Civilian otolaryngologists can help protect the hearing of military members by carefully assessing all veterans for hearing loss and tinnitus. According to the U.S. Department of Veterans Affairs, there are nearly 23 million veterans in the United States, and most experienced auditory insults during the course of their service. Knowing this, otolaryngologists should always ask patients who are veterans about their experiences in military service, said Dr. Ramsey. “Get a history, as best as possible, of what their noise exposure was and how many events and blasts and traumatic injuries they sustained.”
Explore This IssueJanuary 2013
Use that information, as well as the data obtained by a baseline audiogram, to establish an individualized screening program. “Most people who have had accousting trauma in the form of chronic noise exposure or blast events should have their hearing monitored with serial audiograms,” Dr. Ramsey said. “They should be conducted yearly until the hearing levels are stable, but monitoring should continue long-term with audiograms every couple of years or as needed, depending on change in their symptoms.
Veterans may also experience typical age-related hearing loss at younger than usual ages. “There’s some evidence that acoustic trauma and injuries related to blast injuries may exacerbate age-related hearing loss,” Dr. Packer said. “So follow-up needs to be consistent, and rehabilitation strategies should be considered if the hearing decreases.”
Make sure veterans know that help is available; hearing loss and tinnitus aren’t just something they have to “live with.” Fred Minnick, the Iraqi war vet with hearing loss and tinnitus, was offered a hearing aid but declined. Helping service members become aware of the vast variety of hearing aids and assistance available, including barely visible and in-canal hearing aids, may increase acceptance of assistive devices that many young veterans still associate with old age.
Be aware that hearing loss or tinnitus in former military members may hint at other serious health conditions. “Anyone who has hearing loss, there’s a good chance that they have a psychological trauma deeply embedded in there too,” Minnick said. “Something I’ve noticed about doctors who have not worked with the veteran population before is that they tend to be very dismissive of their military service and just kind of treat the symptom. But for a lot of veterans, the war is still very much going on, and validation is huge for them. For many of us, there’s most certainly a connection between our hearing and the trauma we faced.”