A Guide to Cleaning Your Hearing Aids

Did you know?

If you purchased your hearing aids from San Francisco Hearing Center, there is no additional charge to get your hearing aids cleaned by a member of our team. To schedule an appointment call 415-346-6886 or book online.

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The first real-world analysis of 220 American tinnitus patients treated with FDA Approved Lenire at Alaska Hearing and Tinnitus is now available. Real world results were consistent with three large-scale clinical trials for Lenire. The clinical trials used by the FDA to determine the clinical effective of Lenire.

• 91.5% of patients had clinically meaningful tinnitus reduction after 12-weeks of Lenire.
• 78% had clinically meaningful reduction in tinnitus after 6-weeks of Lenire.
• 89.2% of patients said they benefited from treatment with Lenire.

Lenire is available at San Francisco Hearing Center located in San Francisco, California. Patients who wish to be assessed for Lenire can book an appointment by calling 415-346-6886, emailing info@sfhearingcenter.com or booking an appointment online here.

In this study conducted from May 2023 – March 2024, 220 people with moderate or worse tinnitus participated in the study. Of those 159 were male and 61 were female. The average participant age was 60 and together they had a mean length of tinnitus of 8.5 years! Many of those who participated felt they benefited from Lenire and experienced a lasting and meaningful reduction in their tinnitus.

Watch Inspiring Lenire Patient Stories

 Watch real world patients share their stories about getting relief from tinnitus using Lenire in their own words.

Visit Lenire’s Patient Stories page to hear how Lenire helped a pilot overcome tinnitus turbulence and stay airborne, a business leader get relief after 20-years, and many more inspiring stories.

[Watch Patient Stories]

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Lenire is an evidence-based treatment device proven to soothe tinnitus. Use it from the comfort of home to manage your tinnitus with the help of qualified audiologists.

How does Lenire work?

The device plays sounds from headphones and provides gentle pulses to the tongue via a Tonguetip. The sounds and pulses work together to retrain your brain. You pay less attention to your tinnitus reducing its impact on your day-to-day life.

What is the Lenire device?

Bluetooth headphones, which are provided, deliver customized sounds to activate the auditory nerve to the brain.

Tonguetip: The Tonguetip, specifically designed to treat tinnitus, sits comfortably in the closed mouth.
Tiny electrodes on the Tonguetip deliver mild and safe energy pulses to the surface of the tip of the tongue.

Controller: A lightweight handheld device that controls the timing and intensity of the treatment. You can start, pause and resume the treatment session, adjust the volume of the sound, and adjust the level of the tongue stimulation.

The settings are customized by your healthcare professional to suit your tinnitus after an assessment to make sure you’re suitable.

What is the research behind Lenire?

Lenire is the first device of its kind to receive a grant of approval from the FDA to treat tinnitus. This follows a large-scale clinical trial designed to meet the FDA’s requirements during which 83% of patients recommended Lenire for the treatment of tinnitus. The largescale trial’s results were consistent with real-world evidence from 204 patients*.

How can I get started?

We’re a trained provider of treatment of tinnitus with Lenire. Get in touch today by calling 415-346-6886 to book an initial assessment for Lenire. During this appointment the audiologist will conduct a thorough tinnitus and audiologic assessment and design a treatment plan that works for you.

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Hearing involves hearing two different pathways. The first is peripheral hearing which includes the cochlea, the brainstem, and the auditory nerve.  This portion of our hearing is measured in a hearing test which involves the detection of very soft sounds. The other system is our central hearing, also called auditory processing or how our brain puts together sound for the many complex skills needed for hearing such as hearing in noise.  Damage to our peripheral hearing affects the clarity and integrity of sound. With a hearing loss when sound reaches the higher areas of the brain for processing the brain has to undergo some reorganization, and will pull from areas which in turn will change the structure of the central systems needed for cognition and hearing.  These systems include working memory, recall, ability to focus on sound in noise, and the speed at which we process sound.   

Why is hearing loss the most modifiable risk factor in preventing cognitive decline?

Both auditory processes are needed but the question is does weakness in one area, contribute more to cognitive decline?  And how do we detect at an earlier stage if there is a weakness or problem in one of these areas?  Currently, most diagnosis of hearing loss occurs at age 65 and over. The average loss that is identified at this age is a moderate hearing loss.  Evidence indicates that structural changes occur when even a very mild hearing loss is detected. This means that at age 65 structural changes have occurred at least 5 years prior to the identification of hearing loss. Cognitive changes from hearing loss are most likely then present.  Most physicians do not screen for cognitive difficulties until the patient is eligible for medicare.  

Two things are needed in order to lead vibrant, cognitively sharp, healthy lives.

• The first is to identify hearing loss sooner. 
• The second is to determine if hearing loss is causing weaknesses in memory and other cognitive processes. 

Until now we did not have a screening test that was clinically proven, and practical for use in audiology clinics.  Cognivue is the solution. Cognivue was developed to detect the presence of auditory cognitive dysfunction.  The developers have one goal in mind to detect any neurocognitive weakness sooner than is currently being done. 

San Francisco Hearing is taking the lead in the San Francisco Bay area to identify hearing loss sooner in order to improve the lives of individuals, their health, wellbeing, cost, family, and society.  Join us in our efforts to bring you the very best in care by participating in the cognivue screening the next time you visit our offices. 

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Why are my ears plugged? For starters, spring is here which means warm weather, blooming botanicals, longer days, and allergies!  Allergies often induce an inflammatory reaction in the middle ear which will cause a plugged sensation.  Secondly, the plugged ear sensation is often noticed after an upper respiratory infection. Other instances include after air travel, diving, or exposure to loud noise will cause a temporary feeling of a “plugged ear”.  

Audiologists are doctors of Audiology who perform diagnostic tests. Our hearing system is made up of four different areas, the outer ear, the middle ear, the inner ear, and the balance organ. Audiologists perform more than hearing tests. They perform numerous diagnostic tests. Each test will give the audiologist data on the four specific areas of the auditory system. The audiologist will use this information to recommend treatment or to refer to a specialist such as an otolaryngologist. The reports from the testing that is performed by the audiologist are extremely valuable to the specialist.  

The role of the eustachian tube in normal middle ear function.

Sometimes eustachian tube dysfunction is the culprit. The eustachian tube connects the middle ear to the throat behind the nose. The purpose of these tubes is to equalize the air pressure and to drain fluid in the middle ear space.  Plugged ears may be a sign of the eustachian tube not functioning normally. Allergic rhinitis, chronic sinusitis, acid reflux, and smoking. In older adults, an extremely small muscle called the tensor veli palatini may atrophy causing eustachian tube dysfunction. 

Those who suffer from migraines may experience plugged ears. The plugged ear may exist with or without a headache. A very rare cause of plugged ears is a leak of the CSF cerebrospinal fluid. This is caused by the erosion of a thin bone that separates the brain from the middle ear. 

When the sensation persists beyond a few days it may be time to see an audiologist. There is a greater sense of urgency to be evaluated by an audiologist if you are also experiencing the following; pain in either or both ears, tinnitus, or ringing in the ears, dizziness, sensitivity to loud or sudden sounds, or a change in hearing. 

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Autoimmune diseases that cause hearing loss may be due to a dysfunction of the inner ear, the vestibulocochlear nerve, or the central processing areas of the brain. Known autoimmune conditions that may involve hearing loss are: 

• Vogt Koyanagi Harada syndrome, Cogan’s syndrome, Susac’s syndrome, SLE, Antiphospholipid syndrome, RA, Systemic vasculitis, Panarteritis nodosa, Granulomatosis with polyangiitis, SSc, Goodpasture syndrome, Behcet’s disease, Sarcoidosis, SS, Hashimoto thyroiditis, Relapsing polychondritis, Myasthenia gravis, Polymyositis Dermatomyositis, Crohn’s disease, Ulcerative colitis, AS, GuillainBarre´ syndrome, Multiple sclerosis, ( Adapted from Acta Otolaryngol 2006;126:101221)

Autoimmune Inner Ear Disease (AIED) is the most common autoimmune disease that causes hearing loss. In this rare condition, the body’s immune system mistakenly attacks the inner ear.

Seek help from an audiologist immediately if you notice any of the following symptoms as they may be signs of these rare disorders.

• A feeling of pressure, or fullness in either or both ears
• dizziness or vertigo
• tinnitus, also called ringing in the ears
• a change in your perception of sound. This change in perception is often described as speech sounding less clear, muddled, or not as distinct.    

Autoimmune inner ear disease is difficult to diagnose because there are many other types of hearing loss with these same or similar symptoms. It will often start with hearing loss in one ear and then spreads to the other.

Autoimmune disease-causing sensorineural hearing loss is rare, estimated to be at 1% of all hearing loss. It is a loss of hearing sensitivity that occurs over several days to several months. In 50% of all cases, it is accompanied by the sensation of fullness in one or both ears, tinnitus, and feelings of unsteadiness or dizziness. These symptoms may be the first signs of this condition. 

Treatment

A hearing loss caused by an autoimmune condition is one of the rare forms of hearing loss that can be treated. Steroids are a common treatment. Another is medications to calm down your immune system. If you end up with a permanent hearing impairment, hearing aids can help improve your hearing.

Diagnosis

If you are experiencing any of these symptoms or have been diagnosed with one of the conditions above it is important to be seen by an audiologist.  The audiologist will perform a diagnostic battery of tests such as an audiometric evaluation, testing of the reflexes in your middle ear, and otoacoustic emission testing.  The audiologist will make the appropriate referral to ensure that you receive the treatment that you need and will monitor your progress.  

Need to see an audiologist. Please call our office at 415-346-6886 to schedule an appointment or use our online appointment scheduling option to make an appointment.

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People who hear ringing in their ears often wonder how long will tinnitus last and will it eventually go away. These are great questions. Let’s discover more about this bothersome issue.

What is tinnitus?

Tinnitus is any perception of sound without an external stimulus. It is from Latin, “tinnire” to ring. It may sound like:

• • Ringing
  • Buzzing
  • Static
  • Roaring
  • Hissing
  • Electricity
  • Crickets
  • Pulsating
  • Whooshing
  • Musical or speech-like (rare)
  • Different from hallucinations which involve meaningful speech

Types of Tinnitus:

• Objective (Rare): Potentially measurable and heard by an observer.
• Subjective (Common): Only perceptible to the individual.
  • Primarily due to abnormal neural activity either in the brain or the nerves of the auditory system.
  • Ear Noise (Very Common) – Subjective tinnitus that comes and goes.

Did you know? In 1953, Heller and Bergman showed that 97% of normal hearing adults perceived phantom auditory signals when placed in silence for 5 minutes.

Who Has It?

The first written history of ringing or noises in the ear is from Ancient Egypt in the 16^th Treatment involved herbs and oils poured into the ears. Well known people throughout history with tinnitus include Joan of Arc, Michelangelo, Leonardo da Vince, Ludwig van Beethoven, Vincent Van Gogh, and Charles Darwin. Current celebrities with tinnitus include almost every professional rock musician. Others include William Shatner, Keanu Reeves, Sylvester Stallone, Steve Martin, etc.

What Causes It?

Tinnitus is not a disease. It may occur as a symptom of specific diseases or conditions. It is a common symptom of hearing loss. Other common causes are obstructions in the middle ear, Treating the cause is an effective option to managing tinnitus.

Is there a cure?

• Unfortunately, there is no magic pill that can cure tinnitus.

What about gingko?

• Please check with your Primary Care Physician before using. Gingko is a blood thinner.
• Some patients find that gingko helps with their tinnitus.

Tinnitus checklist:

• An appointment with your Primary Care Physician who may refer you to see an Ear, Nose, and Throat doctor (Otolaryngologist or ENT) or an Audiologist.
• See an Audiologist for a comprehensive hearing evaluation (audiological evaluation).

An audiological evaluation by an Audiologist will tell us a great amount of information about your auditory pathway.

• You may have hearing loss.
  • 80% of tinnitus patients have hearing loss.
  • 80% of hearing loss patients have tinnitus.
  • Are you a hearing aid candidate? If you are a hearing aid candidate, treating your hearing loss may be the best solution to decreasing your tinnitus.
  • Treating the hearing loss with hearing aids can alleviate the perception of tinnitus.

Will Tinnitus Go Away?

If your tinnitus is non-bothersome and intermittent, then you are successfully managing your tinnitus. Tinnitus that does not elicit a negative emotional response is easy to habituate to. Most people can habituate! Emotional symptoms sometimes accompany tinnitus. It is the emotional reactions to tinnitus that cause the tinnitus to be problematic.

The three primary areas affected by tinnitus are concentration, sleeping, and hearing. Anxiety and depression are also experienced with tinnitus.

• Normal hearing with tinnitus
  • Sound therapy: people do better with sound. You can use sounds that you already have, including a fan, noise machine, or an app on your phone (Resound Relief, for example). An enriching sound environment reduces tinnitus.
  • Avoid noisy hazardous environments or wear hearing protection when in these environments, including concerts, bars, clubs, using machinery, shooting guns, etc.

Need help with your tinnitus? Call us at 415-346-6886 to request a hearing evaluation and tinnitus consultation.

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Are your ears plugged with wax? Do you need earwax removal, but are concerned that it may hurt?

 

The removal of earwax has the potential to cause discomfort or pain.  The pain, discomfort, and safety of removal depend upon the method that is used to remove the wax.  For most, earwax removal is similar to getting your teeth cleaned. You know it’s happening but it doesn’t hurt. 

There are many options for the removal of earwax.  Some options are not as effective or safe as others.  The doctors of audiology at San Francisco Hearing Center have advanced training in the removal of cerumen. The method that they use involves using a high-powered lighted curette, a loop, or a microscope.  Your audiologist will use these specialized tools to remove the cerumen without pain.  This method is also the safest and most effective in removing wax only by a trained professional.  If further attention is needed by an Ear Nose and Throat physician our office will refer you to one of our trusted ENT partners. If the physician can’t remove it with a curette, they may use gentle suction for earwax removal that generally does not hurt. 

Ear wax or cerumen is produced by three different glands in the ear canal. Cerumen has a protective feature.  It is only the overproduction of overaccumulation that may cause problems such as hearing loss, tinnitus or ringing in the ears, and dizziness.  Ear wax is able to cause hearing loss if it is occluding the ear canal.  The doctors of Audiology at San Francisco hearing are able to determine with a specific exam if you have an overaccumulation of earwax. This exam is always done prior to a diagnostic hearing evaluation.   The wax has to be removed to obtain an accurate hearing evaluation.   

 Does earwax removal hurt? Attempting to remove the cerumen yourself, is not recommended, and may hurt. Cotton tip applicators or Q-tips should never be used inside the ear. The cotton tip applicator may push the wax deeper into the ear canal. This impaction of cerumen may cause a temporary hearing loss and may cause pain.  Your audiologist may recommend a wax softening agent, such as a carbamide peroxide otic if the wax has become impacted or hardened. This lessens significantly any pain that may be associated with the removal of the wax. If this agent is recommended, your audiologist will give very specific instructions.  Our ear canals are lined with thin delicate skin and these agents may cause irritation to the canal.  Regular cerumen removal is a service that San Francisco hearing offers to our patients. Many patients include cerumen removal as part of a regular maintenance program for optimal hearing. 

We only remove earwax when it is necessary to perform a hearing evaluation or fit you with a hearing aid. If routine earwax removal is needed we recommend you see a physician for removal.

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Legislation was passed allowing hearing aids to be sold without seeing an audiologist or hearing care professional. more accessible with the intention of making hearing aids / amplification help for hearing more accessible. The intention was to make hearing aids accessible., While the intent was good,

There is a very important risk factor to delaying getting hearing aids from an audiologist. It has the ability to cause more harm than good.  This seldom talked about risk factor is auditory deprivation. Auditory deprivation may arise after hearing loss occurs because of a lack of auditory information.  This deprivation causes changes in the brain, which could be permanent. The changes in the brain that occur from auditory deprivation were first reported in 1984.  Auditory deprivation is not talked about.  It is common for us to see individuals who seek help from hearing aids when they have a moderate hearing loss. This means that the hearing loss has already gone untreated for many years.

When a hearing aid is fit to an individual, the amount of sound that is provided is specific to the configuration of the hearing loss, both for the amount of sound and the specific frequencies that are amplified. The amount of sound that the device supplies is also dependent upon many variables in the algorithm of the hearing aid and the size, shape and specific characteristics of an individual’s ear canal.  Most device manufacturers of hearing devices design the sound to be acceptable to the average person. Providing individualized very specific amount of sound is therefore not the primary goal.  This customized sound delivered via your ear canal to your brain that allows you to hear the spectrum of speech sounds is called audibility. The only way to ensure that your devices are providing the very specific amount of audibility needed is to use real ear probe microphone measurements when fitting a hearing device. This can only be done in person by a doctor of audiology.

When these measurements are not done that ensure proper fitting of a device, auditory deprivation may occur.  Auditory deprivation also may occur when devices are not worn consistently.  Auditory deprivation results in a loss of clarity of speech. The brain is unable to use the information provided by the device because it isn’t reaching the threshold of activation. Therefore, the protective benefits of a hearing device to stave off cognitive decline is not realized!  It is not enough just to wear a hearing aid. It must be properly fit.

Why seeing an audiologist for your hearing health is one of the best investments you can make.

The benefit of a properly fit hearing aid was validated by a study by Glick and Sharma, which concluded that well- fit hearing devices (defined by the use of real ear probe microphone measurements fit in person by an audiologist) may promote cortical organization that provides cognitive benefit.1

A properly fit hearing device, that is comfortable, has excellent sound quality and allows access to an audiologist for the cleaning, maintenance, hearing evaluations, programming of the device will change your brain and will improve the quality of your life. The long-term costs of untreated hearing loss affect the individual, the entire family and may lead to much more serious consequences than the expense of a well fit hearing device. This is not a place to short change yourself or those you love and communicate with. Take the first step in investing in your health and your cognition by seeing one of our audiologists at San Francisco Hearing Center

See one of our Doctors of Audiology today.

1 Front Neurosci. 2020; 14: 93. Cortical Neuroplasticity and Cognitive Function in Early-Stage, Mild-Moderate Hearing Loss: Evidence of Neurocognitive Benefit From Hearing Aid Use. Hannah Anneli Glick and Anu Sharma.

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