Hearing Life November/December 2019 - 40

Understanding Acoustic Trauma

Acoustic trauma, or noise-induced hearing loss, can
occur in two ways: with a single blast of excessively
loud sound-like an explosion or gunfire near the
ear; or over a longer term, when repeatedly exposed
to loud noises, like aircraft engines and machinery.
Delicate hair cells in the inner ear-sensory
receptors-vibrate in response to sound waves, thereby
sending electrical signals along the auditory nerve to
the brain for interpreting. Extreme, high-decibel sound
overloads these hair cells with too much movement,
causing them to break or die. Fewer functioning hair
cells means diminished hearing. Once destroyed, these
hair cells can't be repaired or replaced.
Tinnitus is another common consequence of
acoustic trauma. Simply described, it's when the brain
perceives a noise, like buzzing or chirping, that has
no external environmental source. It can come on
following damage to the cochlea within the inner
ear, to the vestibular nerve between the ear and the
brain, or to the brainstem. But there can be other
underlying causes as well.

loss-or acoustic trauma. But their reports of tinnitus were
much more severe than I'd seen at Castle Point.
Many of these Veterans also experienced post-traumatic
stress disorder, or PTSD. The VA has done extensive
research and now has a much better understanding of the
complexity of PTSD. In short, exposure to tragic events
changes how the brain reacts and pays attention to sound,
light and other stimuli. When these Veterans perceive
a ringing or buzzing in their ears connected to hearing
loss, they have a much harder time shifting attention away
from it than their predecessors did. The VA maintains two
dedicated research facilities, one of which has a team that
has looked at tinnitus for several decades. This team, led by
James Henry, Ph.D., developed the Progressive Tinnitus
Management program (PTM), which has been shown to be
highly effective. All VA audiologists have access to in-depth
training in PTM. And many VA centers have dedicated
tinnitus specialists.

The Gulf War and Post 9/11

In 2016, I transferred to the VA Long Beach Healthcare
System in California. In just a short time, I noticed
another shift in the population in the audiology service.
40

We still had lots of Vietnam Veterans. But now those
who'd served in the Gulf War, Iraq War and Afghanistan
War were being referred to us, but not by primary care-
rather, by the traumatic brain injury (TBI) team.
The rapid increase in the use of improvised explosive
devices, or IEDs, during the post 9/11 conflicts led to
many more Veterans suffering concussions and other
blast injuries. Research into these kinds of injuries is still
ongoing, but a study by Michael Oleksiak and peers,
published in 2012 in the Journal of Rehabilitation
Research & Development, found that 87% of Veterans
with mild TBI reported some degree of hearing loss
and tinnitus. An earlier study by Stephen Fausti, Ph.D.,
and other VA researchers, published in 2009 in the
same journal, found that those exposed to blasts during
military service also reported a wide range of balance and
other vestibular system disorders.

Addressing Service-Connected Hearing and
Balance Issues

So what does this mean for our men and women in
uniform?
If you're a combat Veteran, you most likely have some
degree of hearing loss and probably tinnitus. This will likely
cause you greater difficulty in background noise than would
be expected from your audiogram alone. If untreated, the
hearing loss is detracting from your quality of life. But it can
be helped by the VA, usually at no cost to you.
If you suffered even a mild TBI, you may also have
balance disturbance, including an increased risk of falling.
The VA is there for you, and audiology is a good entry
point. Once you establish eligibility, you can schedule an
appointment with audiology without a primary care referral.
Starting here allows the team to identify any hearing
or balance issues. It also allows them to make sure you
get appropriate treatment and equipment-as well as
referrals to other teams, as needed.
As my former VA health technician, a Marine staff
sergeant used to say, "We got your six!"
Brad Ingrao, Au.D. is the audiology team
leader at the Watson Clinic in Lakeland,
Florida. He's been in clinical practice since
1992 in a variety of settings, including
academia, private practice, educational
audiology, the VA and the hearing aid industry.
He specializes in severe-to-profound hearing loss, including
cochlear implants, musicians with hearing loss, and hearing
assistive technologies. He's presented at professional and
consumer conferences in 48 states and six countries, in both
English and ASL. Reach him at bingrao@e-audiology.net.

* HEARING LIFE * NOVEMBER/DECEMBER 2019 * HEARINGLOSS.ORG


http://www.HEARINGLOSS.ORG

Hearing Life November/December 2019

Table of Contents for the Digital Edition of Hearing Life November/December 2019

A Note From Our Executive Director
Thoughts From Our Board Chair
Founder’s Corner
Supporting Our Veterans Through All Their Years: The HLAA Veterans Across America Virtual Chapter
Advocacy
Convention
Never Give Up: A Vietnam Veteran’s Hearing Journey
Walk4Hearing Update
Sue, Eleanor, Fred—And Facing Our Fears
Awards and Recognition
Acoustic Trauma and the Impact of Noise on Our Men and Women in Uniform
A Holiday Getaway to the Big Apple
Hearing Loops at Home
Hearing Life November/December 2019 - Cover1
Hearing Life November/December 2019 - Cover2
Hearing Life November/December 2019 - 3
Hearing Life November/December 2019 - 4
Hearing Life November/December 2019 - 5
Hearing Life November/December 2019 - 6
Hearing Life November/December 2019 - A Note From Our Executive Director
Hearing Life November/December 2019 - 8
Hearing Life November/December 2019 - 9
Hearing Life November/December 2019 - Thoughts From Our Board Chair
Hearing Life November/December 2019 - Founder’s Corner
Hearing Life November/December 2019 - 12
Hearing Life November/December 2019 - Supporting Our Veterans Through All Their Years: The HLAA Veterans Across America Virtual Chapter
Hearing Life November/December 2019 - 14
Hearing Life November/December 2019 - 15
Hearing Life November/December 2019 - 16
Hearing Life November/December 2019 - 17
Hearing Life November/December 2019 - 18
Hearing Life November/December 2019 - Advocacy
Hearing Life November/December 2019 - 20
Hearing Life November/December 2019 - Convention
Hearing Life November/December 2019 - 22
Hearing Life November/December 2019 - 23
Hearing Life November/December 2019 - 24
Hearing Life November/December 2019 - 25
Hearing Life November/December 2019 - Never Give Up: A Vietnam Veteran’s Hearing Journey
Hearing Life November/December 2019 - 27
Hearing Life November/December 2019 - 28
Hearing Life November/December 2019 - 29
Hearing Life November/December 2019 - 30
Hearing Life November/December 2019 - Walk4Hearing Update
Hearing Life November/December 2019 - 32
Hearing Life November/December 2019 - Sue, Eleanor, Fred—And Facing Our Fears
Hearing Life November/December 2019 - 34
Hearing Life November/December 2019 - 35
Hearing Life November/December 2019 - 36
Hearing Life November/December 2019 - Awards and Recognition
Hearing Life November/December 2019 - 38
Hearing Life November/December 2019 - Acoustic Trauma and the Impact of Noise on Our Men and Women in Uniform
Hearing Life November/December 2019 - 40
Hearing Life November/December 2019 - A Holiday Getaway to the Big Apple
Hearing Life November/December 2019 - 42
Hearing Life November/December 2019 - Hearing Loops at Home
Hearing Life November/December 2019 - 44
Hearing Life November/December 2019 - 45
Hearing Life November/December 2019 - 46
Hearing Life November/December 2019 - Cover3
Hearing Life November/December 2019 - Cover4
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