The Email Newsletter from Appalachian Audiology

Dr. Jan Dungan and Dr. Jill Barron, Clinical Audiologists

March 2012

How Allergies Affect Hearing

Spring is here and allergy season has begun!  It may surprise you to learn that East Tennessee was recently rated the 6th worst place to live in America for allergy sufferers.
The Asthma and Allergy Foundation of America has rated Knoxville the worst city in America for allergies three years in a row.  Allergies reportedly attack 50 million people each year in the United States alone.  It's estimated that one in four people currently suffer from some type of allergy. Sinus related issues (a by-product of allergies) are now rated the number one medical problem in America.  In fact, the sale of medications that treat allergies now exceeds five billion dollars globally.  How do allergies impact our hearing?  Can allergies cause or worsen hearing loss?  What kind of treatment options exist for allergies?  These are the issues we will discuss in the March edition of APP-likationz

What are "Allergies?"

An "allergy" is simply an over-reaction of the immune system to a substance that is inhaled, eaten, or touched and viewed as a threat.  When a foreign substance is introduced to the body, the immune system may treat this usually harmless substance as a threat.  It immediately produces antibodies to neutralize the threat and to protect the body from future "attacks" by the same substance.  This process leads to the release of histamine.  Histamine is a chemical that causes many of the symptoms associated with allergies including sneezing, inflammation, scratchy throat, and runny nose.  Any substance that triggers an allergic reaction is known as an "allergen."  Pollen, mold, dust, and animal dander are the most common allergens.  Allergies can be inherited and are often unique to the individual. u

For more information on allergies, visit The Asthma and Allergy Foundation.

How Allergies Impact Hearing

The immune system reacts to an allergen by producing antibodies and causing the release of histamine.  Histamine can cause inflamed nasal passages, sinuses, and airways.  This inflammation results in mucus production which leads to congestion, sneezing, and itchy, watery eyes.  The excess fluid created by an allergic reaction can create problems for the ear. 

Eustachian tubes function as the drainage passage for the middle ear.  The Eustachian tube is a muscular tunnel that opens and closes to both drain debris and equalize the pressure between the environment and the middle ear space. Its functions are very important to maintaining the health of the middle ear space.  These tubes are connected to the nose and throat.  If they become clogged from excess drainage from the nose and/or throat, this fluid can build up in our ears along with other debris such as excess ear wax.  Once fluid, excess ear wax, or foreign debris builds up in the ear, numerous problems can occur.  These include:

  • Conductive hearing loss/decreased or fluctuating hearing
    • Conductive hearing loss is caused by the inability of sound waves to travel through the ear and connect with the tiny bones of the middle ear. 
    • Excess fluid and ear wax naturally lead to conductive hearing loss and decreased hearing as they prevent sound from traveling uninterrupted to the cochlea (the hearing organ of the ear).
    • Fluctuating fluid levels in the ear can lead to differing hearing levels due to varying degrees of interruption along the auditory pathway.
    • Conductive hearing loss and fluctuating fluid levels in the ear are curable.
  • Middle ear infections
    • Excess fluid in the ear cavity provides a moist environment in which bacteria may thrive. If these infiltrate the ear, ear infections could result. Multiple ear infections can lead to such conditions as tinnitus and permanent hearing loss.
  • Pressure or a feeling of "fullness"
    • Excess fluid in the ear naturally makes the ear feel like it is "filled up."  This fluid can press against the eardrum/tympanic membrane causing pressure and discomfort.

Treating Allergies

Treating allergies is important to prevent ear infections and conductive hearing loss.  The goal of treatment is to decrease or prevent excess fluid from building up in the ear.  Ear infections, conductive hearing loss, fluctuating hearing, and pressure can be relieved by eliminating excess fluids. 
  • Avoidance
    • The first step to treating allergic reactions is to avoid the allergens that induce them!  To do this, you must identify what you are allergic to.  This is done through skin testing or blood work.
  •  Antihistamines/Steroids/Expectorants/Decongestants
    • Antihistamines
      • Antihistamines work by blocking the effects of histamine.  This relieves or reduces many symptoms including nasal inflammation and excess fluid production.
      • Popular antihistamines include Claritin, Allegra, and Zyrtec.
    • Inhaled Steroids 
      • Inhaled steroids help treat allergies by reducing inflammation and mucus production, particularly in the nasal passages.
      • It can take up to two weeks before the full benefits of inhaled steroids are realized.
    • Expectorants
      • Expectorants work by thinning respiratory secretions such as mucus and phlegm.  They essentially help coughs become more productive in expelling excess fluids out of the respiratory tract.
      • The most common expectorant is called "guaifenesin" and is found in most OTC allergy and cold medicines.
    • Decongestants
      • Decongestants work by reducing swelling in the nasal passages and lessening the amount of fluid that is produced.
  • Immunotherapy 
    • When allergy symptoms cannot be successfully controlled by allergen avoidance and medications, it may be possible to alter a person's hyper-active immune response through immunotherapy.
    • Immunotherapy involves gradually injecting allergens in increasing amounts over a period of time in hopes of helping the body adjust its immune response appropriately.
    • A person's reactivity to specific allergens can potentially be altered by immunotherapy.

Click here for more information on how to treat allergies.

How Audiologists Help With Allergies

Hearing Aids Are Affected By Allergy Symptoms!

Be sure to share with your audiologist if you have chronic allergy conditions.  You would want to have a hearing device with a volume control or remote 
control rather than a totally automatic device so that you can increase or decrease your hearing levels for "good hearing days" and "bad hearing days."

The six most common allergies are airborne, and these microscopic particles can clog the microphone ports of your hearing aids. Hearing aid microphone port covers should be changed every 6 to 9 months.  The microphone port covers should be changed more frequently if you are outside often or sense you are not hearing as well in noise.  This could mean the microphones are no longer balanced (due to drift or pollen).  Replacing the covers will fix this. Schedule an appointment, so we have time to order your specific hearing aid port covers for you.

Seasonal allergies may cause a dip in hearing--but only when the pollen is flying.  Remember, hearing aid service is available for the life of the hearing aids. If your devices need a spring cleaning, don't hesitate to schedule an appointment!

From comprehensive diagnostic testing services and auditory rehabilitation to digital hearing technology and assistive listening devices, Appalachian Audiology individualizes each treatment plan to effectively restore communication.  
In This Issue
What are "Allergies?"
How Allergies Impact Hearing
Treating Allergies

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