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Why is Hearing in Noise So Difficult?

One of the most commonly reported challenges people face with their hearing is understanding speech in background noise. Noise can vary depending on the environment. Sometimes it might be multiple people talking at once, like at a party. It may also be ambient noise such as music from a speaker or dishes clanking at a restaurant. Regardless of the type of sound, extra background noise makes it more difficult to understand conversations with others.

Many people don’t realize that a lot of our hearing ability comes not just from what the ears pick up, but how our brain processes the sound information from our ears. Hearing in noisy places is more challenging for a couple of reasons:

  • Audibility – we have to be able to hear all the sounds of speech in order to easily understand it. Extra noise can overpower soft speech sounds.
  • Focus – noisy environments tend to be busier. If there are distractions present, it decreases our ability to concentrate as effectively as we can in quiet.
  • Memory – in order to understand speech, our brain has to process sound and remember the information. Busier environments compete for the brain’s attention in focusing and remembering speech.

The good news is that hearing devices can address the concerns listed above and make it easier to understand in noisy places. Although in most cases it is not possible to completely eliminate all background noise, hearing devices such as hearing aids or cochlear implants can make a big improvement in speech understanding, both in quiet and in noise.

If you are interested in learning more about how you can optimize your hearing in noisy environments, contact our office at 904-399-0350 to schedule a hearing evaluation.

Hearing Aids Make an Appearance on Team USA

Although COVID took a larger than expected spotlight during the 2020 Summer Olympics in Tokyo, pushing the games back a full year into 2021, for audiologists, there was a special player on Team USA that caught our attention.

That player is David Smith, the 36 year old middle blocker of Team USA Men’s Volleyball. Including Tokyo, David has seen three Olympic games. With his 6-foot-7 stature, you may not be able to see, but David Smith wears hearing aids.  David was born with a severe to profound hearing loss and worn hearing aids since the age of 3. He currently wears a set of Oticon Dynamo hearing aids.  David’s hearing aids are powerful enough that he can hear many things, including the softer voices of his children, but he also relies heavily on lip reading, especially on the noisy volleyball court.

In a recent interview, David thanks his parents for keeping him involved in sports. He states that his hearing loss was less of a barrier in areas where he could watch and learn from others. He says “it was definitely a confidence booster”. Even as he plays overseas, he has become a role model for children with hearing loss, referencing a few children who wore his jersey at every game they attended. David hopes others with hearing loss see that they can achieve anything they want, even making it to the world’s biggest sporting event.

David Smith (Source: https://www.teamusa.org/usa-volleyball/athletes/David-Smith.org)

More information about David can be found at the links below:

How Does Sound Therapy Help My Tinnitus?

Key Concepts of Sound Therapy:

  1. The sound must be relaxing and pleasing to the listener
  2. The sound should be non-significant (nature sounds or white noise)—music with or without vocals has a pattern that tends to draw the brain’s attention which prevents habituation
  3. The sound must be played a volume level softer than the tinnitus—the brain cannot habituate to something it cannot hear

Sound therapy is used in all tinnitus management strategies to help habituate our brains to the presence of tinnitus. When tinnitus becomes noticeable and annoying, our brains tend to perseverate on the sound and pushes us into fight or flight mode, which ultimately makes our tinnitus more bothersome and heightens the fight or flight response further. This cycle often continues into a downward spiral. One of the best ways to stop the cycle is to teach our brain the tinnitus is non-threatening. For example, if you moved into a new house that backs up to the railroad tracks, your first few nights of sleep are going to be interrupted whenever the train passes. With more exposure, eventually your brain learns to habituate to or tune-out the train and your able to get a full night’s worth of sleep. Sound therapy works in a similar way. By providing a relaxing sound at a volume softer than the tinnitus, the brain learns to focus less on the tinnitus and begins to relax. Eventually, your brain no longer relies on the sound therapy to relax away from the tinnitus and is able to do it on its own. This process takes time, patience, and dedication but provides relief to many tinnitus patients.

If you have questions about sound therapy and other tinnitus management strategies, contact our office to schedule an evaluation.

Sporting events and Noise-Induced Hearing Loss

With August comes the start of a new school year, and also the beginning of football season. While many people enjoy the atmosphere of game day, they don’t always recognize that sounds could be loud enough to damage their hearing. According to the Centers for Disease Control (CDC), as many as 40 million U.S. adults may have noise-induced hearing loss. The good news is that noise-induced hearing loss can be prevented. The chart below shows the average decibel levels for many common sounds.

Source: The American Academy of Audiology

As the chart shows, sporting events such as football games can reach levels of 110 decibels or more! Exposure to this level of noise over several hours can be damaging to your hearing. The Guinness world record for the loudest NFL crowd noise was set by the Kansas City Chiefs fans in 2014. The roar of the crowd was measured at an ear-shattering 142.2 decibels!

Even smaller scale sporting events can have noises loud enough to damage hearing. It’s a good idea to bring a pair of earplugs with you, just in case sounds reach loud levels. If you are concerned you may have noise-induced hearing loss, you should schedule a hearing evaluation with an audiologist to learn more about your hearing. We only get one pair of ears, so it is important to protect your hearing as much as possible.  

Noisy Toys and How to Protect your Children’s Ears

It’s finally the holiday season and everyone is excited for good food, (socially distant) gatherings, and presents, unless that is, you have young children with noisy toys constantly playing throughout your house. Although most parents can attest to how loud their children’s toys are, you may not know just EXACTLY how loud. 

The Arizona Commission for Deaf and Hard of Hearing (ACDHH) and the Sight and Hearing Association are two of many organizations that put out an annual list of noisy toys for the holiday season. There are toys on their list that have been tested and shown to have an output of 103 dB! Measurements were taken as if a child had their ear next to the speaker, which is very realistic as anyone with young children would know.  According to the American Speech Language Hearing Association and the American Academy of Audiology, 85 dB is the loudest that a child should be exposure to.  For reference, the Occupational Safety and Health Administration (OSHA) notes that exposure to 90 dB for 8 hours a day is considered a “permissible noise exposure”.  The permissible time of exposure for a 100 dB sound is only 2 hours. Many of theses toys are actually labeled as educational toys.

Here are some tips for testing to see if toys are too loud:

  • Test the toys prior to buying. Many toys have a “TRY ME” button
  • Hold the toy relatively close to your own ear and see if you think it is too loud

Ways to Reduce Volume

  • If there is a volume control, make sure it is set at the lowest volume
  • Put waterproof tape or glue over the speaker to dampen the sound
  • Put tape over the volume control to prevent your child from changing the volume.

The below list was organized by The Arizona Commission for Deaf and Hard of Hearing (ACDHH):

Happy Holidays from JHBI!

Everyone at Jacksonville Hearing and Balance Institute would like to wish you a happy holidays!


See below for a message from Dr. Green!


Types of Hearing Loss

What Is Conductive Hearing Loss?
Conductive hearing loss is caused by problems with the outer or middle ear that prevent sound waves from reaching the inner ear. Problems of this area might be in the ear canal, eardrum, or in the small bones of the middle ear, as a result of infections, fluid, a perforation in the eardrum, or earwax buildup. A medical provider can treat conductive hearing loss with certain medications if it caused by an infection or a buildup of fluid. They can also help by cleaning earwax and making recommendations to help prevent further wax buildup. In some cases surgical intervention is required. A bone-anchored hearing aid (BAHA) is often helpful for patients with this type of hearing loss.

What Is Sensorineural Hearing Loss?
When the inner ear or nerves that send the hearing signal are damaged over time, it can lead to sensorineural hearing loss. This is the most common type of hearing problem and it is most often due to damage to the hair cells that send sound signals to the brain. Aging, loud noise, trauma to the head, genetics, and certain diseases are the most common causes of sensorineural hearing loss. These hair cells cannot be repaired, so sensorineural hearing loss is usually not medically treatable. However, people with this type of hearing problem can turn to hearing aids as a means to hear better and improve their quality of life. Some types of sensorineural hearing loss are treatable, mainly if the injury is short-term. If you have a sudden hearing loss, contact your doctor immediately.

What Is Mixed Hearing Loss?
Some people have a combination of conductive and sensorineural hearing loss. For example, if someone has age-related hearing loss, then suffers trauma to the eardrum. If you have mixed hearing loss, your doctor can recommend which type is to be treated first in order to maximize your chances of success.

FDA Approves Cochlear Implantation for Single-Sided Deafness

Single-sided deafness (SSD) can create difficulties for people localizing sound and listening in the noisy situations. This can lead to negative impacts on communication and socialization. SSD can be caused by viral infections, head trauma, Meniere’s Disease, or have an unknown cause. Treatment options have been limited, with cochlear implants typically reserved for people with severe to profound hearing loss in both ears.

On July 22, 2019, Med-El USA, a manufacturer of cochlear implants, announced that the Food & Drug administration approved their cochlear implant for people 5 years and older with profound hearing loss in one ear and normal to mild hearing loss in the other. Research supporting the approval shows that SSD participants had improvements in speech understanding in quiet and noise, and improvements in sound localization when they obtained the cochlear implant.

Cochlear implantation still requires certain testing and considerations, but is a step forward for the treatment of single-sided hearing loss.

Better Hearing and Speech Month

May was designated as the Better Hearing and Speech Month by the American Speech-Language-Hearing  Association (ASHA)  in 1927.  The goals of Better Hearing and Speech month is to bring awareness to hearing and speech deficits, educate the population on how these issues effect the community, and empower individuals to take action if they suspect they have a speech or hearing deficit.

Hearing loss is the third most common health issue in the United States, effecting one in every eight people over the age of 12.  Difficulty communicating with others can lead individuals to be withdrawn, negatively impacting them both socially and emotionally.  The primary goal of an audiologist, when working with these patients, is to provide the tools they need to maintain an active lifestyle and minimize the effect of their hearing loss.  The National Institute of Health (NIH) developed a short questionnaire* to see if you could benefit from having your hearing evaluated by an audiologist.

NIH QUESTIONNAIRE:

  1. Do you feel frustrated when talking to members of your family because you have difficulty hearing them?
  2. Do you have difficulty hearing or understanding co-workers, clients, or customers?
  3. Do you feel restricted or limited by a hearing problem?
  4. Do you have difficulty hearing when visiting friends, relatives, or neighbors?
  5. Do you have trouble hearing in the movies or in the theater?
  6. Does a hearing problem cause you to argue with family members?
  7. Do you have trouble hearing the TV or radio at levels that are loud enough for others?
  8. Do you feel that any difficulty with your hearing limits your personal or social life?
  9. Do you have trouble hearing family or friends when you are together in a restaurant?

If you answered “YES” to three or more of above questions, feel free to contact our clinic at (904) 339-0350 to schedule an appointment with a provider.  Together you will develop an individualized plan to improve your hearing healthcare.

*Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433.

Non-Surgical Hearing Solution

One type of hearing of hearing loss is known as a conductive hearing loss. This type of hearing loss occurs when there is damage or blockage in the outer or middle ear which prevents sounds from being sent to the inner ear. Causes of conductive hearing loss can include:

– Complete wax build up
– Absence of the ear canal or a extremely narrow ear canal
– Hole in the eardrum
– Fluid behind the eardrum
– Displacement of the three tiny bones (ossicles) behind the eardrum

A bone anchored hearing aid (BAHA) is a treatment option to improve the hearing of people with conductive hearing loss . The BAHA is a surgically implanted post that works together with an external processor to bypass the outer and middle ear and deliver sound directly to the inner ear.

Recently a new processor was introduced by Med El that does not require surgery and is available at a much lower cost than the traditional BAHA. The ADHEAR processor uses an adhesive piece that sits behind the ear to send sound to the organ of hearing.


To learn if you are a candidate for the ADHEAR please contact Jacksonville Hearing & Balance Institute at 904-399-0350.