« Back to Articles December 29, 2009

Hearing Loss No. 1 Diagnosis for U.S. Soldiers in Afghanistan

By: SPC. OPAL HOOD, 5TH MOBILE PUBLIC AFFAIRS DETACHMENT
A U.S. Army soldier with 1st Battalion, 32nd Infantry Regiment, 10th Mountain Division, fires at insurgents attacking from the hills surrounding the remote village of Barge Matal during Operation Mou
U.S. Army Spcs. Patrick Wilson (left) and Evaristo Garcia fire a 120 mm high-explosive mortar round during a coordinated illumination exercise at Forward Operating Base Mizan, Afghanistan, on Sept. 2
Air Force Col. Joseph Brennan (l.), the ear, nose and throat doctorat the U.S.-run Staff Sgt. Heath N. Craig Joint Theater Hospital demonstrates how the portable hearing test machine works

Stephen Franklin, retired Air Force navigator turned rocket scientist, provided engineering oversight for the rocket that launched the Lunar Crater Observation and Sensing Satellite, or LCROSS, which

When gearing up for a mission in Afghanistan, a service member wouldn't dream of forgetting their helmet, gloves, weapon, eye protection or body armor. But what about hearing protection?

According to Air Force Staff Sgt. Lee Adams, an ear, nose and throat (ENT) technician at Bagram Air Field, more than 50 percent of the patients seen in the ENT walk-in clinics are there for hearing-related issues.

The first question I ask a patient who comes in with a hearing complaint is, 'Were you wearing hearing protection?' says Air Force Col. Joseph A. Brennan, the ENT doctor at Bagram. Since I arrived here in May, I have not had one service member answer yes to that question.

Deployed service members are exposed to many dangers while in combat zones. According to Brennan, many troops do not use hearing protection while out on missions because they feel that the hearing protection negatively affects their ability to do their job and complete their missions.

I was in Iraq in 2004 and 2005 in Fallujah, with the Marines and the Army's 1st Infantry Division and we just couldn't get folks to wear their hearing protection, said Brennan. We understand. It's like the old Army helmets: soldiers were complaining they couldn't shoot with them. So even though they offered better protection, which as a doctor is what I care about, the fight is most important.

While in Iraq, Brennan saw more than 600 outpatients in an ENT clinic, and hearing loss was the No. 1 diagnosis there, just as it is today in Afghanistan.

When service members are exposed to loud noises such as improvised explosive devices (IEDs) the primary cause of hearing loss in both Iraq and Afghanistan they are at risk of either conductive or sensorineural hearing loss and tinnitus.

Conductive hearing loss can usually be fi xed surgically, with the causes ranging from damaged ear bones to wax in the external canal of the ear. In sensorineural hearing loss, the nerve in the inner ear has been damaged. There is no way to surgically fix this and the only treatment is hearing aids.

Tinnitus is another form of hearing damage. It is a ringing or whining inside a person's ear that can result from damage to the nerve.

There are two forms of tinnitus: objective and subjective. If a person has objective tinnitus, the sound inside the ear can be measured with a device used by ENTs. With subjective tinnitus, only the person with tinnitus can hear the sound - it is not measurable in any way.
There is no cure for tinnitus. Tinnitus can be masked, however. A tiny device, a type of hearing aid, replaces noise caused by tinnitus with a less annoying, more natural sound inside the ear, according to Brennan.

Another common problem is blown-out eardrums, which can heal on their own. A hole in an eardrum is considered a form of conductive hearing loss. This means that sound is not reaching the nerve in the inner ear that transmits sound to the brain.

In Iraq in 2004, there was a soldier who was in two IED blasts. The second explosion really blew out his eardrums and he could not hear a thing, said Brennan. The soldier's sergeant and his fellow soldiers were on a rooftop in a firefight. The bullets were buzzing by his head. His sergeant had to tackle him to get him out of the line of fire, because the soldier couldn't hear his comrades yelling for him to take cover.

According to Brennan, this story demonstrates why hearing protection is so important to soldiers. A hearing-impaired soldier not only puts himself in danger, but also his fellow soldiers.

Even if a person suffers hearing loss in only one ear, they can still be a danger, says Brennan. Their hearing directionality is impaired, and they will not be able to tell which direction a sound like a whizzing bullet is coming from.

Since hearing damage affects the safety of military personnel and others around them, soldiers with hearing loss can be discharged from the military or forced to re-classify into a different job specialty, where they won't be exposed to loud noises that could further damage their hearing.

Active-duty personnel who have combat-related hearing loss receive hearing aids, and after they leave the military, the Veteran's Administration provides the service member hearing aids as needed, Brennan said.

With IEDs being the number-one problem for Coalition forces in Afghanistan, it is no surprise that IEDs are the No. 1 reason for hearing loss among service members. Service members need to protect themselves from this very real problem and new technology is always being developed to help in the fight against hearing loss.

The best kind of earplug, which the military is actually working on at the Air Force research lab on Wright-Patterson Air Force base in Ohio, uses what is called active hearing protection, Brennan said. A person would wear this device on the inside or outside of their ear. For instance, if you were walking through the woods, this earplug would amplify the sounds around you, but the moment the noise reached a harmful level, the earplug would protect your ear and eliminate the sound, essentially plugging your ears.

This new form of earplug is ideal because it increases a person's awareness, but also protects the service member's ears. Normal earplugs employ what's called passive hearing protection. They have the same effect as plugging your ears with your fingers, according to Brennan.

Hearing protection is just as important to a U.S. military service member's safety as their body armor and helmet. A soldier who suffers severe hearing loss could find his career ending as quickly as if he had suffered other combat-related injuries. Military personnel should listen to their leadership about wearing proper hearing protection while they can still hear the warnings.

It's Not Rocket Science
Smart Veterans Seek Better Hearing
BY Michael Ream

Even as the military hopes to develop more effective hearing protection, the noise of war in particular, blasts from improvised explosive devices (IEDs) can still easily shatter eardrums and cause hearing problems.

Many veterans who were fortunate enough never to be in the line of fire are nonetheless finding, years after their service is over, that healthy hearing was part of their sacrifice for our country. One such veteran is Stephen Franklin, 59, who served on active duty for 20 years after graduating from the Air Force Academy in 1972.

Franklin currently works as an engineer at United Launch Alliance, a Colorado-based company that helps launch spacecraft. He is part of an eight-person team that puts together test launches and addresses every potential problem with an upcoming launch. Franklin is also representative of many veterans because, with intervention such as wearing hearing aids and using assistive listening devices, he has been able to improve his hearing, enabling him to function better in his job, enjoy time with his family and have better quality of life.

Franklin recently spoke to Hearing Health about dealing with his hearing problems:

It was a gradual thing. When I was in the Air Force, I was around loud planes, loud cars and even louder music. Typical young man stuff. I think all that together just wore my hearing down. There was no specific incident that caused my hearing loss.

I flew for 10 years in a KC-135. It's an aerial refueling aircraft. I traveled a great deal and had a lot of fun! We always had headsets and we also wore those little foam earplugs. But that jet was very loud. I don't know the numbers but I know it was one of the louder jets, based on the fact that it was pretty much hollow inside except for the fuel tanks. So it was a loud plane.

When I was in my 30s, about the time my career was finishing up, passing the flight physicals was a bit more of a challenge. I had to really struggle to make sure I could pass the hearing test.

In a conference-type setting, when I was in a large room and someone would be speaking from across the room, sometimes I didn't hear every word that was said and I'd have to have them repeat it or speak up, or embarrass myself by responding to what I thought I heard. Not a good thing to do!

Franklin noticed hearing problems at home as well.

The first thing I noticed was, sleeping on my right side versus my left side, the ambient noise in the room was different. I noticed that when I slept with my right ear down, it was quieter. That became more pronounced as I got into my 40s. By that time, I was wrapping up my Air Force career, and I was no longer flying; I was doing command and- control-type work.

I think it was just a progressive change as I got into my 40s; the higher range of hearing was noticeably missing. I was turning the television up and I noticed I had to focus on people's faces a lot more when they were talking.

After suffering from hearing difficulties for several years, Franklin consulted an audiologist. He was diagnosed with high-frequency hearing loss in both ears.

In 2002, I think, when I was living in California, I saw an audiologist, knowing that I did have a problem, but just to verify how bad it was. I was surprised that both ears were impacted. Since I didn't have any information to go on, I thought it was just one-sided.

When I saw the results of the hearing test, I tried different types of hearing aids and I did not like the in-the canal type because of the sensation it gave me. So we settled on a pair with behind-the-ear design. They were much more comfortable to wear and maintain. Those were Phonak hearing aids.

Franklin stopped wearing hearing aids in 2006.

I really wasn't happy with the performance, so I was wearing them less and less and then I stopped wearing them altogether. Looking back, it was just correcting a narrow band of hearing so that the full spectrum wasn't being treated and I found that bothersome.

My hearing problems were a little bit worse, but I just dealt with it which was selfish thinking. Conversations at home with my wife and television volume had to be much louder than were comfortable for her, because it was hard for me to hear. I would sit about twice as close to the television as she did. These are the things I had to do to cope.

Franklin switched to his current hearing aids in early 2009.

I use Siemens Pure 700 now it's also behind-the-ear. My new hearing aids are much easier to personalize shaping the spectrum of sound that's augmented by the hearing aids to a much greater degree than my previous hearing aids. The range of coverage is different. Rather than just treating the middle range, which is where the majority of sound comes through, the upper and lower ends (of the range) are addressed as well.

It's much better at work, too. I was in a conference room for a large meeting and I was sitting at a table in the center of the room. People were behind me talking and I couldn't hear them very well, because we were set up for music and surround-sound, so I had my hearing aids set to that. Suddenly, a person who was far behind me spoke. I could hear clearly; I didn't have to turn around and focus on them. I thought that was pretty neat!

Michael Ream is a freelance journalist.

Reduced Cost ALDs for Vets

Williams Sound, a global manufacturer of wireless listening technology, has teamed with the Military Audiology Association to offer the Retiree Assistive Listening Device (RALD™) program to retired and active-duty military service members and their families. The RALD program was created to provide these veterans and service men and women access to assistive listening devices (ALDs) at a reduced cost, along with free personalized telephone support.

ALDs are devices to help individuals with hearing difficulties hear more clearly in a wide array of social situations, whether those needs are specific to listening on the phone, to a television, in a group setting or during one-on-one conversations. An ALD is designed to pick up sounds from the sound source and bring it directly to the listener's ear, without the distraction of background noise.

For more information visit www.williamssound.com/rald and www.militaryaudiology.org.