Preserving the Hearing Health of Military Service Members

Dr. Marinelli’s own take on tinnitus focused on two underappreciated comorbid conditions—anxiety and depression. In a recent study of nearly 9,000 patients, those with tinnitus were more likely to suffer from depression (OR = 2.033, 95% CI [1.584; 2.601], P<0.0001), anxiety (OR = 1.841, 95% CI [1.228; 2.728], P=0.0027), or somatic symptom disorders (OR = 2.057, 95% CI [1.799; 2.352], P<0.0001) than individuals without the hearing disorder (J Clin Med. doi: 10.3390/ jcm12031169).

“You have to screen for these psychological conditions when caring for patients with tinnitus,” he said. “Sure, we have effective masking devices and other interventions for the sound component, but the accompanying anxiety and depression can be incredibly debilitating and also need to be addressed.”

For Dr. Adams, successfully treating tinnitus is one of the most satisfying parts of his practice. “When a service member or veteran comes in with hearing loss and is significantly impacted by tinnitus— which, unfortunately, has limited effective treatment options—it can be challenging,” he said. “But when we’re able to properly calibrate the hearing aid and they report noticeable relief and say, ‘I’m good to go,’ it’s incredibly rewarding.”

Looking Ahead

Over the next decade, “we are on the cusp of some incredibly exciting advances, including gene therapy for potentially reversing profound hearing loss—as long as hearing research remains a funding priority,” Dr. Erbele stressed. He added that such advances are not reserved for civilians. In fact, Dr. Erbele said he prides himself on using his research and clinical relationships to ensure that patients in the service “have as much access to cutting-edge clinical trials as anyone else.”

In casting his own eye toward the future, Dr. Marinelli cited expanding access to CIs for veterans. There are myriad reasons why CIs are only implanted in a fraction of all eligible adults in the U.S.—and probably in fewer veterans, he noted. For veterans, one factor is the many comorbid conditions they tend to have, which makes the surgical procedure a challenge, particularly when general anesthesia is used. “But the field is making gains with awake CIs,” he said (J Int Adv Otol. doi: 10.5152/iao.2022.20005). “So hopefully that will move the needle.”

David Bronstein is a freelance medical writer based in New Jersey.

The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, the Department of Defense, the Defense Health Agency, or the U.S. government.