Includes the following article: Allergies: The Hearing
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ALLERGIES: The Hearing Connection
by Max Stanley Chartrand, Director of Research
Health & Human Services/research in communicative
disorders
'My head feels plugged up when I wear these hearing
aids!' exclaimed my new patient, a middle-aged female
who had used her new instruments for less than a week.
'Mmmmm, let me see,' I said as she removed her hearing
instruments.
I quickly inspected them to see if the earmold vents
were plugged. They were not. An otoscopic exam and a
screening tympanogram both revealed a fluid-filled
middle ear cavity. No sign of redness.
'Hmmmmm.. .your ears feel plugged up because they are,'
I assured her. 'Do you have allergies?'
'Oh, no, I don't think so.'
'Do you have sinus drainage, hay fever, or anything of
that nature?'
'Oh, I do have that once in a while. I thought you
meant: am I allergic to anything.'
That was exactly what I meant.
A visit to her physician revealed that she was, indeed,
suffering from airborne allergies (pollen, spores,
household dust) which caused her eustachian tubes not to
open every third or fourth swallow, as they normally
should, to equalize pressure in the middle ear. The
result was a fluid-filled middle ear cavity and a
fluctuating conductive hearing loss of about 45 dB in
the low frequencies. Coupled with her permanent
high-frequency sensorineural (nerve) hearing loss, she
did, indeed, feel 'plugged up.'
UNDER-DIAGNOSED CONDITION
The 20th century's two most prevalent yet under
diagnosed health problems are hearing loss, affecting
12%, and significant allergies of all types, affecting
more than 50%, of the general population. These two
health problems are generally elusive in their own way
and therefore achieve high marks on life's misery index,
once properly attributed through timely health and
medical examinations. In the case of allergies, one may
be allergic to certain foods, drugs, medicines, toxins,
spores, dust, pollen, and/or a wide variety of everyday
substances. The problem is that the myriad sources of
allergens, overlapping symptoms, and the often resulting
infections and disease can mask allergy as a recognized
and treatable factor in one's health.
A CASE OF FRIENDLY FIRE
In the Gulf War of 1991, some of the most tragic losses
on the battlefield were from 'friendly fire' -- good
guys accidentally shooting other good guys.
Most allergies share that same dubious distinction: they
are the good guys responding to perceived enemies. To
protect itself, the body responds to a supposed danger,
creating symptoms identical to pathological disease.
In many individuals, the predisposition to allergy is
heredity; some conditions, such as asthma, are generally
accepted as psychosomatic and emotionally-related.
In either case, it is common that, starting in infancy,
the antibody IgE is produced by the body to ward off al
allergens, causing an overreaction and, therefore,
swelling of tissues, increased mucous production, spasm
of smooth muscles, itching, and accumulation of
inflammatory cells. The stage is set for bacteria
growth, particularly in the upper respiratory system.
Wheezing, runny nose, headache, burning eyes, and middle
ear fluid accumulation may result.
ALLERGIES IN SMALL CHILDREN
The undeveloped eustachian tubes (the tube in the back
of the throat that connects with the middle ear cavity)
of infants and small children are particularly sensitive
to even small irritations due to allergy. One of the
most common problems in young children is chronic otitis
media (recurring middle ear infection). In most cases,
the underlying cause appears to be airborne or food
allergy. The resulting infection is secondary. Yet, it
is often the infection that receives the treatment, not
the allergy that creates the infection in the first
place.
So the cycle of allergy, fluid build-up, infection, and
antibiotic treatment continues over and until the
child's eustachian tube has finally matured (lengthened)
and he outgrows some of the allergies experienced so
prevalently during early childhood. Some times, this
vicious cycle is superficially broken by the physician
placing tubes in the ears (myringotomy) or by removal of
the adenoids and tonsils.
By venting the eardrums, fluid build-up from allergy is
kept under control. However, the unprotected middle ear
cavity is then subject to bacterial infections by direct
exposure to air and water. Resulting scar tissue on the
eardrum may cause a mild hearing loss for the child. In
the case of removal of the tonsils and adenoids, these
procedures were once very common in medical practice,
but today are carried out only as a 'last resort.'
However, the continual pattern of allergy, secondary
infection, and antibiotic course can finally bring about
the state of malfunc tion requiring removal of these two
important immunological glands.
Not all cases of otitis media and tonsillitis are caused
by allergy; yet recent studies find that up to 50% of
subjects respond to treatment without antibiotics as
well as others who are prescribed antibiotics. The
caution here is that overuse or constant use of
antibiotics predisposes the individual to future im mune
deficiencies and more allergies later in life.
In certain areas of the country, where airborne
allergens are particularly high, the cycle of allergy
(as primary cause) and infection (as secondary cause)
could be more effectively managed if the allergy
received medical atten tion before infection sets in.
Meniere's Disease and Allergy: A Connection?
Meniere's Disease (or endolymphatic hydrops) is a
condition of the ear which usually exhibits the symptoms
of vertigo (nausea), tinnitus (head noises), and hearing
loss (particularly low frequency). Because of lack of
fluid (endolymph) resorption in the cochlea (inner ear),
the result is feelings of pressure and the symptoms
listed above. Attacks may last minutes or hours and
occur unexpectedly at any time of day or night. Hence,
many tragic cases of sudden deafness and stark lifestyle
changes have been shared by sufferers of Meniere’s.
Known as Meniere’s Syndrome in its lesser stages, sudden
hearing loss sometimes occurs, or more often,
fluctuating hearing loss. In some cases, complete
deafness results.
Another complication is accompanying recruitment,
especially hyper-recruitment, where gradual increase of
sound is sensed as a rapid increase, instead.
In general, the condition is known as idiopathic because
the cause is rarely known and occurs unilateral ly (one
ear only) in approximately 75% of cases.*
According to Dr. Jack Pulec, M.D., of Los Angeles,
California, the most common cause of Meniere’s Disease
is allergy, particularly food allergies. In another
report, allergy to sugar and caffeine was suspect. Yet,
people with Meniere’s very often do not receive a
complete food allergy assessment before medical
treatment begins. Of course, there are other causes of
the condition, but none so universal as allergy. While
many of the symptoms of Meniere's may he medically
managed by artificial or surgical means, it is important
that the primary cause of the Meniere's first he
established before the proper remedy can be determined.
THE ALLERGIC EAR CANAL
The ear canal is often a reflection of the state of
health of the whole person. A pH balance problem such as
diabetes mellitus, hyperglycemia, and hypoglycemia, will
also appear in the ear in the form of mild irritation
(itching) or even
chronic external otitis (pain and in fection), often due
to fungus and/or yeast, and, in chronic cases,
psuedomonas.
Other causes of pH imbalance might involve high blood
pressure resulting from high sodium, low potassium in
the body (again, fungus, yeast). By treating symptoms
only (relief of itching or infection) and not the cause,
the problems persist.
It is frequently reported that hearing aid users have a
higher-than-normal incidence of ear itching and pain,
yet in actuality, wearing the instru ments only
exacerbates the problem, making it appear more
pronounced. With or without the earmold in the ear, the
problems are there, although not as obvious. This is
especially true in cases of pseudomonas and fungal
growth. Untreated, the problem is always there, possibly
noticed only while wearing hearing aids.
Persons who have skin allergies elsewhere on the body
can also ex pect allergic symptoms in the ear canal.
Hearing aid shells and earmolds are therefore available
in non-allergenic or hypo-allergenic materials to
accommodate the problem. In addition, a more strategic
wearing schedule may be necessary for the new hearing
aid user who has skin allergies.
Information about allergies must be shared with the
audiologist or hearing instrument specialist. Avoidance
of this vital information can cause unnecessary failure
in the adaptation and rehabilitation process.
In today's specialized healthcare system, it is
sometimes easy for one not to interrelate the various
cond of the body. hearing loss is probably the most
overlying condition because it is affected by such a
wide variety of other health conditions.
Only a complete hearing health assessment, looking at
the total person, can paint the true picture of one’s
hearing health and special needs. This must be
accomplished by one trained in such assessments.
Allergies of all kinds are SO common in the general
popula tion, it is important that its af fects upon
hearing health he sear ched out and considered in the
overall aural rehabilitation program. Only then may
those with hearing loss successfully take advantage of
the marvels of ad vanced hearing technology and
rehabilitation. And, once again, enjoy the colorful
world of sound.
BIBLIOGRAPHY
Brackelt. 0. Macon AB. Ross. M: Assesment and Management
of Mač htaflrg /.np.s Children. Austin. TX: P,o-ed.
1991.
Chartrand, MS: Hearing lnstrument Counseling: Practical
Applications for Counseling the Hearing lmpaired,
Livonia, MI: National Institute for Hearing Instruments
Studies. 1991.
Hoover, S: Tinnitus and Allergy, Proceedings III Inter.
nat Tinritus Scm Mueniter. 1987.
Kieste,. Edwin .1’.. ed: Ne Family Medical Guide. Des Mo
IA: Mor Corporation, 1 929.
Newby, HA: .4udiology (SIN cdl. E Cihi. NJ:P,eht,ce-H&I.
Inc., 1982.
Vade, C: Home Encyclopedia of Symp:cnrs A/let. ge'rs.
a,,d Tb Nolumal fle,r,ed,eo. V'/e Nva NY:
Perke, Pr.ibi.shirrg. 1991.
DigiCare Hearing Research & Rehabilitation, Rye, CO. Fax
719-676-6882.
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