Preserving the Hearing Health of Military Service Members

One such intervention is cochlear implants (CIs). In the civilian population, as with hearing aids, access to CIs remains a challenge, with utilization rates lagging far behind the number of patients who are eligible for the procedure. In one study, investigators estimated that only between 2% and 13% of people in the U.S. undergo CI, depending on the audiometric CI criteria used (Otol Neurotol. doi: 10.1097/ MAO.0000000000003513).

Dr. Erbele said he was not aware of any data on CI utilization rates in the military, but he certainly is aware of the overall nationwide trend of low CI uptake, because he and fellow researchers cited this low uptake in their own review of CI trends (Laryngoscope. doi: 10.1002/ lary.32037). Dr. Erbele and his colleagues offered one potential fix: making CI surgery a requirement for otolaryngology residency education. “This would ensure that general ENTs actually have that skill,” he said. “Of course, it’s one piece of a much bigger puzzle for increasing CI utilization. But it’s an important one: If our surgeons in GME [graduate medical education] programs—including our own in the military—have the ability to perform CIs, then more patients who need them will get them.”

Tackling Tinnitus

Tinnitus is another common condition that Dr. Erbele and his military audiology colleagues often see in their patients. The two conditions are strongly linked, with some research suggesting that up to 80% of patients with unilateral or bilateral tinnitus are also diagnosed with hearing loss using standard pure-tone audiometry (Front Neurol. doi: 10.3389/fneur.2017.00605). Fortunately, recent advances, particularly for tinnitus rehabilitation, are encouraging.

Dr. Erbele said the one he is most excited about is Lenire (lenire.com), a U.S. Food and Drug Administration-approved device for treating tinnitus that alters the way the brain experiences phantom sounds by simultaneously providing sound stimuli to the ear and electrical stimuli to the tongue. In one clinical study, the device had a response rate of approximately 92%, with a mean tinnitus improvement of about 28 points on the Tinnitus Handicap Inventory and no device-related serious adverse events (Commun Med [Lond] doi: 10.1038/ s43856-025-00837-3).

“The way this device operates is through biofeedback,” Dr. Erbele said. “It works similarly to cognitive behavioral therapy, which is one of the tools we already have to manage tinnitus.” Coupled with some preliminary work using CI as a suppression tool for severe tinnitus, “there are some exciting advances here to look forward to.”