial phase, VAERS was queried for reports of SSNHL following SARS-CoV-2 vaccination in the 7-month study period. Cases that represented probable SSNHL were compiled, with the use of such search terms as deafnessdeafness bilateraldeafness unilateraldeafness neurosensoryhypoacusis, and sudden hearing loss chosen as adverse events for data extraction.

A total of 555 incident reports in VAERS met the definition of probable SSNHL (mean time to symptom onset, 6 days; range, 0 to 21 days) over the period studied, which represented an annualized incidence estimate of 0.6 to 28.0 cases of SSNHL per 100,000 individuals per year. Of these incidents, 305 occurred among women and 250 occurred among men. The mean participant age was 54 years (range, 15 to 93 years).

Of the 3 manufacturers of the COVID-19 vaccines, 305 of the incidents involved the Pfizer-BioNTech vaccine, 222 involved the Moderna vaccine, and 28 involved the Janssen/Johnson & Johnson vaccine. The VAERS reporting rate of probable SSNHL was similar across the vaccine manufacturer groups (ie, 0.16 cases per 100,000 doses administered of both the Pfizer-BioNTech vaccine and the Moderna vaccine; 0.22 cases per 100,000 doses administered of the Janssen/Johnson & Johnson vaccine).

Additionally, a multi-institutional case series was performed to better understand the clinical profiles of patients who reported SSNHL following COVID-19 vaccination. Overall, 21 patients were identified across the study sites. Of these individuals, 13 were women; the mean age was 61 years (range, 23 to 92 years). Of the 21 patients, 6 had a history of autoimmune disease. Mean time to onset of SSNHL in the patients in the case series was 6 days (range, 0 to 15 days) following vaccination; 6 of the cases occurred at 7 days following vaccination. Of these 21 patients, 18 received treatment—9 with intratympanic steroids, 5 with oral corticosteroids, and 4 with both. A total of 14 patients had posttreatment audiometric data available, 8 of whom reported improvement after receiving treatment.

A major limitation of the case series is its lack of a comparison group (ie, a group that comprised patients who did not receive the COVID-19 vaccine but nevertheless experienced SSNHL within that same time frame).

“These results suggest that there is no association between vaccination and the development of SSNHL among adults who received a COVID-19 vaccine,” the researchers concluded. Additional prospective studies are warranted, to identify any potential links between COVID-19 vaccination and SSNHL in certain individuals.

Disclosure: Some of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Article originally appeared on Neurology Advisor

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Frequent use of common, over-the-counter painkillers such as aspirin and Tylenol isn’t risk-free, with new research suggesting it may increase your risk of tinnitus, or “ringing in the ears.”

A study of more than 69,000 women found that, in addition to aspirin and Tylenol (acetaminophen), nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil and Motrin (ibuprofen) also raised the risk of tinnitus.

“Our findings suggest that analgesic [painkiller] users may be at higher risk for developing tinnitus and may provide insight into the precipitants of this challenging disorder,” said study lead author Dr. Sharon Curhan of Brigham and Women’s Hospital, in Boston.

“Even though these analgesics are widely available without a prescription, these are still medications, and there are potential side effects. For anyone who is considering taking these types of medications regularly, it is advisable to consult with a health care professional to discuss the risks and benefits, and to explore whether there are alternatives to using medication,” Curhan said in a hospital news release.

Tinnitus is the perception of sounds such as whistling, buzzing, hissing, swooshing and clicking when there is no actual external noise. Tinnitus can be a temporary or a long-term condition.

For the study, the researchers examined data from the Nurses’ Health Study II. Participants were followed for 20 years after enrolling between the ages of 31 and 48.

The analysis showed that frequent use (six to seven days a week) of moderate-dose aspirin was associated with a 16% higher risk of tinnitus among women younger than 60 but not among older women.

Frequent use of low-dose aspirin was not associated with an increased risk of tinnitus. However, frequent use of other NSAIDs or acetaminophen was associated with an almost 20% higher risk of developing tinnitus, and the risk rose with use.

The researchers also found that regular use (two or more days a week) of prescription COX-2 inhibitors, such as Celebrex (celecoxib), was associated with a 20% higher risk of tinnitus. COX-2 inhibitors share similar properties with other NSAIDs but cause fewer gastrointestinal side effects.

The study was published Feb. 9 in the Journal of General Internal Medicine.

In the United States, about 20 million people have chronic tinnitus, and about 3 million are severely disabled by the condition, according to Curhan.

In most cases, the cause of tinnitus is unknown and treatments provide limited relief.

The study findings show that it “is important to take these medications mindfully and to limit their use as much as possible, and to discuss any change in medication use, whether prescription or non-prescription, with your health care provider,” Curhan said.

Article originally appeared on HealthDay

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Over 1 billion people aged 12 to 35 years risk losing their hearing due to prolonged and excessive exposure to loud music and other recreational sounds. This can have devastating consequences for their physical and mental health, education, and employment prospects.

Ahead of World Hearing Day 2022, under the theme To hear for life, listen with care! WHO has issued a new international standard for safe listening at venues and events. The standard applies to places and activities where amplified music is played.“Millions of teenagers and young people are at risk of hearing loss due to the unsafe use of personal audio devices and exposure to damaging sound levels at venues such as nightclubs, bars, concerts and sporting events,” said Dr Bente Mikkelsen, WHO Director for the Department for Noncommunicable Diseases.She added: “The risk is intensified as most audio devices, venues and events do not provide safe listening options and contribute to the risk of hearing loss. The new WHO standard aims to better safeguard young people as they enjoy their leisure activities.”

New recommendations to limit risk of hearing loss

The Global standard for safe listening at venues and events highlights six recommendations for implementation to ensure that venues and events limit the risk of hearing loss to their patrons while preserving high-quality sound and an enjoyable listening experience. The six recommendations are:

(1) a maximum average sound level of 100 decibels

(2) live monitoring and recording of sound levels using calibrated equipment by designated staff

(3) optimizing venue acoustics and sound systems to ensure enjoyable sound quality and safe listening

(4) making personal hearing protection available to audiences including instructions on use

(5) access to quiet zones for people to rest their ears and decrease the risk of hearing damage; and

(6) provision of training and information to staff.

The new standard was developed under WHO’s Make Listening Safe initiative which seeks to improve listening practices especially among young people, drawing on the latest evidence and consultations with a range of stakeholders including experts from WHO, government, industry, consumers, and civil society.

Hearing loss due to loud sounds is permanent but preventable

Exposure to loud sounds causes temporary hearing loss or tinnitus. But prolonged or repeated exposure can lead to permanent hearing damage, resulting in irreversible hearing loss. Young people can better protect their hearing by:

  • keeping the volume down on personal audio devices
  • using well-fitted, and if possible, noise-cancelling earphones/headphones
  • wearing earplugs at noisy venues
  • getting regular hearing check-ups

Advocating for the new global standard

WHO encourages governments to develop and enforce legislation for safe listening and raise awareness of the risks of hearing loss. The private sector should include WHO’s recommendations for safe listening features in their products, venues, and events. To motivate behavior change, civil society organizations, parents, teachers, and physicians can educate young people to practice safe listening habits.

“Governments, civil society and private sector entities such as manufacturers of personal audio devices, sound systems, and video gaming equipment as well as owners and managers of entertainment venues and events have an important role to play in advocating for the new global standard,” said Dr Ren Minghui, WHO Assistant Director-General. “We must work together to promote safe listening practices, especially among young people.”

Article originally appeared on WHO

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Tinnitus, most often described as “ringing” in the ears even though no external sound is present, also can be perceived as humming, hissing, buzzing or roaring sounds. According to the United States Centers for Disease Control and Prevention (CDC), more than 50 million Americans experience some form of tinnitus — 2 million have extreme and debilitating cases. Worldwide, about 30 percent of people will experience tinnitus at some point in their life.

Many individuals impacted by COVID-19 experienced changes in their sense of smell, taste, hearing, balance and in some cases, tinnitus. Among the various causes of tinnitus is stress, including tension, anxiety and depression. What’s unclear, however, is whether the psychological impacts of the pandemic such as stress actually worsened tinnitus and its impacts.

Researchers from Florida Atlantic University, the Royal Surrey NHS Foundation Trust in the United Kingdom, and the University of Cambridge conducted a study that focused on the potential indirect effects of COVID-19 on the experience of tinnitus. They assessed whether the severity of tinnitus, as measured using ratings of tinnitus loudness, annoyance, and effect on life, was influenced by the lockdown related to pandemic. Although COVID-19 upended so many aspects of society, there is some good news — at least as it relates to tinnitus.

For the study, researchers compared two independent groups of new patients; one group assessed during three months of lockdown in the United Kingdom and one group assessed during the same period in the preceding year. They examined patients’ pure-tone audiometry, and their score on visual analog scale (VAS) of tinnitus loudness, annoyance, and effect on life, which were imported from their records. Researchers compared VAS ratings from both groups. All patients were seeking help for their tinnitus for the first time.


Results of the study, published in the Journal of the American Academy of Audiologydo not support the idea that the pandemic led to a worsening of tinnitus loudness, annoyance, or impact on life and the mean scores did not differ significantly for the groups seen prior to and during lockdown. Any changes in psychological well-being or stress produced by the lockdown did not significantly affect ratings of the severity of tinnitus.

“People experienced various types of adversities during the pandemic, including loss of income, difficulty in obtaining services, experience of the virus itself, and the impact of constant bad news and social distancing,” said Ali Danesh, Ph.D., co-author, professor, Department of Communication Sciences and Disorders/Communication Disorders Clinic within FAU’s College of Education, a member of FAU’s Stiles-Nicholson Brain Institute and FAU’s Institute for Human Health and Disease Intervention, professor of biomedical sciences, FAU Schmidt College of Medicine, and an affiliate faculty, Department of Psychology, FAU Charles E. Schmidt College of Science. “It’s possible that pandemic related factors exacerbate the experience of tinnitus, as tinnitus is linked to general anxiety and psychological well-being. On the other hand, perhaps the effect of COVID-19 on everyday life made individuals with tinnitus realize that there are more important things than tinnitus, putting it into perspective and leading to a decrease of the impact of tinnitus that counteracted any effect of increased anxiety and decreased well-being.”

Several studies on tinnitus reported sleep-related problems, poor mental health, and suicidal ideations as consequences of the COVID-19 pandemic and its associated social isolation and economic uncertainties.

“It is questionable whether people are able to judge reliably whether their tinnitus itself has changed or whether their tinnitus-related symptoms such as sleep disturbances or anxiety have changed,” said Hashir Aazh, Ph.D., affiliate associate professor at FAU and Honorary Hearing Research Consultant, Department of Audiology, Royal Surrey County Hospital. “Prior studies of the indirect effects of COVID-19 on the experience of tinnitus have used different methodologies, which may have led to biases.”

The current study avoided potential biases by comparing self-reported tinnitus severity between new patients seen during lockdown and another group of patients seen during the same time frame, preceding lockdown.

“If a given respondent felt that their tinnitus was worse during the pandemic than before the pandemic, how could they determine whether this was due to lifestyle changes, health concerns, or social distancing?,” said Danesh. “Visual analog scale scores for tinnitus loudness, annoyance, and impact on life did not differ significantly between new patients seen prior to and during lockdown. This may indicate that tinnitus can influence anxiety and well-being, but there is not an effect in the opposite direction.”

The retrospective study examined data for 105 consecutive patients who were seen at a tinnitus clinic in an audiology department in the United Kingdom during lockdown and 123 patients seen in the same period of the previous year. The average age of the patients seen during the lockdown was 50 years, while the average age of the patients seen in 2019 was 56 years. The two groups were reasonably well matched in age, gender, and severity of hearing loss.

Article originally appeared on ScienceDaily