stars & disk

Bird & Flags

text

ABOUT HEARING LOSS

• Some hearing loss can be reversed

through surgery or medication. In other 

cases, hearing loss is permanent, but can 

be reduced through the use of hearing 

aids. Though almost all people with 

hearing loss could be helped by hearing 

aids, only about 1 in 5 who would benefit 

from them uses them, according to the 

National Institute on Deafness and Other 

Communication Disorders.

• Conductive hearing loss, which is due to

damage to the eardrum and middle ear 

structures, can often be reversed through 

surgery or medication. Sensorineural 

hearing loss, caused by damage to the 

inner ear and auditory nerve, is permanent, 

but can often be helped through the use 

of hearing aids.

• At the close of fiscal year 2015, more than

1 million Veterans were receiving disability 

compensation for hearing loss, and 1.45 

million received compensation for tinnitus. 

In addition, many Veterans score normally 

on hearing tests but have difficulty 

understanding speech. This condition, 

called auditory processing disorder, is 

often associated with blast exposure.

VA RESEARCH ON HEARING 

LOSS: OVERVIEW

• VA researchers, engineers, and clinicians

are studying ways to prevent, diagnose, 

and treat hearing loss. They are also addressing a wide range of technological, 

medical, rehabilitative, and social issues associated with tinnitus and blast exposure.

• In 1997, VA established the National

Center for Rehabilitative Auditory 

Research (NCRAR) to study hearing 

problems in Veterans, and to develop 

effective treatments. Researchers here 

work to alleviate communication, social, 

and economic problems resulting from 

hearing loss and tinnitus. Among the 

topics studied at the center are methods 

of early detection of hearing loss; the 

effects of certain diseases or conditions, 

such as diabetes and multiple sclerosis, on 

auditory functioning; and the impact of 

auditory problems on speech perception.

• NCRAR researchers and their colleagues

throughout VA system also looking at ways 

to improve speech recognition in noisy 

areas for people with hearing impairments, 

and studying the combined effects of 

aging and noise exposure on hearing.

SELECTED MILESTONES AND 

MA JOR EVENTS 

1992 – Began, with the National Institutes 

of Health (NIH), an innovative collaboration

to support the development of advanced 

hearing aids

1996 – Initiated, with NIH, the Hearing Aid 

Clinical Trial to demonstrate the efficacy of 

three types of analog hearing aids in both 

quiet and noisy environments

1997 – Established the National Center for 

Rehabilitative Auditory Research (NCRAR) 

in Portland, Oregon

2000 – Demonstrated, with NIH, that three 

types of analog hearing aids provided 

substantial improvements for users both in 

quiet and noisy environments.

2005 – Published a comprehensive 

protocol for the management of tinnitus, 

now referred to as Progressive Tinnitus 

Management (PTM)

2014 – Linked exposure to jet propulsion 

fuel to auditory processing problems

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• Tinnitus is common in Veterans, but

there are no objective tests to diagnose 

the problem. NCRAR researchers and 

researchers from Oregon Health and Science University conducted three phases of 

testing to try to distinguish Veterans with 

tinnitus from those who do not have it. 

They found some differences between the 

groups, but also that no single test or series 

of tests could reliably diagnose the condition. (Journal of Rehabilitation Research & 

Development, Vol. 50, No. 4, 2013)

VA research on 

HEARING LOSS

Hearing loss affects more than 28 million Americans, including 

more than half of those over age 75. Hearing problems—

including tinnitus—are by far the most prevalent serviceconnected disability among American Veterans.

(Continued on back)

Photo: ©iStock/mumininam
stars & disk

Bird & Flags

text

Though almost all people with hearing loss could 

be helped by hearing aids, only about 20 percent 

of those would benefit from them use them.

• Exposure to jet propulsion fuel-8 

(JP-8) is linked with auditory 

processing dysfunctions—changes 

that occur inside the brain rather 

than the ear. In auditory processing 

dysfunction, people hear sounds 

properly, but the brain has a hard 

time deciphering the message. A 

research team from the VA Loma Linda 

Healthcare System in California believes 

that hydrocarbon chemicals in JP-8 may 

be the reason this occurs, and advocates 

for increased monitoring of the 

combined exposure of fuel and noise 

around aircraft. (Journal of Toxicology 

and Environmental Health Part A, 2014)

• Veterans with tinnitus frequently 

have anxiety, depression, or both, 

according to researchers with VA and 

Loma Linda University Medical School. 

The team found that 71.9 percent of the 

91 Veterans with tinnitus they studied 

also had a diagnosis of anxiety, 59.3 percent had depression, and 58.2 percent 

had both conditions. Patients with either 

or both conditions suffered from more 

severe tinnitus symptoms than patients 

without either condition. (International 

Journal of Otolaryngology, 2015)

• Frequency modulation (FM) may 

help Veterans who have normal 

hearing but problems understanding 

speech due to mild traumatic brain 

injury. NCRAR and Tampa VA researchers 

tested an FM system, which uses radio 

waves to transmit signals directly 

from a microphone to an earpiece to 

make a speaker’s voice more clear. 

They also tested a “brain training” 

computer program that has users 

follow instructions or interpret sound. 

Preliminary results showed improved 

outcomes among those using the 

system. (Journal of Rehabilitation Research 

& Development, Vol. 52, No. 4, 2015)

• Blast injuries can and do result 

in damage to the central auditory 

system, but there is no common set 

of symptoms relating to problems 

with auditory processing experienced 

by Veterans exposed to blasts. 

NCRAR asked 99 Veterans exposed to 

blasts in Iraq and Afghanistan who 

reported problems hearing in difficult 

listening situations to participate in 

10 performance-based tests that have 

been shown to uncover problems 

people may have in processing hearing 

signals. They found many of the 

participants had difficulty in one or 

more of the tests compared to nonblast exposed Veterans, but that they 

also performed well in other tests. 

(Journal of Rehabilitation Research and 

Development, Vol 52, No, 3, 2015)

• VA researchers are studying 

the effects of a treatment called 

transcranial magnetic stimulation 

(TMS) on tinnitus. In TMS, clinicians 

hold a magnetic coil, usually in the form 

of a figure eight, against the skull. The 

coil emits repetitive electromagnetic 

pulses that reach the brain cells under 

the scalp and change their activity 

pattern. In a recent NCRAR study, 32 

Veterans received TMS treatments for 

10 working days; another 32 received 

a placebo treatment. 56 percent of 

those who received the TMS treatment 

saw their tinnitus symptoms improve, 

compared to 22 percent of those who 

received a placebo treatment. (JAMA 

Otolaryngology-Head and Neck Surgery,

Aug. 14, 2015)

• A device called OtolD allows 

patients to easily and reliably test 

their own hearing loss. Designed by 

NCRAR researchers to help patients 

using chemotherapy drugs, OtolD 

runs on tablet computers and allows 

hearing test results to be transmitted 

to VA clinics. If hearing loss is detected, 

doctors will be able to adjust the dose 

of the drug the patient is taking, or 

perhaps use a different one. (Journal 

of the American Academy of Audiology,

October 2015)

For more information on VA studies 

on hearing loss and other key topics 

relating to Veterans’ health, please 

visit www.research.va.gov/topics

HEARING LOSS

Updated September 2016 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics