August 30, 2011

The Next Generation of Hearing Aids

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August 30, 2011
Bottom Line's Daily Health News
In This Issue...
  • Double the Pain Relief of Glucosamine & Chondroitin!
  • The Next Generation of Hearing Aids
  • Enjoy the 100 Greatest Books of All Time... and Never Have to Read a Word
  • The Genius of a Q-Tip

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The Next Generation of Hearing Aids

Hearing aids have improved a great deal over the years, and yet they’re still far from perfect. Case in point: My elderly neighbors are very well off and have the best hearing aids available. But at a party with lots of people, they’ll simply turn them off. The noise, they say, becomes overwhelming. I thought of my friends as I read about Ray Meddis, PhD, a British scientist at the University of Essex, who is using computer models to develop better hearing aids that people won’t turn off.

I phoned Dr. Meddis to ask why hearing aids are still so frustrating for people. The devices, he said, are currently prescribed after a test in which an audiologist checks a patient’s ability to hear various tones (frequencies) at different levels of loudness (amplitude). Since most people with impaired hearing can identify some tones better than others, doctors simply target those that are giving the person the most difficulty when they write the hearing aid prescription.

But despite all that, it’s still hit or miss. "Many patients are happy with the extra loudness at certain frequencies," said Dr. Meddis, a psychologist who specializes in hearing and speech. But for others, a hearing aid simply makes many sounds too loud. Sometimes people find thathearing is improved when there’s a little background noise, such as when they’re relaxing around the dinner table with family members. But when they’re in a crowded environment "hearing aids are not able to help with that confusion of sound," Dr. Meddis said.

YOUR EAR ON A MICROCHIP

He and his colleagues have been working to solve just this sort of problem for more than 20 years. Finally, thanks to increased computer power, there have been significant breakthroughs. "We’ve built computer models that reproduce what goes on inside the ear when you listen to sounds both for normal hearing and impaired hearing," Dr. Meddis told me. "The models help us to understand how people with normal hearing, for instance, can tune in to a single voice in a noisy, crowded room.

The researchers are writing software for hearing aids that can be very specifically customized for an individual’s specific hearing problems. This new generation of hearing aids will contain software encoded on a personal microchip. The aim is to replicate the functions of normal hearing to compensate for those functions that no longer work. This applies particularly to the regulation of sound levels that keep hearing in a comfortable range. Currently, oversized lab models of the hearing aids are being tested on patients in Dr. Meddis’s lab.

Since about 36 million American adults have hearing problems, I was especially interested in finding out when the new hearing aids would be on the market. Dr. Meddis said the next step is to develop a microchip small enough to be put inside the hearing aids. Then working models will be tested by hearing-impaired people. But because development costs are high, Dr. Meddis said it would probably be several years before the highly computerized hearing aids will be available for sale. The good news is that one hearing aid manufacturer, Swiss-based Phonak, is already working with the Meddis team.

Source(s):

Ray Meddis, PhD, professor emeritus of psychology and director of the Hearing Research Laboratory at the University of Essex in Colchester, Great Britain.


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The Genius of a Q-Tip

Is it possible in an era of such complex medical technology for anything new and effective to also be stone simple? My answer is, of course -- and this is something we should never lose sight of. Latest example: I’ve come across a fascinating new medical study describing a technique for preventing infections in certain surgical wounds using nothing but a cotton swab similar to the Q-tips brand that we all grew up with. This approach is used solely for patients who have what surgeons call "dirty" wounds. Because of the type of operation -- for example, bowel surgery, perforated appendix or surgery for trauma -- a dirty wound is likely to be heavily contaminated with bacteria, putting patients at high risk for infections.

Infection Rates Drop, So Does Pain

As a rule, efforts to prevent postsurgery infection in dirty wounds have included inserting under-the-skin drains... leaving the site open and cleaning it regularly... or applying topical antibiotics, but the success rate with these methods is disturbingly low. Risk for infection can reach up to 50% in the US, depending on the amount of contamination -- which translates to more than 500,000 such infections each year, representing 25% of all hospital-acquired infections and a major cause of patient death. The new study included 76 patients who had undergone surgery for a perforated appendix. In half of the patients, doctors used iodine to clean the incision wounds, and in the other half, they gently probed the wounds with cotton swabs daily. The results were impressive. While 19% of the iodine-only group developed wound infections, just 3% of the patients in the probed group did. The probed group also had shorter hospitals stays, on average (five days versus seven)... less postoperative pain... and better cosmetic healing of the incisions.

A Study Speaks to Doubters

The author of this study was surgeon Shirin Towfigh, MD, attending surgeon at Cedars-Sinai Medical Center in Los Angeles. She told me that she learned this technique while a resident at another medical center and assumed that it was common knowledge. Much to her surprise, she later discovered that very few doctors knew anything about it. Indeed she initially got a lot of resistance from her colleagues. "They were worried that the probing would be painful and thought it best to leave an incision alone to heal," she told me. This prompted her to do the clinical study and now, as she says, "the evidence speaks for itself."

To be able to do cotton-swab probing, the incision must be closed loosely, with staples placed at least two centimeters apart, says Dr. Towfigh. This provides enough room for doctors to insert the dry swabs deep into the incision between the staples. (Contrary to doctors’ fears, Dr. Towfigh says, patients experience only a minimum amount of pain from the technique.) Daily probing starts the morning after surgery, takes two to four minutes, and continues until the wound closes completely, generally in three to five days. Gentle insertion doesn’t open up the sealed portions of the wound, and the trick here is that bacterial fluid is removed from the site, allowing the body’s natural defenses to deal with the infection. Some patients are ready to leave the hospital before their wounds have completely sealed -- and believe it or not, they are given instructions on how to probe the incisions themselves so they can continue at home.

The Word Spreads

Dr. Towfigh says that her study has engendered excitement among surgeons around the country and abroad and that they have been contacting her to learn more. (She also is preparing an instructional video of the technique.) Doctors at Cedars-Sinai now are using the technique on appropriate patients throughout the hospital, and a team of colorectal surgeons there has started a similar study in their patient population. The success of this simple method is a good reminder that an easy, low-tech approach is sometimes just exactly what is needed.

Source(s):

Shirin Towfigh, MD, attending surgeon and associate professor of surgery, division of general surgery, Center for Minimally Invasive Surgery, Cedars-Sinai Medical Center, Los Angeles.

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Be well,


Carole Jackson
Bottom Line's Daily Health News


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