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UM SOM Study Announces Breakthrough in Understanding Hearing Loss

NewsArchive Pages2017 ArchiveUM SOM Study Announces Breakthrough in Understanding Hearing Loss

August 03, 2017 | Larry Roberts

Zubair Ahmed, PhD

Study Pinpoints a Mechanism Behind Some Deafness

Researchers at the University of Maryland School of Medicine (UM SOM) today announced a breakthrough discovery that could eventually help scientists repair hearing problems or protect those at risk for hearing loss – a condition that affects some 40 million Americans.

In particular, with 74,000 children currently affected by profound, early-onset deafness, scientists have been trying to solve the mystery of what causes hearing disorders, especially those that may have genetic causes.

Now, the new UM SOM study, has identified a crucial protein in the process that turns sound waves into brain signals. The new understanding could eventually help repair or prevent hearing problems for those with the highest risk.

The findings were published recently in the Nature Communications. The study is the first to illuminate in detail how the protein, known as CIB2, enables hearing.

“We are very excited by these results”, said the senior author of the study, Zubair Ahmed, PhD, Professor in the Department of Otorhinolaryngology-Head and Neck Surgery at UM SOM. “This tells us something new about the fundamental biology of how hearing works on a molecular level.”

CIB2, which is short for calcium and integrin-binding protein 2, is essential for the structure of stereocilia, the structures at the top of the sensory hair cells in the inner ear. Stereocilia are extremely small, less than a half a micrometer in diameter, which is about the wavelength of a visible light. Each ear contains 18,000 hair cells that do not divide or regenerate.

Saima Riazuddin, PhD, MPH, MBA

Dr. Ahmed and his colleague Saima Riazuddin, PhDProfessor in the Department of Otorhinolaryngology-Head and Neck Surgery at UM SOM, along with their collaborators, discovered five years ago that CIB2 was involved in hearing. Since then, they have studied the protein in flies, mice, zebrafish and humans. The new study is the first to explain the mechanism behind CIB2 in hearing.

In this study, they genetically engineered mice without CIB2, as well as mice in which a human CIB2 gene mutation had been inserted. The researchers found that the human mutation affects the ability of the CIB2 protein to interact with two other proteins, TMC1 and TMC2, which are crucial for converting sound to electrical signals, a process known as mechanotransduction.

People with this mutation cannot turn soundwaves into signals the brain can interpret, and so are deaf. When the researchers inserted the human CIB2 mutation into the mouse, they found that the mice were deaf.

“This is a big step in determining the identity of key components of the molecular machinery that converts sound waves into electrical signals in the inner ear,”said the study’s co-senior author, Gregory Frolenkov, PhD, of the Department of Physiology at the University of Kentucky.

Dr. Ahmed and his colleagues are now looking for other molecules beyond CIB2 that play a key role in hearing. In addition, they are exploring potential therapies for CIB2-related hearing problems. In mice, they are using the gene editing tool CRISPR to modify dysfunctional CIB2 genes. They suspect that if this modification occurs in the first few weeks after birth, these mice, which are born deaf, will be able to hear. The scientists are also experimenting with gene therapy, using a harmless virus to deliver a copy of the normal CIB2 gene to baby mice that have the mutated version. Dr. Ahmed says the early results of these experiments are intriguing.

It is not clear how common CIB2 mutations are in the US population, or how large a role these mutations play in deafness in humans worldwide. In his research on a group of families in Pakistan that have a higher risk of deafness, Dr. Ahmed has found that about 8 to 9 percent seem to have mutations in CIB2. Overall, he says, the gene could play a role in tens of thousands of cases of deafness, and perhaps many more than that. He is also studying CIB2 among the general population. It may be that some versions of the gene also play a role in deafness caused by environmental conditions, creating a predisposition to hearing loss.

Arnaud Giese, PhD, a Post-Doctoral Fellow at UM SOM, and Yi-Quan Tang, PhD, from Cambridge University in England, are co-authors of this study. Other significant contributors include Dr. Riazuddin, William Schafer, PhD, from Cambridge University, Steve S.D. Brown, PhD, from the MRC Harwell Institute, UK, and Robert Fettiplace, PhD, from the University of Wisconsin.

“Hearing loss and deafness remain major physiological and sociological problems, with enormous economic and emotional costs,” said UM SOM Dean E. Albert Reece, MD, PhD, MBA, who is also the vice president for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor. “This innovative work by Dr. Ahmed and his colleagues opens a key molecular window that could lead to the development of cutting-edge translational treatments in the future.”

About the University of Maryland School of Medicine

Commemorating its 210th Anniversary, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world — with 43 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Sciences, and a distinguished recipient of the Albert E. Lasker Award in Medical Research.  With an operating budget of more than $1 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically-based care for more than 1.2 million patients each year. The School has over 2,500 students, residents, and fellows, and nearly $450 million in extramural funding, with more than half of its academic departments ranked in the top 20 among all public medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total workforce of nearly 7,000 individuals. The combined School and Medical System (“University of Maryland Medicine”) has a total budget of $5 billion and an economic impact of nearly $15 billion on the state and local community. The School of Medicine faculty, which ranks as the 8th-highest public medical school in research productivity, is an innovator in translational medicine with 600 active patents and 24 start-up companies. The School works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

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• UM SOM Department of Otorhinolaryngology-Head and Neck Surgery

CONTACT

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University of Maryland School of Medicine
Larry Roberts
Web Communications
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chemo patients get hearing loss 80% of time

IU cancer center researcher awarded $5.7 million to study chemo-induced hearing loss, toxicities

IU School of Medicine Sep 02, 2020

Lois Travis, MD, IU Simon Cancer Center, oncology

INDIANAPOLIS—A researcher at the Indiana University Melvin and Bren Simon Comprehensive Cancer Center has been awarded a five-year, $5.7 million National Cancer Institute grant to evaluate long-term health outcomes for cancer patients who receive platinum-based chemotherapies. 

An internationally recognized expert on cancer survivorship, Lois B. Travis, MD, ScD, leads the ongoing study that could lessen cancer treatment side effects for millions of patients. 

Nearly 6 million patients globally are diagnosed with a cancer each year in which first-line therapy potentially includes highly toxic, platinum-based chemotherapies. While the treatment may lead to hearing loss, ringing in the ears, numbness in hands and feet and other side effects, it is the only proven cure for the vast majority of testicular cancer patients. 

When IU’s Lawrence Einhorn, MD, developed a revolutionary therapy for testicular cancer in the 1970s, he flipped the 95 percent mortality rate for the disease to a 95 percent survival rate. His regimen of platinum-based cisplatin and two other drugs continues to be the standard care for testicular cancer. Einhorn is the Livestrong Foundation Professor of Oncology at IU School of Medicine and a physician scientist at the IU Simon Comprehensive Cancer Center.

Now Travis, Einhorn and a team of researchers from other top cancer centers are following more than 2,000 testicular cancer survivors who are part of the largest clinical cohort of germ cell cancer survivors worldwide. The alliance of researchers leads The Platinum Study, which was established through a previous NCI grant awarded to Travis in 2012. 

“We have shown with audiometric examination that 80 percent of the patients had hearing loss with one in five classified as severe to profound, levels at which hearing aids are recommended,” Travis, the Lawrence H. Einhorn Professor of Cancer Research at IU School of Medicine, said. Additionally, researchers found that 56 percent of patients had nerve damage called neuropathy and 40 percent had tinnitus or permanent ringing in their ears.

With this grant, researchers will tap into the existing cohort of patients who are part of the Platinum Study. The median age at diagnosis for testicular patients is 30, and the cohort’s median age now is 37. As patients age, researchers will continue to follow health changes, including if they are more susceptible to age-related hearing loss.

“We will examine the role of genetic variants in the platinum toxicities to try to identify high-risk subgroups,” Travis said.

The team of investigators wants to understand better which patients are at higher risk for these adverse outcomes and the daily effects of the toxicities. 

Collaborators of the Platinum Study gathered in Indianapolis in 2015.
Collaborators of the Platinum Study gathered in Indianapolis in 2015.

“The goal is to follow this cohort for many decades to characterize the longitudinal trajectory of toxicities related to platinum-based chemotherapy,” she said. “For the first time, we will evaluate the impact and severity of the hearing loss and tinnitus on the patients’ physical, emotional and social functioning.”

Patients will complete questionnaires to track the different facets of their lives that are affected by hearing loss, or pain and numbness associated with neuropathy, as well as other toxicities. Researchers will also investigate the social and emotional consequences of the constant ringing in the ears, such as difficulty sleeping or concentrating.
Additionally, researchers will continue to analyze previously collected patient blood samples to track platinum levels, which can remain in the body for decades after chemotherapy is completed.

“Platinum is not completely excreted and is believed to be held in several body reservoirs. As tissue is remodeled with age, platinum regains access to the circulation,” Travis explained. “We will continue to measure the residual serum platinum levels.”

While cisplatin is used for many cancers, Travis notes that the testicular cancer patient cohort offers researchers a unique opportunity to study the toxicities.

“If we want to improve our understanding of long-term cisplatin-related toxicities, this is an ideal population,” she said. “When doing genetic studies, we know that all patients received about the same cumulative dose of cisplatin. We can then consider: who developed hearing loss and who didn’t, and what genetic and other factors are associated with this outcome?”

Ultimately, Travis hopes this research can determine which patients are most likely to experience adverse effects from cisplatin and then provide guidelines that could decrease damaging side effects, such as duration of treatments or improved symptom management.

“This is a critical part of my life’s mission: to decrease the cost of the cure for cancer survivors,” Travis said.

Collaborators include researchers from Memorial Sloan Kettering Cancer Center (Darren Feldman, MD), Dana-Farber Cancer Institute (Neil Martin, MD), University of Pennsylvania (David Vaughn, MD), University of South Florida (Robert Frisina, PhD), Vanderbilt University (Nancy Cox, PhD), University of Chicago (Eileen Dolan, PhD), Princess Margaret Hospital (Robert Hamilton, MD), the Royal Marsden Hospital (Robert Huddart, PhD), University of Rochester (Chunkit Fung, MD), Loyola University (Heather Wheeler, PhD), Harvard School of Public Health (Howard Sesso, ScD), and the British Columbia Cancer Agency (Christian Kollmannsberger, MD).

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IU School of Medicine is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.

defective earplugs cause hearing loss mass suit

More than 200,000 people say that Combat Arms earplugs were knowingly defective, imperceptibly loosening and leaking in noise. By Mike Hughlett Star Tribune SEPTEMBER 19, 2020 — 8:22PM

RODRIGO ABD – ASSOCIATED PRESS FILEU.S. soldiers from the 2nd Brigade, 87th Infantry Regiment, 10th Mountain Division, in Helmand Province, southern Afghanistan, in June 2006. At the litigation’s heart is the U.S. Army’s request in 1999 to Aearo — before 3M owned it — to shorten the Combat Arms earplugs so they would fit in a carrying case and not interfere with helmet fit.TEXT SIZE15EMAILPRINTMORE

When 3M bought Aearo Technologies in 2008 it became a giant in the military earplug market. Aearo’s Combat Arms earplug was standard issue for U.S. soldiers in Iraq and Afghanistan.

A dozen years later, 3M is mired in one of the largest U.S. mass torts ever over the earplugs. More than 200,000 people — mostly veterans and active duty soldiers — say that Combat Arms earplugs were knowingly defective, imperceptibly loosening and leaking in noise.

Kevin Wilhelm, a Navy veteran, is one of them. Wilhelm said he now wears hearing aids almost constantly and is plagued by “nonstop” tinnitus — ringing in the ears, a common ailment among those suing 3M.

“I didn’t know these earplugs were defective,” he said. “I thought they were the best of the best.”

Indeed, the Combat Arms earplugs were groundbreaking, offering hearing protection while allowing soldiers to hear commands even in war zones.

3M maintains that the earplugs were not “defectively or negligently designed” and did not cause injuries. “Plaintiffs’ attorneys have created a false and baseless narrative regarding the product, and we will vigorously defend ourselves against such allegations,” 3M said in a statement.

Several “bellwether” earplug suits are scheduled for trial in April in a Pensacola, Fla., federal court. Their disposition is likely to set the tone for a possible settlement of all Combat Arms claims.

If the verdicts go against Maplewood-based 3M, the damages could tally in the hundreds of millions of dollars, if not more, based on the outcome of other large mass tort cases in recent years.

In July, a federal judge shot down a key 3M defense strategy, which would have granted the company some legal immunity as a government contractor.

At the litigation’s heart is the U.S. Army’s request in 1999 to Aearo — before 3M owned it — to shorten the plugs so they would fit in a standard-issue military carrying case. The company did so, but plaintiffs claim Aearo’s fix caused bigger problems.

Tests in 2000 at Aearo’s Indianapolis laboratory indicated that the shorter earplug didn’t always fit properly — and thus wasn’t always effective — unless it was inserted in a particular way, according to internal Aearo documents filed in court.

Two Aearo sales managers said in court depositions that soldiers did not need to know of the earplugs’ possible shortcomings.

Asked if it was “OK for Aearo/3M to conceal this information from the government,” former Aearo vice president Martin Salon said in a deposition: “I suppose it is, if the product is working — in most cases. … Nothing is perfect.”

3M said that neither it nor Aearo concealed information about the earplugs.

The earplug battle comes as 3M is grappling with an even bigger legal war over PFAS, a class of chemicals. Hundreds of cities, states and individuals are suing the company for allegedly contaminating water and soil with PFAS.

The earplugs in question are the second version of Combat Arms, which were sold to the government from 1999 to 2015 when 3M abruptly discontinued the product. The 200,000-plus earplug claims against 3M were lodged after the company settled a whistleblower suit in 2018.

That suit was brought by rival earplug maker Moldex-Metric on the federal government’s behalf, after an inquiry by the U.S. Army Criminal Investigations Command. The suit claimed Aearo knew about “dangerous design defects” in 2000.

In a 2018 report, the Army concluded that had the government known about tests Aearo had done in 2000 it may not have purchased Combat Arms earplugs. In the whistleblower settlement, 3M paid a $9.1 million penalty, but denied all claims and did not admit liability.

Auditory ailments are common occupational hazards in the military — and not only in combat. Hearing loss and tinnitus were the two most prevalent service-connected disabilities in 2019, according to the Veterans Benefits Administration.

Wilhelm, 57, said his tinnitus is so severe that he sleeps poorly and has developed anxiety and depression. The ringing “just grates and grates on you,” he said. “You never get a moment’s rest.”

Wilhelm, a Michigan native, retired in 2012 after 30 years in naval aviation, rising from jet mechanic to the top enlisted rank of maintenance master chief, often working on aircraft carriers.

He said he had worn ear protection throughout his career, switching to Combat Arms plugs by early 2003. Four years later, he said he began to noticeably struggle with his hearing.

The “dual-ended” Combat Arms earplug was considered an advancement.

The dark-colored end of the plug was solid, and when inserted into the ear would block steady noise, from helicopters to armored personal carriers. The yellow end was attached to a filter and when plugged into the ear, it would allow speech to be heard, while still blocking “impulse noise” such as gunfire.

The Combat Arms earplug became a big seller as the U.S. went to war in Afghanistan and Iraq. Aearo/3M tallied over $30 million in Combat Arms Version 2 sales from 1999 through 2009, mostly between 2004 and 2008, court records show.

The earplugs appeared to be quite profitable, too. In a deposition, one 3M marketing manager acknowledged that a set of earplugs cost 85 cents to make and were sold to the military for $7.63 apiece.

Plugs were tweaked

In 1997, Army and Aearo officials met for the first time to discuss a dual-ended earplug at an Army proving ground in Maryland. Doug Ohlin and Elliott Berger were both there.

Ohlin, an audiologist, was the hearing conservation manager at the Army’s Center for Health Promotion and Preventive Medicine. “Doug was the one that pretty much dictated how we were to provide hearing protection to the military,” one former Aearo and 3M sales executive said in a deposition.

Berger, an acoustical scientist, founded Aearo’s lab and had more than 20 years experience with the company when development began on the Combat Arms earplug. Well-regarded in hearing conservation circles, Berger worked for 3M until his retirement in 2018.

Ohlin said he chose the Combat Arms in 1999 because “it was the best game in town” — indeed one of the only games, court records show.

But the plugs turned out to be too long for the Army’s carrying case and could interfere with the fit of a soldier’s helmet. So, Ohlin told Aearo in 1999 to shorten them, and the first Combat Arm earplugs were shipped to the military that year.

In 2000, Berger supervised tests of the Combat Arms earplugs at Aearo’s lab, including one to establish a Noise Reduction Rating, or NRR. The higher an NRR, the better the noise protection, and an NRR must be derived from a test with 10 subjects.

The initial test was stopped after eight subjects because the results were variable and the estimated NRR was an 11, Berger and a colleague wrote in a July 2000 internal Aearo memo known as the “Flange Report.”

Other court documents said that an NRR of 11 is far below adequate, indicating the earplug would not stop sound as claimed.

A big part of the problem, Berger and his colleague found, was that because the plug had been shortened, it was difficult to fit deeply into some test subject’s ears, especially those with medium and larger ear canals, the Flange Report said.

For a second test, Aearo scientists changed the plugs’ fitting, pulling back the “flanges” of the yellow end sticking out of the ear. By folding the flanges, the plugs fit more consistently and deeper into the ear, the Flange Report said.

The second test achieved a Noise Reduction Rating of 22, much better than the first and in line with what was needed to sell the product.

Judge’s ruling pivotal

The Flange Report was never shared with the Army, wrote U.S. District Court Judge Casey Rodgers, who is presiding over the Combat Arms suits in Pensacola. Plaintiffs claim neither Aearo nor 3M even discussed the contents of the report with the military.

3M disputes that, saying in a statement that “the issues outlined in the Flange Report regarding fitting were communicated to the military,” and that the military was responsible for informing soldiers about the earplugs’ proper fit.

Berger, in a deposition, didn’t recollect providing test data to Ohlin. But he said this “entire development project was discussed with him and the issues from shortening [the earplug] to how it affected our testing were reviewed.”

Ohlin died in 2013. He had retired from his Army post in 2007, and soon thereafter became a contract consultant for Aearo and then 3M.

Veterans and soldiers suing 3M claim they were never told they needed to roll back the earplug’s flanges to receive proper hearing protection. “I would have adhered to that policy if I knew,” Wilhelm said.

The judge’s conclusions on the Flange Report were part of her July 24 order disallowing 3M’s use of the “government contractor defense” — a blow to the company’s legal plan.

That defense shields contractors from liability for defects in products designed and developed for the federal government. 3M has long said that the Combat Arms was designed in conjunction with the military.

However, Rodgers ruled that “the Army never issued a request for a design proposal for the new earplug.” And there was no contract between the Army and Aearo when Ohlin said the plugs needed to be shortened, she wrote.

“No reasonable jury could conclude that Dr. Ohlin or the Army made Aearo do anything,” the ruling said.

3M said it will continue to argue — and “ultimately prove” — that the company worked in close coordination with the U.S. military, and that the earplug’s design “reflected the direction and feedback of individuals acting on the military’s behalf.”

Mike Hughlett covers energy and other topics for the Star Tribune, where he has worked since 2010. Before that he was a reporter at newspapers in Chicago, St. Paul, New Orleans and Duluth.
mike.hughlett@startribune.com612-673-7003

Bose Corp. introduces Sleepbuds II

Better Noise (tinnitus) Masking, New Relaxation Content, Now with Clinically Proven Technology

22 September 2020

Framingham, MA — Today, Bose announced Sleepbuds™ II, the next generation of its revolutionary bedtime wearable with technology now clinically proven to help people fall asleep faster. Sleepbuds II feature demonstrably better noise masking than their predecessor and introduce new categories of content to combat the other barrier to rest: the inability to relax. They combine a new acoustic and electronics design, a new enclosure that’s lighter than a dime, new proprietary ear tips for a secure, super-soft fit, and over 35 free tracks — all methodically produced and tested. The result is an engineering breakthrough: two tiny, ultra-comfortable, truly wireless buds that block, cover, and replace the audible distractions from loud partners, neighbors, dogs, and traffic — and reduce the mental distractions from long, busy days.

Sleep Buds Ii Wide

Bose Sleepbuds II will be available on October 6th for $249.95 and preorders start today. They aren’t active noise cancelling headphones or in-ear headphones with an added feature, and they don’t stream music or let you take and make calls — because every last detail was optimized for one thing — better sleep, all night, every night.

“Bose Sleepbuds II use advancements in our proprietary noise masking technology because covering sound — not cancelling it — is a better solution for sleeping,” said Steve Romine, head of the Bose Health Division. “You can’t duplicate the experience combining earbuds with apps, playing your music louder, or using earplugs and bedside machines — so millions of people are still suffering. We never gave up on helping them, and that’s why we’re so excited about Sleepbuds II. They ‘quiet’ more of the low frequencies found in the biggest threats to a peaceful bedroom — like snoring partners, idling engines, and nearby footsteps. And with new relaxation tracks, they help quiet your mind, too.”

The User Tested Study

In a first-of-its-kind study, Bose partnered with the University of Colorado Anschutz Medical Campus and the UCHealth CARE Innovation Center to test the impact of Bose sleep technology — which was clinically proven to help people fall asleep faster. The research also found that 100% of participants confirmed Bose noise masking worked against the common disturbances that kept them up or woke them up; 86% said the product helped them fall asleep easier; 76% said it helped them stay asleep; and 80% reported an overall improvement in sleep quality.

New Library of Content — Quiets the Room, Quiets the Mind

For control and updates, the free Bose Sleep App lets you set an alarm, change volume, and now includes three categories of content — all precisely developed, engineered, and mixed to overcome what keeps you up or wakes you up. When that’s caused by noise, 14 noise-masking tracks mirror the frequencies of night-time disruptions, hiding them under soothing layers of audio. When it’s caused by how you feel, new relaxation options are now available: 15 Naturescapes help calm racing thoughts with walks down a Country Road, Shore Line, Boardwalk, and beyond; 10 Tranquilities help lower stress and tension with tones to Lift, Drift, Dream, and more.

Better — from Noise Masking to Bud, Bluetooth to Battery, Transducer to Tip

Bose Sleepbuds II feature advancements in noise management, acoustics, psychoacoustics, and electronic miniaturization. Each bud is a just a quarter-inch deep — about the same as a pencil’s eraser — to dramatically reduce irritating contact when your head is resting on a pillow, even on your side. A new anti-friction coating covers each enclosure to prevent “squeaking” against fabric, and a new etched antenna produces a more reliable phone and tablet connection using low-energy Bluetooth. Inside, a new NiMH (Nickel-metal Hydride) battery powers 10 hours of run time, and a new miniscule circuit board stores up to 10 files from the Sleep App’s library. Its noise-masking tracks are matched to a new transducer to “cover and replace” more unwanted sounds than ever before — while a new pressure equalization design and soft silicone tips “block” more from entering your ear. With three sizes included, the tips are different than those made for daytime use. Their materials, shape, and design are all optimized to stay in place for a full night of peaceful, pain-free rest.

New Charging Case, Equally Compatible, IPX4 Rated

Sleepbuds II come with an improved anodized aluminum case that stabilizes each bud while they’re stored and charged and provides up to 30 additional hours of battery life. For convenience, they’re equally compatible with iOS and Android devices. For durability, they’re sweat- and water- resistant with an IPX4 rating.

About Bose Corporation

Bose Corporation was founded in 1964 by Dr. Amar G. Bose, then a professor of electrical engineering at the Massachusetts Institute of Technology. Today, the company is driven by its founding principles, investing in long-term research to develop new technologies with real customer benefits. Bose innovations have spanned decades and industries, creating and transforming categories in audio and beyond. Bose products for the home, in the car, on the go and in public spaces have become iconic, changing the way people listen to music.

Bose Corporation is privately held. The company’s spirit of invention, passion for excellence, and commitment to extraordinary experiences can be found around the world — everywhere Bose does business.

Covid 19 causing hearing loss in some patients

Hearing LOSS symptoms Vary In COVID-19 Patients

Kevin Munro, PhD, a professor of audiology at the University of Manchester in the U.K., says that hearing loss and/or tinnitus tend to appear later in the course of a COVID-19 infection, or even after recovery. These symptoms can manifest in multiple variations and volumes, and more research needs to be done to pinpoint their exact prognosis. 

Munro, who also serves as the director of the Manchester Centre for Audiology and Deafness, is examining the link between COVID-19 and hearing loss in his own research.

“What surprises me the most is the number of people who are reporting problems with their hearing—I’ve been getting hundreds of emails from people telling me they’re experiencing hearing loss or tinnitus,” Munro says. “Still, I think we have to be careful and not say that COVID-19 is causing everyone to be deaf. We can say that more than one in 10 people are reporting that something has changed with their hearing, but we still don’t know everything about it.”

In his first study on the topic, Munro reviewed seven research projects studying hearing loss in COVID-19 patients. The patients all exhibited some form of hearing impairment: one patient had severe hearing loss in both ears, another mild hearing loss in one ear, and others experienced tinnitus that fluctuated between both ears. But there was no unifying root between them.

His second study examined 121 adult patients and found that 13% self-reported hearing deterioration or the development of tinnitus eight weeks after discharge.  

Munro says it’s too early to tell the extent of the damage COVID-19 will cause on the ears. Some of the patients contacting him have reported an increase in their symptoms, while others have noted improvement over time. 

What This Means For You

If COVID-19 has affected your hearing or triggered tinnitus, you’re not alone. Researchers don’t yet know if this condition is temporary or permanent, but they advise you to seek guidance from a medical professional as soon as possible. If the hearing loss is sudden, steroids may help reverse it in the first 24 hours.

SARS-CoV-2 Isn’t the First Virus to Cause Hearing Loss 

It isn’t rare for a virus to affect the auditory system. Even though MERS and SARS—two other coronaviruses from the same family as SARS-CoV-2—weren’t known to trigger hearing loss, other viruses can. 

Examples of these include:

  • Measles: Can cause an ear infection that leads to permanent hearing damage
  • MumpsTriggers severe swelling on one side of the face and usually inflicts hearing damage on the affected side
  • Human immunodeficiency virusCauses the body to attack its cells, sometimes leaving patients with hearing loss and tinnitus as a result 
  • Congenital cytomegalovirus infection: Can induce hearing loss in children

“We know that viruses can damage our hearing through different mechanisms that can cause permanent damage,” Munro says. “None of the other coronaviruses caused hearing problems, but none of the other coronaviruses cause the long-term health problems that we are now fighting with this particular one. That’s why people have been surprised when these young, healthy people who may have had mild symptoms are now reporting a hearing deterioration.”

How COVID-19 Could Affect the Ears

For Gaviria, her tinnitus most likely has a neurological root, as most of her post-COVID-19 symptoms—vertigo, concentration difficulties, and chronic brain fog—have neurological underpinnings. 

But scientists don’t yet know if these symptoms are purely neurological in origin or if they can also affect the auditory system in other ways.

Direct Auditory System Damage

Researchers at John Hopkins Hospital reviewed the autopsies of three patients who died of COVID-19 and found genetic traces of SARS-CoV-2 in the ears of two of them—showing that the virus can physically infiltrate the ears. 

However, according to Caitlin Barr, PhD, an audiologist and CEO of Soundfair Australia, it’s unlikely that the SARS-CoV-2 virus will enter your ear canal the way it would enter your mouth and nose.

“The organ of the ear that is responsible for taking in sounds is called the cochlea, and it’s made up of tiny auditory hair cells that can easily be damaged,” she tells Verywell. “The blood supply going to it is very small, so it’s very easy for a virus that’s in your bloodstream to go into your cochlea. Just a small amount can have a really big impact, and this is most commonly what causes the damage.” 

Nasal Inhalation

According to Munro, inhaling SARS-CoV-2 could trigger ear infection-like mechanisms that cause blockage in the ear.

Nerve Damage

Recent findings show that COVID-19 is sometimes associated with the development of Guillain–Barré Syndrome (GBS)—a rare condition that can lead to paralysis. Munro says that in this case, ears aren’t directly damaged, but the nerves that transmit sounds are. This type of damage is called peripheral neuropathy.

Cytokine Storm

Barr says that cytokine storm, a severe immune reaction released by the SARS-CoV-2 virus, can trigger inflammation throughout multiple organs in the body. If this inflammation occurs in any of the structures next to the ears, it could trigger a ringing sound. 

“The fact that these hearing symptoms have a later onset means it may take some time for the damage to build-up and be noticeable, and this could be because of a slow progression of inflammation to the brain, joints, or facial nerves,” Barr says. 

Medication May Contribute to Hearing Loss

According to Munro, COVID-19 is probably not the sole source of ear-related symptoms. Medications prescribed for the disease, like remdesivir, hydroxychloroquine, lopinavir, and ritonavir, are all ototoxic medications that cause damage to the cochlea.

“It’s possible that some of these patients were given high doses of drugs to help them with a life-threatening condition, and that it’s the drugs themselves that directly caused a hearing problem or tinnitus,” Munro says.

Munro is currently raising funds for a research study that looks at the longer-term impact of COVID-19 on adult hearing.

How to Cope With COVID-Induced Hearing loss and Tinnitus

Barr says she’s been inundated with calls since the start of the pandemic. She advises patients experiencing any form of hearing loss or tinnitus to initially consult with an audiologist for an evaluation. From there, the audiologist can perform a hearing test that measures ability to discern different pitches and frequencies. 

If the hearing loss is sudden, Barr says to seek medical attention immediately.

“[Steroids are] one of the medical interventions that could potentially reverse hearing damage,” she says. “But if it turns out to be permanent, there are therapeutic options available, such as hearing aids and cochlear implants.”

Tinnitus is more complicated. If it accompanies hearing loss, then treating the hearing loss will most likely treat the tinnitus, Barr says. However, if tinnitus happens on its own, then there is currently no medical remedy for it.

According to Barr, tinnitus can be triggered and aggravated by any form of stress. To combat mental stress, she recommends Cognitive Behavioral Therapy (CBT), which can reprogram the mind’s negative perception of the auditory symptoms and help people cope.

You can try CBT through apps such as Relax. This app also includes different sounds to buffer the tinnitus.

PEACEFUL sleep

Bose Presents Sleepbuds II

Better Noise Masking, New Relaxation Content, Now with Clinically Proven Technology

22 September 2020

Framingham, MA — Today, Bose announced Sleepbuds™ II, the next generation of its revolutionary bedtime wearable with technology now clinically proven to help people fall asleep faster. Sleepbuds II feature demonstrably better noise masking than their predecessor and introduce new categories of content to combat the other barrier to rest: the inability to relax. They combine a new acoustic and electronics design, a new enclosure that’s lighter than a dime, new proprietary ear tips for a secure, super-soft fit, and over 35 free tracks — all methodically produced and tested. The result is an engineering breakthrough: two tiny, ultra-comfortable, truly wireless buds that block, cover, and replace the audible distractions from loud partners, neighbors, dogs, and traffic — and reduce the mental distractions from long, busy days.