Jared R. Langerman MD

Aging contributes to changes in our hearing, which can in turn affect our physical, cognitive, and psychological state. Read on to learn how you can address your hearing concerns.

Shelby Stockton: (00:00)
Thank you for tuning in to the South Florida ENT Audio Blog. My name is Shelby Stockton, and September is Healthy Aging Month. To celebrate, I sat down with otolaryngologist, Dr. Jared Langerman, to discuss how aging affects our hearing. He tells us what happens to our hearing as we age, gets some preventative care advice, and points out why addressing these issues is very important for our mental health. Dr. Langerman reiterates how far hearing aids have come, and also gives some insights on other procedures that help us hear later in life. Take a listen. Dr. Langerman is so nice to meet you.

Dr. Jared Langerman: (00:36)
Glad to be here. Thanks for having me today. I'm pretty excited about it.

Shelby Stockton: (00:39)
I'm excited too. So September is Healthy Aging Month, and we're here to discuss how aging affects the functions of the ear, nose and throat. So having had said that, Dr. Langerman, as we age, what happens to these areas of our bodies?

Dr. Jared Langerman: (00:55)
Yeah, I think the biggest and most important area that I want to focus on, is hearing. And hearing's a really interesting topic to me and I think to most ENTs, because hearing loss is overlooked by I think the general community. And everyone knows that as we age, we typically lose our hearing, some people more than others, but it's really been treated, I think more as, a lifestyle problem in general, as opposed to a medical problem. And I think we're going to see, this is already happening, but we're going to see over the coming years, that hearing should really be considered a medical problem that has other effects. And we need to take prophylactic steps to identify hearing loss, treat hearing loss, because really it's more than just a lifestyle problem where patient says, "Well, I'm doing fine. I don't care what my hearing test shows. I have no problem interacting." And I think we're going to see a big shift in that, in the coming years. And I'm already trying to Institute that in my practice and it's really changed the way I practice.

Shelby Stockton: (02:13)
Is hearing loss inevitable?

Dr. Jared Langerman: (02:15)
So for a lot of patients, yes. Hearing loss comes in multiple flavors, but to keep it simple, the main cause of hearing loss is aging. And really what happens is, the nerves in the ear sort of burn out. So most patients will have some degree of hearing loss and it's hard to predict how much. You can look to your parents and say, "How did they do hearing, as they aged?" And that can be a little bit of an indicator, but patients come in and tell me, or ask me, "I have a little bit hearing loss. Is this going to get worse?" And I say, "Probably, but it may not get worse for 10 years. It may be worse when we recheck your hearing in a year from now." The thing that's changed about our understanding of hearing loss in the last, I want to say three to five years is, there's been a lot of evidence that shows, hearing loss and dementia are closely associated.

Dr. Jared Langerman: (03:15)
So what they've realized is that, patients with dementia are much more likely to have untreated hearing loss. So the theory is that, having hearing loss that you're not treating, is essentially putting your brain on overdrive and that affects your memory down the road. And this is why I think this is so critically important, because again, even me in practice, when I have patients who identified hearing lost in before, I would say to them, "This is what you're hearing touch shows. You have mild, moderate, whatever hearing loss, but how are you doing? Are you struggling? Are you hearing things when you go out to dinner? Are you hearing your grandchildren?" If they said I'm not having a problem, I'd essentially say, "Okay, let's test your hearing in another year and make sure it hasn't changed." But the conversation's really changed with my patients, because now I say, "Well, okay, I can get the same answer from them and maybe they're not having a big problem."

Dr. Jared Langerman: (04:14)
But then I talk about, "Well, this could be affecting the health of your brain. And by treating your hearing loss, you may help prevent memory problems or help prevent the progression of worsening memory problems." And that really catches a tone with patients, and all of a sudden they take it more seriously. So again, that's why I say hearing loss used to be, in my mind, this lifestyle problem. And now, it really is a health problem. And I think that we're going to hit a point where screening for hearing loss at a certain age becomes recommended, just as we do colonoscopies, mammograms, you name it, because it really is such an easily treated problem that potentially can prevent big problems down the road.

Shelby Stockton: (05:05)
So obviously genetics are genetics. There's not much we can do about that, but is there some preventative things we can do?

Dr. Jared Langerman: (05:11)
Right. The genetics is the genetics. That is what it is. The simplest thing is avoiding loud noise exposure. And the big things where you're going to have that are, let's say you go to concerts where there's sustained loud noise for a long period. A lot of it is occupational. So if you have a job where you're on a factory floor, you're a mechanic, you're working with airplanes, you really need to have hearing protection on all the time. And I think employers are doing a much better job of mandating that. OSHA's involved with that. But then recreation. Here in Florida, we have a lot of patients who shoot firearms recreationally, and that can cause a tremendous amount of hearing damage in a short period of time. I saw a patient yesterday actually, who went to shoot firearms and she wore ear protection, but it was really cheap ear protection.

Dr. Jared Langerman: (06:05)
She immediately has noticed hearing loss and ringing in her ears and I tested her hearing and she has this classic noise induced hearing loss, all because she didn't have the right ear protection. And a lot of that is irreversible. Once you have it, that's it. So the best thing you can do is, prevent loud noise exposure. There's this other question about, patients always ask me, "How do I clean my ears?" Which is less of an issue of long-term hearing loss. But I always tell them less, is more with the ears. They are a self cleaning mechanism and that's not true of everyone. Some ears do a better job than others, but for the most part, you leave the ears be, a little bit of ear. Wax is healthy, it prevents infection. It moisturizes, it prevents foreign bodies from going into ear, and over time the ears will push it out. Some patients obviously need to have frequent cleanings, but the ears just want to be left alone.

Shelby Stockton: (07:03)
Oh, that's good advice. That's really great advice. I'm glad I heard that actually. So are there surgical procedures to help patients achieve any kind of rejuvenation? Whether it be ears, nose, throat, you name it.

Dr. Jared Langerman:  (07:15)
Right. So we'll keep talking about hearing loss because that's what I focused on. The mainstay of treating age related hearing loss is, traditional hearing aids. The technology continues to improve on them. So some patients will say, "Oh my parents, my grandparents had them and hated them." Well, give them a chance, because the technology is constantly changing, they're Bluetooth now. You can take phone calls in them, listen to music, adjust them on your phone. There are new hearing products that are nonsurgical, that are on the market now. And one of them is this brand called Earlens, which is a custom hearing device that's nonsurgical, but it actually vibrates your eardrum, which is a lot different than traditional hearing aids. And a lot of patients who don't like the idea of traditional hearing aids, like the idea that there's this custom, higher end, almost better product out there.

Dr. Jared Langerman: (08:11)
Surgically for hearing loss. If we're talking about age related hearing loss, really, it only comes into play when you're on the border of being deaf. And there are things like cochlear implants that can help with that. But that's hearing loss that's extremely severe. If we talk about hearing loss that's not age related or nerve related. That includes problems with the eardrum, problems with the hearing bones. That's where surgery has more of an impact. Most types of hearing loss don't fit that mold, but there's no way of the patient knowing in advance. It feels the same to the patient. They're having trouble hearing. The only way to know, is to have a formal hearing test and then have a medical provider evaluate it. And that's how we can tell the difference between age related hearing loss and what we call a mechanical hearing loss is, again, problem with the eardrum, ear bones. And that type of hearing loss is where surgery is more common to repair or fix those.

Shelby Stockton: (09:11)
Wow. Dr. Langerman, thank you so much for taking time out of your day to talk to me about this. It's very, very fascinating.

Dr. Jared Langerman: (09:17)
Shelby, thanks for having me. I appreciate it. And I really feel so strong about this, so I'm happy to talk about it.

Shelby Stockton: (09:24)

Dr. Jared Langerman: (09:25)
You're welcome.

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