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Ear, Nose & Throat Associates |
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December 2009 News Archives
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December 07: Hard of hearing for the holidays, The Washington Post
If your dad seems a bit standoffish or withdrawn at your holiday gatherings this year, or if your great aunt keeps asking people to quit mumbling and repeat themselves, they may not be persnickety. Those behaviors can be signs of hearing loss.
That was the message I got in a pitch from a p.r. person whose client wanted to talk with me about how hearing loss can be socially isolating for people -- something that might become apparent during family gatherings this season -- and how hearing loss can be addressed. All interesting, useful stuff, for sure.
But to heck with Dad and the great aunts. The hearing loss I'm most worried about right now is my own.
Years of listening to really, really loud rock music has exacted a price: In some situations, I can't make out what people are saying to me.
When I go to yoga class and try to enjoy a one-on-one pre-practice conversation with a fellow student, I strain to comprehend above the background noise of other people's chatter. When I went out for a holiday lunch with a friend last week and a large group of boisterous people sat at the table next to ours, I found myself practically lip-reading through the meal. In fact, I find myself nodding a lot when people talk to me these days, pretending I know what they mean when in fact I can't even hear all their words. By the way, I'm 49 years old.
Dr. Thomas Powers, vice president of audiology and compliance for Siemens Hearing Instruments made the case that hearing loss usually can be thoroughly countered by use of a hearing aid. (To his credit, he never mentioned, much less recommended, a Siemens hearing aid during our conversation.)
He acknowledged that many people avoid seeking hearing aids because of the devices' fuddy-duddy stigma, but points out that today's high-tech instruments can be concealed behind the ears. You'd have to really be looking for them to know they were there. You can even hook them up to your Bluetooth these days!
Me, I could care less about how hearing aids might make me look. I'm not getting my hearing checked right now because I'm afraid someone's going to tell me I need them. And I can't afford them.
Powers tells me that although an estimated 35 million people in the U.S. have hearing loss severe enough to hamper communication, only 2 million hearing aids are sold each year -- half of them as replacements for worn-out aids -- and only 6 million to 8 million aids are in use in this country in a given year. That sounds like a lot of people doing without.
Powers confirms that most insurance plans, like mine, don't cover the cost of hearing aids. And those costs are substantial, as they include not just the instruments themselves -- which can run anywhere from $1,200 to $3,000 per ear -- but also the several doctor visits required to diagnose the hearing loss, custom fit the hearing aids and adjust them after a trial run. Plus, the aids need replacing every five to seven years.
"The vast majority of hearing aids in the U.S. are privately paid for," Powers notes. "And they're one of the few medical devices excluded under Medicare."
Of course, my husband and I would bite the bullet and pay up if my hearing seemed to interfere with my ability to, say, drive safely, or if I had trouble hearing during phone conversations, or if I became the spouse who kept insisting we turn the volume up on the TV. But for now, since my loss seems to affect only those situations in which I'm trying to focus on a single voice when there's lots of other noise nearby, I'll muddle through.
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December 14: How Much Does a CT Scan Raise the Risk of Cancer?, The Wall Street Journal
By Jacob Goldstein
CT ScanWe’ve been writing for a while now about the risk of cancer associated with CT scans, an issue doctors have begun to pay more attention to as the use of CT scans has soared.
A few papers published this afternoon in the Archives of Internal Medicine add a bit to the discussion; one estimated that the roughly 72 million CT scans performed in the U.S. in 2007 will ultimately cause some 29,000 cases of cancer.
A separate study that’s less likely to lead to eye-popping headlines but includes some interesting findings caught our eye: CT scans expose patients to more radiation than is commonly believed, and the amount of radiation a patient is exposed to varies wildly, even for a given type of scan.
Doctors commonly say a CT scan of the abdomen and pelvis, a frequently performed scan, exposes patients to 8 to 10 mSv of radiation, but the study found that the median exposure was actually 66% higher. (Here’s an explanation of mSv, which is a unit of radiation.) What’s more, the researchers found that the radiation for a given type of scan varied by a factor of more than 10 — meaning that some patients received far, far more radiation than others who had the same type of scan.
The study looked at scans from more than 1,000 patients who were treated at four different hospitals, and each hospital showed significant variation from patient to patient for the same type of scan. So the variations weren’t solely the result of differences between hospitals.
While there are reasons that some patients need to be given higher doses of radiation than others, the variation observed in the study is “dramatic and much greater than widely considered acceptable,” according to the authors, who include docs from UC San Francisco and a few other institutions.
The variation — along with the fact that estimating cancer risk from exposure to radiation is notoriously difficult — means it’s impossible to say precisely how much a single scan increases the risk of cancer. In general, risks decrease as the patient gets older, and at a given age the risks are higher for women.
And the authors do include a some estimates of risk based on their findings: One in 270 women who get coronary CT angiography (a scan of the heart) at age 40 will develop cancer as a result of the scan, and one in 600 men. For 40-year-olds who get scans of the head, the risk is much lower: One in 8,100 for women and one in 11,080 for men, according to the article.
The study was funded by NIH and UCSF.
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December 15: Puberty May Trigger Sleep Apnea in Overweight Kids, HealthDay News
TUESDAY, Dec. 15 (HealthDay News) -- Among teenagers, being overweight or obese increases the risk of obstructive sleep apnea, but the same does not appear to be true for younger children, Australian researchers have found.
In sleep tests conducted on 234 white children, aged 2 to 18, who were referred for evaluation of snoring and possible obstructive sleep apnea, the researchers found that among those aged 12 and older the risk of obstructive sleep apnea increased 3.5-fold with each standard-deviation increase in body-mass index (BMI) score. But, increasing BMI did not significantly increase the risk of obstructive sleep apnea in younger children.
The increased risk of obstructive sleep apnea in overweight and obese teens may be linked to developmental changes, such as anatomic changes and reductions in upper airway tone, the study authors noted in the Dec. 15 issue of the Journal of Clinical Sleep Medicine.
"These results were a little surprising to us initially, as obesity is generally considered to increase the risk of sleep apnea amongst all children. Previous results have been inconsistent, however, and appear to be confounded by using mixed ethnic populations and different ages of children," principal investigator Mark Kohler, research fellow at the Children's Research Center at the University of Adelaide, said in a news release from the American Academy of Sleep Medicine.
He and his colleagues said developmental changes in the association between obesity and obstructive sleep apnea may occur at different ages in children of other races and ethnicities. They noted that black American children appear to be at higher risk for obstructive sleep apnea independent of obesity and they may begin puberty earlier than white children.
Tonsil size may be another factor that interacts with obesity to affect the risk of obstructive sleep apnea, they added.
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December 28: MythBusters: Earwax Candle, Discovery Channel
Larry Lustig, MD assists the MythBusters television program in helping to bust the myth of the “earwax candle.” Note: Scroll ahead to 16:05 to view the segment. VIDEO
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