According to Dr. Emily Cooper, a clinical audiologist and audiology supervisor with OSF HealthCare Illinois Neurological Institute, the best treatment depends on the severity and type of hearing loss. An audiogram, or hearing test, can help audiologists determine the most appropriate option for each patient.

As hearing loss progresses, hearing aids may no longer provide enough benefit, especially when it comes to understanding speech.

When hearing becomes more severe, patients may still hear sounds but struggle to clearly understand conversations, even while wearing hearing aids.

"That's when we would consider someone for a cochlear implant," she adds.

Not just for children

Many people associate cochlear implants with children who are born with hearing loss. While cochlear implants can be life-changing for children, Dr. Cooper says adults should not overlook them as a treatment option.

"From nine months, all the way to 95. As long as you're healthy enough to undergo an outpatient surgery, you can get a cochlear implant," Dr. Cooper says.

Despite their effectiveness, cochlear implants remain underused.

"They're completely underutilized," Dr. Cooper stresses. "Only 6-13% of people who could benefit from a cochlear implant actually have one."

For adults experiencing hearing difficulties, the first step is making sure their current hearing aids are working as intended. Dr. Cooper recommends having hearing aids professionally evaluated and adjusted if necessary.

If hearing challenges persist, patients should schedule an appointment with an audiologist to discuss their concerns and determine whether a cochlear implant evaluation may be appropriate.

Who qualifies for a cochlear implant?

Many people are surprised to learn they may qualify for a cochlear implant sooner than they think.

According to Dr. Cooper, candidates may include individuals who:

• Have hearing levels of 60 decibels or poorer
• Score 60% or lower on word understanding testing

A comprehensive hearing evaluation can help determine whether a patient meets candidacy requirements and whether a cochlear implant could improve communication and quality of life.

What happens after implantation?

A cochlear implant works differently than a hearing aid. Rather than simply making sounds louder, the implant bypasses damaged parts of the inner ear and directly stimulates the hearing nerve.

After surgery, the device is activated and adjusted by an audiologist.

Dr. Cooper says patients should expect an adjustment period when the device is first turned on.

"Part of the process is doing listening therapy," Dr. Cooper says. "Over the first 1-3 months, people start to really notice their hearing a lot more than they used to, and understanding a lot more than they used to. So, it can be a slower process over the first couple of months as the brain relearns to hear with this implant."

Initially, sounds may seem robotic or static-like. Over time, however, the brain adapts to the new signals and learns to interpret them more naturally.

Hearing loss can affect anyone

Hearing loss is often associated with aging, but it can affect people at every stage of life.

"Hearing loss does not discriminate," Dr. Cooper says. It can impact infants, children, adults and older adults alike.

Some individuals are born with hearing loss, while others develop it later due to genetics, illness, injury or long-term noise exposure.

Certain genes can increase a person's susceptibility to hearing loss, and genetic forms of hearing loss often appear earlier in life. To identify hearing issues as soon as possible, every newborn receives a hearing screening before leaving the hospital.

Early identification is critical because untreated hearing loss can affect speech and language development.

The U.S. Food and Drug Administration recently lowered the minimum age for cochlear implant candidacy to seven months, allowing more infants with significant hearing loss to receive treatment earlier.

For children born with hearing loss, earlier intervention can help reduce the risk of speech delays and support language development during critical stages of growth.

Protecting your hearing throughout life

Not all hearing loss develops immediately after exposure to loud noise. In many cases, hearing damage accumulates over time.

Dr. Cooper notes that someone who attended loud concerts, worked around machinery or experienced other significant noise exposure years ago may not notice hearing loss until much later in life.

Because hearing changes often occur gradually, regular hearing evaluations can help identify problems early and connect patients with treatment options before hearing loss significantly impacts daily life.

Whether the solution is hearing aids, cochlear implants or another intervention, Dr. Cooper says people should not assume hearing loss is something they simply have to live with. Advances in hearing technology continue to provide opportunities for people of all ages to stay connected to the sounds and conversations that matter most.

Speaking with your primary care provider can help start the conversation, and figure out a plan that works for you.

Video Interview Clips

Do you ever get a loud ringing in your ears? What about a hissing or whooshing or clicking sound? Chances could be that you have tinnitus.

And you’re not alone. Many people have a ringing or another sound in their ears from time to time. But tinnitus (tin-NITE-us or TIN-ne-tus) can be both persistent and frustrating for people with a severe case of it.

“Anywhere between 10 to 20% of the population may have tinnitus at one time or another. Estimates of 50 million people in the country which is quite significant," says Chris Workman, AuD, an audiologist with OSF HealthCare. "For most of those people, it's not something that's significantly disabling. However, there is a percentage of population where it can cause significant issues.”

That includes having trouble sleeping or concentrating. Being alone in a quiet room can exasperate the situation. Dealing with tinnitus on a daily basis can make people feel angry, depressed and feeling irrational.

Tinnitus is a symptom, not a disease. It’s been linked to noise exposure, hearing loss, a side effect from taking certain medications at high doses and the aging process. (Hearing loss impacts one in three people over the age of 65.) An injury to the head or neck can damage the structures of the ear, and even ear wax or an ear infection can cause a blockage of the ear and trigger tinnitus.

Tinnitus can occur in one or both ears.

“Most of the time, we see it happen in both ears because it's gradual due to aging, noise exposure or some other health issues," says Dr. Workman. "Sometimes hypertension, cardiovascular health can play a role. So it may come on slowly and gradually and usually both ears. If it's one ear, I would definitely suggest having it checked out.”

There is no cure for tinnitus. But there are therapies and devices called sound generators which may help silence tinnitus, mask the sounds or help the patient get used to the noise or distract them.

“Some patients who have normal hearing may not need a hearing aid, so we might use that device as a tinnitus masker where it has different noises, whether it's a white noise or ocean-like noise, something else to focus on," says Dr. Workman. "We have fit patients with no hearing loss with a mild-gain hearing aid as a means to kind of drown it out. Sometimes just a little amplification is helpful to help the brain focus on the external noises around them.”

Because ongoing noise in your ears is annoying, Dr. Workman says anxiety will play a pivotal role in how a person handles tinnitus. He recommends that people find ways to reduce stress, which may help.

“Part of the key in minimizing the annoyance is reducing anxiety, educating them on the possible causes, and the fact that over time it may reduce the level of intensity," adds Dr. Workman. "It may not be a cure, but exercise and those types of things can help reduce overall stress levels, which will help minimize the annoyance of the ringing. It also may help them get better sleep, which in turn will help lead to less stress.”

Dr. Workman also suggests limiting the intake of caffeine, alcohol and cigarettes, which can increase tinnitus. Lifestyle issues such as exercise and diet are also important to cardiovascular health which also helps overall health, including hearing.

When it comes to your hearing, protection is the key. To minimize any type of damage, Dr. Workman recommends wearing earplugs whether it’s going to a rock concert or mowing the lawn. And if you use earbuds turn down the volume. If someone else can hear your music or podcast, it’s too loud.  

For starters, people age 55 and over should schedule a hearing test to establish a baseline.

For more information, visit OSF HealthCare.

Interview Clips 

B-Roll

Chris Workman, an audiologist with OSF HealthCare, loves to crank up his music from time to time. But since it’s his profession, he knows the dangers of loud noise and the lasting impact it can have on his hearing.

“It stirs some emotion. It gets you pumped up,” says Dr. Workman. “It gets you if you're working out, you might crank some music. Some folks will listen to music for other emotions. Maybe they're feeling a different way, and cranking a song will bring them out of that depression or whatever they're going through.”

But our listening habits could be doing more harm than good. Especially for younger people. A recent study published in the BMJ Global Health Journal cautions that between 670 million and 1.35 billion teens and young adults could face hearing loss due to unsafe habits.

The study analyzed data from 33 studies covering more than 19,000 people between the ages of 12 to 34. Researchers concentrated on two main sources of loud music exposure: Live music events and personal listening devices, like headphones and earbuds.

Listening to sounds at a decibel level of 85 or higher for long or a repeated amount of time can cause hearing loss.

Researchers found that 24% of young people listen to their devices at volumes high enough to harm their hearing. And 48% are exposed to unsafe sound levels at concert venues. Listening at high volumes can lead to noise-induced hearing loss as well as lifelong hearing problems like tinnitus, which is a constant ringing noise in your ear.

“Most of our kids are walking around with headphones in their ears. Athletes are walking around with headphones in their ears,” says Dr. Workman. “They're listening to something multiple hours a day, some of which is at loud levels, which, over time, is going to do some damage to their hearing.” 

Dr. Workman doesn’t see many young adults in his practice. But when he does, he makes sure to give them a reminder about taking care of their hearing. Ongoing bad listening habits can lead to problems within 10 years.

“I'm all for listening to some loud music. I like it myself, but I know to do it in short durations, crank a couple songs, turn it down, or take them off. Give your ears a break,” he says. “That way you're letting those hairs in the inner ear come back and protect them from any permanent damage.”

Dr. Workman offers a few helpful tips. “Encourage them to wear hearing protection around loud noise. If they’re going to a concert don’t sit up front. Back away a little bit. If you do sit close, wear some hearing protection. You can get an inexpensive pair online for $20. That will help make the music sound normal at a reduced level.” 

The best place to start is getting a hearing test to establish a baseline. Dr. Workman recommends testing for people as young as 20-25. In addition to loud noises, there are other reasons for hearing loss such as aging, genetics, certain medications and diseases like diabetes.

Dr. Workman says the bottom line is to use common sense when it comes to your hearing. Afterall, the last thing you want as a young person is to be fitted for hearing aids. 

“A lot of us feel invincible at that age, so we tend not to take that message to heart,” he adds. “Hopefully they understand the potential damage they could do.”

For more information on audiology services, visit OSF HealthCare.

Interview Clips 

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There are many health complications for people living with diabetes including heart and kidney disease, oral health and vision problems. You can add hearing loss to the list.

According to Chris Workman, AuD, an audiologist with OSF HealthCare, people with diabetes are twice as likely to suffer from hearing loss compared to those who don’t. Even people with prediabetes have a 30% higher rate of hearing loss than people with normal blood sugar levels.

“There's about 28 million people in the United States with hearing loss,” Dr. Workman says. “There's 37 million people with diabetes. So, we can surmise that there's a good portion of that 28 million who have diabetes that also have hearing loss.”

The link appears to be nerve damage. All senses rely on good blood flow and nerve function. Dr. Workman says blood vessels feed the nerves, which are crucial to good hearing. According to the Centers for Disease Control and Prevention (CDC), the average person is born with about 16,000 hair cells within their inner ear, which allow your brain to detect sounds. By the time most people notice a change in their hearing, 30% to 50% of hair cells have already been damaged or destroyed. And they do not grow back.

“I believe high blood sugar could potentially affect the blood flow to the inner ear and some of the hair cells which could affect and cause some hearing loss,” Dr. Workman says. “Low blood sugar could cause some damage to the nerve and transmission of the hearing.”

Dr. Workman adds that for the past 10-15 years the audiology field has seen a rise in patients who also have diabetes – including in his own practice. For those patients, especially those who have other comorbidities such as hypertension, screening tests are especially important.

“For those patients, we would recommend following up with an annual hearing test to keep an eye on things,” he says, “We encourage them to diet, exercise and take their medication as needed to get better control of diabetes. Otherwise, they’re prone to potential hearing loss and more severe loss.”

There are many signs of hearing loss.

·         Ringing in the ears

·         A tendency to assume everyone is mumbling

·         Difficulty understanding what people are saying

·         Needing to turn the TV volume up high

·         Struggling to hear in group settings

Dr. Workman encourages patients to talk with their primary care physician to establish a hearing baseline. He also recommends stopping smoking and avoiding frequent exposure to loud noises. In addition to physical changes, hearing loss can also lead to depression or feeling secluded, which can impact your social life and mental health. 

The month of May is National Speech-Language-Hearing Month. It’s a time which raises the importance of taking care of your hearing.

Dr. Workman says the key to better outcomes is early treatment. “I think raising awareness of hearing loss not only impacts the individual with the hearing loss, but impacts family, friends, coworkers. If we can raise that awareness and get them help sooner, we're going to continue their quality of life and transition easier to any type of treatment.”

For more information on hearing loss, visit OSF HealthCare.

Interview Clips 

B-Roll

Hearing loss can affect anyone. According to some studies, about 23% of Americans ages 12 and older experience hearing loss. While it can be mild or severe, hearing loss can also increase the odds of developing dementia later in life.

That’s according to a study published in JAMA that focused on people ages 70 and older.

While the reasons aren’t clearly understood, it’s important to note that there is a causal effect between hearing loss and dementia, according to Christopher Workman, Au. D., an audiologist with OSF HealthCare.

“There's enough research out there that shows some link to it," says Dr. Workman. "Some of that may be related to the hearing loss itself. Some of it may be related to the effects of hearing loss, which could include loneliness, depression, or lack of social interaction. There may be a direct and indirect cause to dementia, Alzheimer’s, and those type of things.”

In the past 30 years Dr. Workman has seen several patients with cognitive issues including dementia, and that number is growing. Some of their symptoms are significant, which he says raises concerns about their cognitive capabilities.

He adds that one way to prevent feelings of loneliness, depression and to stay socially active is by wearing hearing aids.

“I've read a number of these studies over the past several years and there's some debate as to exactly what's happening or what's causing it," he says. "But I think that hearing aids can play a role in minimizing the potential for dementia occurring. Obviously, you could still have dementia without and have good hearing. You could also have dementia and have hearing aids early on and still have dementia. It's not a cure, but it can help minimize some of the factors that may lead to dementia.”

But getting someone to wear hearing aids isn’t always easy. Some people cite the cost of the devices, while others have issues with sound quality. Other reasons are more of a social stigma – hearing aids are associated with becoming older, and some people have a difficult time with that reality.

A new Illinois law was signed in August, which requires all insurers to provide coverage to Illinois residents if their doctor prescribes a hearing instrument. This expands on a bill in 2018 that required insurers to cover hearing aids for children under the age of 18.

“When we see a patient, I try to kind of screen where they're at mentally, as far as the acceptance of the idea of hearing aids and sometimes I'll recommend they wait if they're not mentally ready, because the last thing we want as people buying hearing aids and they sit in a drawer, so the key is mental acceptance," says Dr. Workman. "And then the second key is committing to the idea of wearing them and wearing them all day. Because if you only wear them for an hour a day, they're not providing the benefit that they need. We want to keep stimulating the auditory pathway to prevent any atrophy from occurring.”

The goal is to treat the patient’s hearing loss as soon as possible before they experience any signs of dementia or cognitive decline. Many times, if an audiologist does suspect some cognitive decline, he or she will refer the patient back to their primary care provider for further evaluation.

Dr. Workman stresses that not everyone who experiences hearing loss is going to get dementia. But he encourages patients and family members to pay close attention to potential warning signs such as asking people to repeat themselves, accusing people of mumbling or turning up the volume on the TV, for example.

“When you start realizing you're withdrawing or the spouse or children recognize that they're withdrawing, then it's time to have something done," he adds. "Get it checked out, find out what's going on and then address it before it continues to lead to further isolation, depression and loneliness.”

Dr. Workman is optimistic that the medical community will have a better understanding of the connection between hearing and dementia in the next several years as more data is compiled and further research is conducted.
 

Interview Clips