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Over-The-Counter Hearing Aids; What Does This Mean for Audiology?

As technology and medical research continue to advance, more facets of your healthcare are becoming increasingly over the counter, whether that be medication, devices, or just medical advice. Treatment for hearing loss is no exception, with over the counter hearing aids becoming an imminent reality, invoking worry in many audiologists across the country. As hearing aids become more accessible over the counter, audiologists fear the impact on their profession and practice. This disruptive innovation is poised to achieve a new market foothold, becoming a more attractive option to new consumers who are looking for the most convenient and simple transition into hearing aids, taking business from traditional hearing aid manufacturers and audiologists who often bundle devices into their services. Though they seem convenient, the introduction of OTC hearing aids shows that despite intentions to increase accessibility and reduce costs, patients are not receiving the treatment they desperately need in exchange for ease.

Don’t Bypass Your Doctors Appointment Just Yet

According to the OTC Hearing Aid Act, the intention was to increase accessibility and affordability of devices, though OTC hearing aids have done little to achieve those goals. In fact, they hinder the ability of patients to get the information and proper assessments that they should have before finding the most effective hearing aid. OTC Hearing Aids utilize a business model designed to bypass diagnostic evaluations, hearing needs assessments, and audiologists all together in favor of self-identifying a device. Not only does this keep patients out of their doctor’s office, but also from receiving the medical advice they may need, ignoring the advocation by organizations such as the American Academy of Audiology for required medical evaluations for OTC hearing aids. Moreover, “receiving an OTC device is expected to be based on self-perceived mild to moderate hearing loss, not measured hearing capability that directly aligns with the definition provided by ASHA.”
 
As hearing loss can differ greatly from patient to patient, it’s critical that patients do not bypass professional medical advice. Herein lies the fear of audiologists, as numerous unofficial polls conducted via social media and trade publications have documented the anxiety had by medical professionals as OTC devices are positioned to impact not only their practice but their profession as a whole.

Changing Public Perception

To combat this imminent and disruptive technology, Audiologists must aim to change public perception about the importance of their profession and medical advice regarding hearing loss. ”The efforts of the profession should be focused not on a device, but rather on educating the public such that they recognize audiologists’ value and demand access to it.” says Dr. Sarah Sydlowski, Audiology Director of the Otolaryngology department at Cleveland Clinic, ”Take every opportunity to reinforce the value audiologists provide. Emphasize the importance of a hearing evaluation before deciding to use any hearing device. Help the public understand that an inappropriate hearing device can be as detrimental as no hearing device.” With proper advocation, audiologists can continue to give the critical information required for patients with hearing loss, ensuring that patients do not give up their doctors for convenience.

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Treating Hearing Loss With Inner Ear Drug Delivery

Hearing loss has a tremendous impact on our quality of life. The ability to hear is a vital part of our overall sensory experience and our connection to the world around us. The impact of hearing loss may be profound, with consequences for the social, functional, and psychological well-being of the person. A hearing impairment limits our engagement and affects our self-identity. Because many people with hearing loss neglect treatment due to the options available, a pharmaceutical approach to treatment may be the answer. New research is focusing on the inner ear for effective drug delivery.

Medications

Although there are 466 million people worldwide who have hearing loss, there are no FDA-approved drugs available for preventing and treating inner ear disorders. A lack of clinical experience involving the inner ear creates challenges for the pharmaceutical companies that are developing inner ear medications. With indications such as ototoxicity and Meniere’s disease, these companies are developing therapies such as otoprotection, hair cell regeneration, and gene therapy. Selecting the most appropriate delivery method that will transport the medication is of vital importance.

Delivery Method

Inner ear drug delivery involves three routes of administration: intratympanic, intracochlear, and systemic. Intratympanic uses a syringe injection to the tympanic membrane to deliver a drug across the middle ear and into the cochlea. This route is beneficial for administering drug solutions, drug suspensions, and injectable gels. Intracochlear is the transfer of the drug into the cochlea. Although this method is precise, it is also high-risk. An injection, a perfusion system, or a cochlear implant device are the delivery methods for this route. Systemic delivery is the favored route for future delivery as it poses a low risk for complications and is more comfortable for patients. Research is focusing on finding new systemic administration methods for ear therapy.

Advancements

There is progress in the improvement of inner ear drug delivery systems. Drug targeting, gene and stem cell therapy, and hair cell regeneration are making effective inner ear drug delivery a reality. Collaboration is vital for translating lab bench results into viable treatment options. Researchers feel confident that partnership will overcome the challenges of administering therapy directly to the inner ear.

Challenges

There are obstacles to be cleared in the development of efficient inner ear drug delivery systems. The main problem is not knowing the exact drug formulation for the intended drug delivery system. Another issue is the conversion of clinical findings that utilized animal models to applications for humans. What works in a rat may not be successful in a human. For systemic drug delivery, achieving a therapeutic dose in the inner ear after crossing the blood-labyrinth barrier without side-effects is the goal.

The Future

Inner ear therapies will encourage patients to seek care for their hearing loss. As an alternative to a hearing device, drugs provide a long-lasting, convenient, and efficient treatment option. The research team hopes that inner ear drug delivery systems will lay the groundwork for effective prevention and treatment with medications.