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Surgical Hearing Devices
Dr. Derrick Tint shares the different hearing devices available at TVH.
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Learn more about Derrick Tint, MD
Derrick Tint, MD
Dr. Derrick Tint received his medical degree from the University of Pittsburgh School of Medicine. He then went on to Temple University Hospital where he completed his residency in Otolaryngology/Head and Neck Surgery. During his residency, he developed a passion for treating disorders of the ear.Learn more about Derrick Tint, MD
Transcription:
Melanie Cole (Host): This is TVH Health Chat with Temecula Valley Hospital. I’m Melanie Cole, and today we’re discussing surgical hearing devices. Joining me is Dr. Derrick Tint. He’s an otolaryngologist and a member of the medical staff at Temecula Valley Hospital. Dr. Tint, it’s such a pleasure to have you join us today. Tell us a little bit about the prevalence of hearing loss, and what are some of the most common reasons for it that you see?
Derrick Tint, MD (Guest): So, hearing loss is probably the third most common, you know, medical disease. I mean most people don’t actually consider it to be a medical problem, but it’s something that’s very prevalent, and you know, as people age, it becomes more and more prevalent where by the time you’re 75 years old, you have over a 50% chance of having some form of hearing loss. You know, the most common reason, as I alluded to earlier, is age-related hearing loss. So, as we get older, the fine hair cells inside of our ear start to die. So, basically, the older you get, the more hearing loss you start to have. Some other common reasons are, you know, things that are like holes in the eardrum, infection, scarring of the ear, and sometimes you get stiffening of the bones and so there’s, you know, a lot of different types of hearing loss, but they all sort of cause the same issue, but they do have, you know, many different ways of treating them.
Host: Dr. Tint, is it a myth about wearing headphones and for the kids today that have those AirPods in their ears all the time listening to music at very loud—can loud noises and that sort of thing—can that contribute?
Dr. Tint: Absolutely. That’s a really good question. At the noise levels that most people are listening to headphones or AirPods with, you know—certainly that shouldn’t cause a problem—but, you know, I generally tell my patients that if you can hear the headphones from outside, like if someone’s wearing the headphones and you can hear them—that’s probably a little bit too loud, and if you’re starting to have ringing from your ears after wearing the headphones from an extended period of time, that probably means that you were wearing the headphones and listening to them too loud, and yes, I did forget to mention that noise-induced hearing loss is definitely one of the very common causes of hearing loss, but usually that’s due to, you know, long exposure from heavy machinery or, you know, people who shoot guns frequently or work with chainsaws. Less often it’s from people going to a loud concert one time, but it can happen.
Host: Well, thank you for that. So, let’s talk about some of the help that’s available for people that are suffering from hearing loss. Is there a first line of defense or do you discuss some of the surgical opportunities that people might have to help restore some of their hearing?
Dr. Tint: You know, I think the first thing, you know, you need to talk about is, you know, how bad the hearing loss is and what type of hearing loss that you have. So, with the types of hearing loss, there’s basically two types. There is one called sensorineural, which is, you know, as I generally tell patients, it’s because of the nerves of hearing, and then the second one is conductive, which is usually a problem with the mechanical transduction of sound through the eardrum, through the bones, until it makes it to the inner ear, which is called the cochlea. Most people, like I said earlier, have age-related hearing loss, which is a type of sensorineural hearing loss, and I think for the people who are listening to this podcast, most of them will probably have that type of hearing loss and so, you know, in general, most people will do fine with a hearing aid. So, you know, there’s many different types of hearing aids and so, you know, when you come in for an evaluation, you know, not only will you test your hearing, but we’ll also start giving you a consultation for different types of hearing aids.
Host: Well then let’s talk about some of the newer implantable hearing devices and your reasons for using them. Tell us about some of the things going on in your field right now and how do you decide which treatment for which patients?
Dr. Tint: Like I said before, you know, you have to look at the types of hearing loss that the patient has, and then that’ll sort of lead you to the way that you want to correct the hearing. So, for example, with a conductive hearing loss, that might be caused by a hole in the ear drum or might be caused by stiffening of the bones of the ear, you know, that might be better for a surgical correction of that. Although you can use a hearing aid for those patients who don’t want to undergo surgery, but for those types of things a lot of patients who do really well with, you know, correction of the problem so that, you know, they don’t actually have to wear a hearing aid at the end of the day, and then the patients who have a nerve type of hearing loss, or the sensorineural type of hearing loss, you know, if they’ve been wearing hearing aids for a really long time or their hearing loss becomes so bad that hearing aids are no longer working for them, then we start to have discussions about cochlear implantation. So, cochlear implantation is an implantable device that goes behind the ear and use[s] an electrode that stimulates the cochlea—so that no matter how bad the type of hearing loss you have, the electrical signal from the implant will allow the person to hear again. So, basically it restores hearing in even a person who’s completely deaf.
Host: Wow, that’s really amazing. So, what else are available? Bone-anchored hearing systems and there’s middle ear implants—tell us about any of the others that are available and why you might choose those.
Dr. Tint: So, the other very common type of implantable hearing device would be the bone-anchored hearing aid, also known as the BAHA. Most of them currently are made by the Cochlear Corporation, and basically, it involves implanting a screw, a titanium screw, near the ear, and it basically vibrates and sends the sound past the ear straight to the cochlea so that if a patient has a draining ear, or they can’t wear a hearing aid for any reason, or they have a problem with like a conductive hearing loss that the sound can bypass that system and just go straight to the ear. This is actually a very exciting part of, you know, what I do because right now there’s a lot of research going into bone-anchored hearing aids. There’s a bunch of new devices being developed. MED-EL has a new device called the BONEBRIDGE which came out a few years ago and then actually Cochlear Corporation is coming out with a brand new one. You know, the reason why there’s so much development going on is because the current system, which uses the screw, has a portion of it that sometimes sticks out, or it uses a large magnet, and so there’s been a lot of problems with the skin and healing issues with these old devices. So, they’re starting to use cochlear implant technology to sort of prevent some of these wound healing issues that we’ve been seeing.
The other thing that you mentioned was middle ear implantation. You know, this was a large trend that was happening maybe like 10, 15 years ago, and there was a lot of research going into this, but I think more recently, sort of the interest has been dying down, but basically a middle ear implant is like a hearing aid, but basically, you put the implant into the bone of the ear, and it kind of acts like a hearing aid, but you don’t actually need to wear anything on the outside. All the things are, you know, inside the ear. The problem with these devices is that they’ve been very expensive, and they’re kind of difficult to put in, and they do need to have a surgical battery that needs to be changed every couple of years, and so ultimately, I think, you know, we’ve been sort of trending away from these devices as, you know, first of all hearing aid technologies has gotten better and then as also, cochlear implantation has become much more prevalent.
Host: When you do these procedures, can your patients hear right away? Do these things take a while to start to work whether it’s BAHA or a cochlear implant? Do they take a while, or can they hear right away and how exciting is that for patients?
Dr. Tint: You know, patients are very excited at the end of the day. It is quite a process to undergo surgery and to have the wound heal and so, you know, technically, you can turn these devices on right away, but I generally wait one to three months to allow the wound to heal before turning on the device, and that’s just because basically the incision sits right on top of the implant, and so, these implants require an external processor, and, you know, you just don’t want to be putting anything external on top of a fresh wound because that might cause, you know, infection issues and such.
Host: As we wrap up, Dr. Tint, tell us about surgical hearing devices and when you feel that it’s important for someone who’s suffering from hearing loss—maybe it’s minimal, maybe it’s starting to get pretty bad—when you feel it’s important that they visit a physician and get this assessed and the level of loss assessed so that they can decide on the treatment options.
Dr. Tint: Ultimately, hearing loss is something that often goes ignored by many patients, but it frustrates a lot of family members because, you know, people need to be constantly repeating themselves and so when hearing loss starts to become the quality of life issue, is when I tell patients that they need to go and get assessed, and, you know, that differs for a lot of people. Some people can live with a lot of hearing loss and have no problems and some people can have a little bit of hearing loss and have a lot of problems. So, you know, ultimately if you think you have hearing loss, you should definitely go and get tested, and then, you know, to have a discussion with your physician about what the best treatment options are. In terms of getting a surgical hearing device that’s usually, you know, the physician usually will tell you if you need one, but you know, at the end of the day, a lot of people still may not get that information passed along to them. So, if you do already have a hearing aid, and you really just aren’t having any benefit from it; you’re constantly having to have people repeat themselves. You just really don’t understand anything that’s going on, you know, that might be a good time to go in and see an ear specialist to have a, you know, formal consultation to see if you are a candidate.
Host: Thank you so much, Dr. Tint. What great information. That concludes this episode of TVH Health Chat with Temecula Valley Hospital. Please visit our website at temeculavalleyhospital.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Temecula Valley Hospital podcasts. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole.
Melanie Cole (Host): This is TVH Health Chat with Temecula Valley Hospital. I’m Melanie Cole, and today we’re discussing surgical hearing devices. Joining me is Dr. Derrick Tint. He’s an otolaryngologist and a member of the medical staff at Temecula Valley Hospital. Dr. Tint, it’s such a pleasure to have you join us today. Tell us a little bit about the prevalence of hearing loss, and what are some of the most common reasons for it that you see?
Derrick Tint, MD (Guest): So, hearing loss is probably the third most common, you know, medical disease. I mean most people don’t actually consider it to be a medical problem, but it’s something that’s very prevalent, and you know, as people age, it becomes more and more prevalent where by the time you’re 75 years old, you have over a 50% chance of having some form of hearing loss. You know, the most common reason, as I alluded to earlier, is age-related hearing loss. So, as we get older, the fine hair cells inside of our ear start to die. So, basically, the older you get, the more hearing loss you start to have. Some other common reasons are, you know, things that are like holes in the eardrum, infection, scarring of the ear, and sometimes you get stiffening of the bones and so there’s, you know, a lot of different types of hearing loss, but they all sort of cause the same issue, but they do have, you know, many different ways of treating them.
Host: Dr. Tint, is it a myth about wearing headphones and for the kids today that have those AirPods in their ears all the time listening to music at very loud—can loud noises and that sort of thing—can that contribute?
Dr. Tint: Absolutely. That’s a really good question. At the noise levels that most people are listening to headphones or AirPods with, you know—certainly that shouldn’t cause a problem—but, you know, I generally tell my patients that if you can hear the headphones from outside, like if someone’s wearing the headphones and you can hear them—that’s probably a little bit too loud, and if you’re starting to have ringing from your ears after wearing the headphones from an extended period of time, that probably means that you were wearing the headphones and listening to them too loud, and yes, I did forget to mention that noise-induced hearing loss is definitely one of the very common causes of hearing loss, but usually that’s due to, you know, long exposure from heavy machinery or, you know, people who shoot guns frequently or work with chainsaws. Less often it’s from people going to a loud concert one time, but it can happen.
Host: Well, thank you for that. So, let’s talk about some of the help that’s available for people that are suffering from hearing loss. Is there a first line of defense or do you discuss some of the surgical opportunities that people might have to help restore some of their hearing?
Dr. Tint: You know, I think the first thing, you know, you need to talk about is, you know, how bad the hearing loss is and what type of hearing loss that you have. So, with the types of hearing loss, there’s basically two types. There is one called sensorineural, which is, you know, as I generally tell patients, it’s because of the nerves of hearing, and then the second one is conductive, which is usually a problem with the mechanical transduction of sound through the eardrum, through the bones, until it makes it to the inner ear, which is called the cochlea. Most people, like I said earlier, have age-related hearing loss, which is a type of sensorineural hearing loss, and I think for the people who are listening to this podcast, most of them will probably have that type of hearing loss and so, you know, in general, most people will do fine with a hearing aid. So, you know, there’s many different types of hearing aids and so, you know, when you come in for an evaluation, you know, not only will you test your hearing, but we’ll also start giving you a consultation for different types of hearing aids.
Host: Well then let’s talk about some of the newer implantable hearing devices and your reasons for using them. Tell us about some of the things going on in your field right now and how do you decide which treatment for which patients?
Dr. Tint: Like I said before, you know, you have to look at the types of hearing loss that the patient has, and then that’ll sort of lead you to the way that you want to correct the hearing. So, for example, with a conductive hearing loss, that might be caused by a hole in the ear drum or might be caused by stiffening of the bones of the ear, you know, that might be better for a surgical correction of that. Although you can use a hearing aid for those patients who don’t want to undergo surgery, but for those types of things a lot of patients who do really well with, you know, correction of the problem so that, you know, they don’t actually have to wear a hearing aid at the end of the day, and then the patients who have a nerve type of hearing loss, or the sensorineural type of hearing loss, you know, if they’ve been wearing hearing aids for a really long time or their hearing loss becomes so bad that hearing aids are no longer working for them, then we start to have discussions about cochlear implantation. So, cochlear implantation is an implantable device that goes behind the ear and use[s] an electrode that stimulates the cochlea—so that no matter how bad the type of hearing loss you have, the electrical signal from the implant will allow the person to hear again. So, basically it restores hearing in even a person who’s completely deaf.
Host: Wow, that’s really amazing. So, what else are available? Bone-anchored hearing systems and there’s middle ear implants—tell us about any of the others that are available and why you might choose those.
Dr. Tint: So, the other very common type of implantable hearing device would be the bone-anchored hearing aid, also known as the BAHA. Most of them currently are made by the Cochlear Corporation, and basically, it involves implanting a screw, a titanium screw, near the ear, and it basically vibrates and sends the sound past the ear straight to the cochlea so that if a patient has a draining ear, or they can’t wear a hearing aid for any reason, or they have a problem with like a conductive hearing loss that the sound can bypass that system and just go straight to the ear. This is actually a very exciting part of, you know, what I do because right now there’s a lot of research going into bone-anchored hearing aids. There’s a bunch of new devices being developed. MED-EL has a new device called the BONEBRIDGE which came out a few years ago and then actually Cochlear Corporation is coming out with a brand new one. You know, the reason why there’s so much development going on is because the current system, which uses the screw, has a portion of it that sometimes sticks out, or it uses a large magnet, and so there’s been a lot of problems with the skin and healing issues with these old devices. So, they’re starting to use cochlear implant technology to sort of prevent some of these wound healing issues that we’ve been seeing.
The other thing that you mentioned was middle ear implantation. You know, this was a large trend that was happening maybe like 10, 15 years ago, and there was a lot of research going into this, but I think more recently, sort of the interest has been dying down, but basically a middle ear implant is like a hearing aid, but basically, you put the implant into the bone of the ear, and it kind of acts like a hearing aid, but you don’t actually need to wear anything on the outside. All the things are, you know, inside the ear. The problem with these devices is that they’ve been very expensive, and they’re kind of difficult to put in, and they do need to have a surgical battery that needs to be changed every couple of years, and so ultimately, I think, you know, we’ve been sort of trending away from these devices as, you know, first of all hearing aid technologies has gotten better and then as also, cochlear implantation has become much more prevalent.
Host: When you do these procedures, can your patients hear right away? Do these things take a while to start to work whether it’s BAHA or a cochlear implant? Do they take a while, or can they hear right away and how exciting is that for patients?
Dr. Tint: You know, patients are very excited at the end of the day. It is quite a process to undergo surgery and to have the wound heal and so, you know, technically, you can turn these devices on right away, but I generally wait one to three months to allow the wound to heal before turning on the device, and that’s just because basically the incision sits right on top of the implant, and so, these implants require an external processor, and, you know, you just don’t want to be putting anything external on top of a fresh wound because that might cause, you know, infection issues and such.
Host: As we wrap up, Dr. Tint, tell us about surgical hearing devices and when you feel that it’s important for someone who’s suffering from hearing loss—maybe it’s minimal, maybe it’s starting to get pretty bad—when you feel it’s important that they visit a physician and get this assessed and the level of loss assessed so that they can decide on the treatment options.
Dr. Tint: Ultimately, hearing loss is something that often goes ignored by many patients, but it frustrates a lot of family members because, you know, people need to be constantly repeating themselves and so when hearing loss starts to become the quality of life issue, is when I tell patients that they need to go and get assessed, and, you know, that differs for a lot of people. Some people can live with a lot of hearing loss and have no problems and some people can have a little bit of hearing loss and have a lot of problems. So, you know, ultimately if you think you have hearing loss, you should definitely go and get tested, and then, you know, to have a discussion with your physician about what the best treatment options are. In terms of getting a surgical hearing device that’s usually, you know, the physician usually will tell you if you need one, but you know, at the end of the day, a lot of people still may not get that information passed along to them. So, if you do already have a hearing aid, and you really just aren’t having any benefit from it; you’re constantly having to have people repeat themselves. You just really don’t understand anything that’s going on, you know, that might be a good time to go in and see an ear specialist to have a, you know, formal consultation to see if you are a candidate.
Host: Thank you so much, Dr. Tint. What great information. That concludes this episode of TVH Health Chat with Temecula Valley Hospital. Please visit our website at temeculavalleyhospital.com for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Temecula Valley Hospital podcasts. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole.