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Hearing / Deafness

Does Medicare cover hearing aids?

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Sections A and B under Medicare do not cover hearing aids or other related services, such as hearing aid fitting assessments. Nevertheless, Medicare Part B may cover part of the cost of general hearing tests when the ordering doctor deems it necessary to help in medical treatment.

Medicare Parts A and B do not provide hearing aids for older adults or individuals with a disability that has Medicare.

Most hearing loss sufferers will benefit from using hearing aids. Such tools are important for the general well-being of the deaf and partly hearing-losing individuals, for whom they can greatly boost the quality of life.

In this article we look at which aspects of Medicare will cover the cost of medication and diagnosis of hearing loss.

Cover for hearing aids in 2020

Woman receiving hearing exams
individual can get coverage with Medicare Part B for part of the cost of general hearing exams.

Medicare Parts A so B shall not include hearing aids as of 2020. However, this could change because of a government bill currently under consideration.

The HR 3 bill reached by Congress in 2019 requires the government to control prescription drug costs, according to the Hearing Loss Association of America. If the Senate passes the bill, the lower-price benefits will cover hearing treatment, which may require hearing aids.

HR 3 has not yet passed the Senate, however, and it could not succeed in becoming law.

This legislation named the 2019 Medicare Audiologist Access and Services Act is also a step in the right direction for audiology services coverage and, potentially, hearing aids. The act is still to become law, though, and its fate is unknown.

Lawmakers and advocacy groups step in a better direction when it comes to hearing aids. Now, however, it is not clear if Medicare will amend its policies to cover those tools in the coming years.

Medicare Part B and hearing aids

Partie B in Medicare does not make hearing aids or hearing aid fitting tests. Medicare Part B usually covers medically needed services to treat an active medical condition.

While Medicare Part B does not cover hearing aids, it does cover hearing tests prescribed by a doctor to diagnose a hearing problem. The person on the program, however, remains responsible for paying 20 per cent of the bill.

They will also have to pay a portion of any remaining policy deductibles. Individuals who attend a hearing test in a hospital’s emergency department will need to cover a co-payment directly to the health care provider.

Medicare Part B also provides hearing aids with bone anchoring (BAHA). Medicare categorizes the BAHA as a prothetic system rather than a hearing aid.

A BAHA is a surgically implanted system that supports individuals with some forms of hearing loss. This operates differently than traditional hearing aids. A BAHA transmits sound waves by bone conduction, activating the cochlea and bypassing the outer and middle ears.

It is important to realize that a BAHA is not the same as a conventional hearing aid. It may however be an option for certain individuals with other types of hearing loss.

Does Medicare Advantage cover hearing aids?

Medicare Part C, also known as the Medicare Advantage, is an insurance plan provided by private insurance companies to supplement Medicare Parts A and B. But cost and coverage vary according to schedule.

Many Medicare Advantage programs, such as insurance, cover hearing aids and associated costs.

People who are considering Medicare Advantage will compare individual plans ‘ benefits before choosing the best choice for their needs.

How much does a hearing aid usually cost?

The cost of hearing aids is complex. The average cost of one hearing aid is around $2,400, according to a 2015 study by the President’s Council of Advisors on Science and Technology.

Some people may need two hearing aids, the cost of which would be $4,800.

The high cost of hearing aids will make it hard for some people to deal with their hearing loss. Those tools, however, can greatly improve the quality of life for people with hearing conditions.

How to know whether you need a hearing aid

There are several early warning signs of loss of hearing. A person may benefit from hearing aid if they:

  • frequently ask people to repeat what they said
  • have an inability to understand dialogue when watching TV
  • strain to hear conversations
  • have trouble understanding what people say when their faces are not visible
  • think that others are mumbling
  • have trouble hearing over the phone
  • hear ringing, hissing, or rushing noises
  • regularly miss the doorbell when it rings
  • receive suggestions from other people that they have a hearing problem
  • avoid group conversations over concerns that they may be challenging to follow
  • often find that the source or location of a sound is difficult to identify
  • regularly hear from others that the TV, radio, or phone is too loud when they use it
  • find male voices easier to follow than female voices, which may be a sign of high register hearing loss
  • feel tired and stressed after trying to follow a conversation
  • have the sense that people are mumbling more than they did previously

Hearing aids are an adaptation for the deaf which partially hearing losers, which can make life easier to handle. Nevertheless, they are not a cure, since they do not address the underlying biological causes.

Sensorineural hearing loss (SNHL) may also be treated with hearing aids. SNHL is the most common form of permanent hearing loss, and includes damage to the inner ear, according to the American Speech-Language-Hearing Association.

People who have hearing loss should speak to their physician. Statistics indicate that it takes an average of 7 years for people to receive hearing loss care, likely because of high costs and concerns about social stigma.

Anyone who puts off thinking about hearing aids because of concerns that they are too noticeable should find some comfort in recent advances in technology. Hearing aids are smaller now than ever before and more discreet.

People with hearing-loss symptoms should seek a doctor’s appointment for a hearing test. If the doctor finds a problem, they will usually refer an ear, nose and throat doctor, or otolaryngologist, to a specialist.

The specialist must carry out further verification tests to determine the type and severity of any hearing issues.

Why hearing aids are vital

According to The National Academies of Sciences, Engineering and Medicine, there are about 30 million people living with hearing loss in the United States. The Academy also states that they are not used by an estimated 67–86 percent of people aged 50 and older who could benefit from hearing aids.

Hearing aids can however improve the quality of life for people with certain types of hearing loss.

Hearing loss, especially in older adults, can have multiple adverse health effects without treatment.

For instance, according to this 2014 report, hearing loss may result in an increased risk of falling, dementia, and reduced cognitive functioning in older adults. Treating hearing loss can however prolong cognitive decline and dementia.

Summary

Medicare Sections A and B as it stands in 2020 will not cover the cost of hearing aids or hearing aid appropriate tests. Nevertheless, legislation could adjust Medicare’s coverage for potential hearing aids.

Most Medicare Advantage programs cover hearing aids and the associated costs thereof.

Leaving untreated hearing loss will result in unforeseen health consequences, such as dementia and increased risk of falling.

People with hearing loss should ask their doctor about hearing tests to determine if the hearing aids will help them.

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Ear, Nose and Throat

Symptoms, treatment, and causes of ear infections

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Infections in the middle ear can be caused by viruses or bacteria. These frequently cause in pain, inflammation, and fluid accumulation.

Before they become three years old, almost 75% of youngsters will have had at least one ear infection. The most common reason for a child’s visit to the doctor is an ear infection.

Glue ear, secretory otitis media, middle ear infection, and serous otitis media are all terms for ear infections.

Infections of the ear are widely understood, and their frequent recurrence necessitates ongoing investigation. This article discusses the symptoms and causes of ear infections, as well as the treatment choices and diagnostic methods available.

What is it?

ear infections

A bacterial or viral infection of the middle ear is known as an ear infection. Inflammation and fluid buildup in the ear’s interior cavities are caused by this infection.

The middle ear is a space behind the eardrum that is filled with air. It has vibrating bones that translate sound from outside the ear into messages that the brain can understand.

Ear infections hurt because the swelling and accumulation of extra fluid puts pressure on the eardrum.

An ear infection can be acute or chronic. Chronic ear infections might harm the middle ear permanently.

Causes

An ear infection is frequently preceded by a cold, flu, or allergic reaction. These increase mucus in the sinuses, causing the eustachian tubes to discharge fluid slowly. The nasal passages, throat, and eustachian tubes will all be inflamed during the initial illness.

The role of eustachian tubes

The eustachian tubes run from the middle ear to the throat’s rear. These tubes’ ends open and reopen to control air pressure in the middle ear, restock air, and drain natural secretions.

The eustachian tubes can become blocked due to a respiratory infection or allergies, resulting in an accumulation of fluid in the middle ear. If this fluid becomes bacterially contaminated, infection may result.

Young children’s eustachian tubes are smaller and more horizontal than those of older children and adults. This implies that fluid is more likely to pool in the tubes instead of draining away, raising the risk of ear infection.

The role of adenoids

Adenoids are tissue pads found in the back of the nasal cavity. They respond to bacteria and viruses in the air and help the immune system function. The adenoids, on the other hand, can sometimes trap bacteria. The eustachian tubes and middle ear may get infected and inflamed as a result of this.

The adenoids are adjacent to the eustachian tube entrances and can cause the tubes to close if they expand. The adenoids in children are larger and more active than those in adults. Children are more likely to get ear infections as a result of these factors.

Symptoms

The signs and symptoms in adults are simple. Adults with ear infections suffer from ear pain and pressure, as well as ear fluid and hearing loss. Children are exposed to a broader spectrum of symptoms. These are some of them:

  • ear pain, especially when lying down
  • difficulty sleeping
  • difficulty hearing
  • fever
  • lack of appetite
  • headache
  • tugging or pulling at the ear
  • crying more than normal
  • loss of balance

Types

In general, there are three types of ear infections.

Acute otitis media (AOM)

The most common and least dangerous type of ear infection is AOM. The fluid beneath the eardrum gets infected and bloated, and the middle ear becomes infected and swollen. Fever is another possibility.

Otitis media with effusion (OME)

There may be some fluid behind the eardrum after an ear infection has cleared. Although a person with OME may not show symptoms, a doctor will be able to detect any lingering fluid.

Chronic otitis media with effusion (COME)

COME refers to fluid returning to the middle ear on a regular basis, whether or not an infection is present. This reduces your ability to fight other infections and has a detrimental influence on your hearing.

Diagnosis

Ear infection testing is a simple procedure, and a diagnosis can often be determined solely on the basis of symptoms.

To examine for fluid behind the eardrum, the doctor will usually use an otoscope, which is a light-attached tool.

A pneumatic otoscope is sometimes used by a doctor to check for infection. This device uses a puff of air to check for retained fluid in the ear. The eardrum will move less than normal if there is any fluid behind it.

If the doctor is unsure, he or she may perform further tests to confirm a middle ear infection.

Tympanometry

The doctor employs a device that shuts up the ear canal and changes the pressure inside it. The eardrum movement is measured by the instrument. This allows the doctor to determine the middle ear pressure.

Acoustic reflectometry

The eardrum is bouncing sound against the eardrum in this technique. The amount of sound that bounces back shows the level of fluid buildup. The bulk of sound is absorbed by a healthy ear, whereas an infected ear reflects more soundwaves.

Tympanocentesis

A clinician may employ tympanocentesis if an ear infection has not responded well to treatment. A small hole is made in the eardrum and a small amount of fluid is drained from the inner ear during this treatment. The infection’s cause can then be determined using this fluid.

Treatments

Antibiotic treatment is required for infants under the age of six months to help prevent the spread of infection. Amoxicillin is frequently used as an antibiotic.

Unless the kid shows signs of a severe infection, doctors usually recommend monitoring the child without antibiotics for children aged 6 months to 2 years.

Ear infections usually go away on their own, and the only prescription required is pain relief. Antibiotics are only used in circumstances that are more serious or last longer.

The American Academy of Family Physicians (AAFP) advises patients to be on the lookout for:

  • children aged 6 to 23 months who have experienced mild inner ear pain in one ear for less than 48 hours and a temperature of less than 102.2° Fahrenheit (39° Celsius)
  • children aged 24 months and over with mild inner ear pain in one or both ears for less than 48 hours and a temperature of less than 102.2°F

Antibiotics are rarely recommended for children above the age of two. Antibiotic resistance develops as a result of overuse. Serious infections may become more difficult to treat as a result of this.

For persistent infections, the AAFP recommends acetaminophen, ibuprofen, or eardrops as pain relievers. These are useful for reducing fever and pain.

A warm compress, such as a towel, can help to relieve the pain in the affected ear.

If you have recurrent ear infections for several months or a year, your doctor may recommend a myringotomy. A surgeon creates a small cut in the eardrum to allow the build-up of fluid to be released.

To help air out the middle ear and prevent future fluid buildup, a very small myringotomy tube is implanted. These tubes are typically left in place for 6 to 12 months before falling out naturally rather than requiring manual removal.

Prevention

  • Ear infections are very frequent, particularly among children. This is linked to a developing immune system and variations in ear architecture. There is no surefire way to avoid infection, however there are a few things you can do to lower your chances:
  • Ear infections are less common in children who have been vaccinated. Inquire with your doctor about immunizations for meningitis, pneumococcal disease, and the flu.
  • Wash your hands, as well as your child’s, frequently. This can help your child avoid having colds and flu by preventing bacteria from spreading to them.
  • Second-hand smoking should never be exposed to a child. Ear infections are more common in infants who spend time with people who smoke.
  • If at all possible, breastfeed infants. This aids in the improvement of their resistance.
  • Feeding a newborn from a bottle while sitting up reduces the risk of milk going into the middle ear. When a baby is lying down, do not allow them to sip on a bottle.
  • Allow your child to play with ill children as little as possible, and limit their exposure to group care or big groups of children.
  • Antibiotics should only be used when needed. Ear infections are more common in children who have had an ear infection in the last three months, especially if antibiotics were used to treat it.

Ear infections are a common occurrence in most children’s lives. They can be unpleasant and debilitating, but if appropriately handled, they pose very few long-term issues.

Sources:

  • http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001480.pub4/abstract
  • http://www.aafp.org/afp/2013/1001/p435.html
  • http://cmr.asm.org/content/16/2/230.full
  • https://www.medicalnewstoday.com/articles/167409
  • http://www.aafp.org/patient-care/clinical-recommendations/all/otitis-media.html
  • https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_youth_508.pdf
  • https://jamanetwork.com/journals/jama/fullarticle/211068
  • http://www.ncbi.nlm.nih.gov/pubmed/25156728

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Dermatology

Causes, symptoms, treatment of psoriasis in the ears

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Psoriasis is a skin condition caused by an autoimmune disease. In some parts of the body, such as the ears, a thick layer of skin cells can form.

It usually affects the elbows, knees, legs, back, and scalp, although it can also affect more sensitive body parts.

Psoriasis is the most common autoimmune condition in the United States, and it comes in a variety of degrees of severity.

This article discusses the causes of psoriasis in the ears as well as treatment alternatives.

What is psoriasis?

psoriasism in ear

Psoriasis is caused by an overactive immune system, which causes the fast development of extra skin cells. Experts aren’t sure whatcauses causing it.

It takes roughly 28 days for healthy skin cells to form. The body eliminates old skin cells during this time to make place for new ones.

In people with psoriasis, the body produces new skin cells every 3 to 4 days, leaving little time for old cells to slough.

This results in the accumulation of old and new cells on the affected areas, resulting in thick, red or silvery scales. These scales are often itchy, crack, and bleed, and they can be uncomfortable.

Researchers are still trying to figure out why psoriasis arises in certain parts of the body, including why some people get it in their ears while others don’t. They do know, however, that it cannot be passed from person to person.

According to a report published in the journal American Family Physician, psoriasis is not contagious. Scratching or touching does not cause psoriasis or transfer it to other parts of the body.

Psoriasis around the ears

People with psoriasis in their ears are extremely uncommon. However, if this occurs, an individual’s emotional and physical well-being may be jeopardised.

Psoriasis can cause the skin rough and scaly. Self-consciousness may be felt by people who have symptoms on their face and ears.

Because the skin on the face is frequently more delicate than that on the elbows, knees, and scalp, some treatments may be excessively harsh for this area. As a result, ear psoriasis might be more difficult to cure.

A blockage can occur if scales and wax build up inside the ear. Itching, pain, and hearing loss may cause from this obstruction.

Scales should be kept out of the ear canal to avoid hearing loss and discomfort.

Psoriasis might worsen over time for certain people. This can happen when something sparks a flare, but it’s often unknown why some people’s psoriasis spreads or worsens. New parts of the body, such as the ears, can be affected at any time.

There is no link between psoriasis in the ears and cleanliness, contact, or other things.

Anyone with psoriasis in their ears should see a doctor to find out which psoriasis treatments are safe to use in their ears.

Treatment

Although there is no cure for psoriasis, it is generally managed with treatments.

People who have psoriasis in their ears may need constant medical attention to keep flares under control and avoid problems like hearing loss.

Some psoriasis drugs should not be used in the ears. Certain topical lotions and ointments, for example, may irritate the fragile eardrum. People should inquire about drugs that are safe for the ear canal with their doctor.

Among the treatment options available are:

  • Eardrops containing liquid steroids.
  • In addition, liquid steroids may be used in conjunction with another psoriasis treatment, such as a vitamin D cream.
  • Shampoos with antifungal properties to help clean the ear and kill fungus.
  • Medications that help the immune system work more efficiently.
  • A few drops of heated olive oil to moisturise and remove wax inside the ears and keep them clean

If psoriasis in the ear causes discomfort or interferes with hearing, a specialist can safely and effectively remove the scales and wax.

It is critical not to attempt to remove the scales by inserting things into the ears.

Pushing the debris deeper into the ear can cause in a blockage, eardrum damage, or skin injury.

A doctor may give a systemic drug if the symptoms are mild to severe. Biologics, a relatively new class of medications, can treat the underlying causes of psoriasis.

Causes

The causes of psoriasis differ from individual to person. Certain factors can briefly aggravate psoriasis before it returns to normal for some people.

Others see their scales and other symptoms get worse over time.

In any case, psoriasis people should strive to avoid triggers wherever feasible. Those who have psoriasis in their ears may notice that a flare affects their hearing, which can be extremely aggravating and frustrating.

The following are some of the most common psoriasis triggers:

  • Stress: While it may not always be feasible to avoid the causes of stress, being able to manage it can help prevent flare-ups. Relaxation, exercise, deep breathing, and meditation may all be beneficial.
  • Medications: Certain medications, such as those for high blood pressure, heart disease, arthritis, mental health disorders, and malaria, might aggravate psoriasis. People with psoriasis should work with their doctors to discover treatments that do not exacerbate their condition.
  • Cuts, scrapes, sunburn, and other skin injuries: Any type of skin trauma might cause in a new case of psoriasis in the affected area.
  • Certain illnesses: When an infection strikes, the immune system goes into overdrive. This can also cause psoriasis flare-ups. Strep throat, ear infections, tonsillitis, and even regular colds can all cause flare-ups.

Avoiding triggers, whether on the ears, face, or other parts of the body, is an important component of controlling this condition.

Hearing loss and psoriasis

Even if psoriasis does not damage the skin in and around the ears, a person may nevertheless experience hearing loss.

People with psoriasis are more prone to acquire abrupt deafness, according to a study published in the American Journal of Clinical Dermatology.

This type of hearing loss might happen in a matter of minutes or over the course of a few days. People over the age of 50 are more likely to be affected by it.

The cause of sudden deafness in psoriasis is unknown, however it could be linked to the immune system harming part of the inner ear. Within 2–3 weeks, almost half of those who have abrupt deafness regain some or all of their hearing.

Doctors may advise that people with psoriasis and psoriatic arthritis have regular hearing tests to ensure that any abnormalities are detected and treated early.

Living with psoriasis in the ears

Many people suffer from psoriasis, which can be emotionally and physically draining, but with the help of a doctor, they can generally manage the condition.

Finding an effective treatment, whether the flares occur in the ears or elsewhere, is critical to reducing symptoms and flares.

Hearing tests and ear examinations should be done on a regular basis for people who have psoriasis in their ears so that any difficulties can be addressed as soon as feasible.

Because everyone with psoriasis reacts to drugs differently, finding the proper treatment may take some time. Some people’s psoriasis medicine stops working over time, necessitating the use of a different treatment.

People with psoriasis should be able to live full, active lives once they find a suitable treatment.

Conclusion

Psoriasis is a painful, long-term skin condition that can affect the inside and outside of the ear.

It is more difficult to treat than psoriasis elsewhere on the body when it does this. Hearing loss can occur as a result of the condition, both temporary and permanent. Although a complete treatment is not yet attainable, people can control their symptoms with condition and live a normal life.

To avoid serious flare-ups, get regular hearing tests and consultations.

Sources:

  • https://www.psoriasis.org/about-psoriasis/causes
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797675/
  • https://www.jaad.org/article/S0190-9622(18)33001-9/fulltext
  • https://www.psoriasis.org/about-psoriasis/specific-locations/face
  • https://www.aad.org/public/diseases/scaly-skin/psoriasis
  • http://www.niams.nih.gov/Health_Info/psoriasis/default.asp
  • https://www.medicalnewstoday.com/articles/314768
  • http://www.aafp.org/afp/2007/0301/p715.html
  • https://www.psoriasis.org/content/statistics
  • https://www.nidcd.nih.gov/health/sudden-deafness
  • http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/what-is-psoriatic-arthritis.php
  • https://www.ncbi.nlm.nih.gov/pubmed/25687690

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COVID-19

Tinnitus, hearing loss, and vertigo have been linked to COVID-19

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Could COVID-19 have an effect on your hearing?
Could COVID-19 have an effect on your hearing?
  • SARS-CoV-2, the virus that causes COVID-19, has been linked to tinnitus, hearing loss, and vertigo, according to a study of published data.
  • Nerve infection, autoimmune injury, and blood clots are all possible causes.
  • Since most cases of hearing and balance issues depend on patient questionnaires and medical history rather than diagnostic testing, the results are preliminary.

According to the National Institute for Health and Care Excellence in the United Kingdom, dizziness, tinnitus, and ear pain are among the most common symptoms of long COVID.

Other viral infections, such as rubella, measles, and cytomegalovirus, have been related to hearing difficulties, but research into COVID-19 and hearing issues is still in its early stages.

Specialists at the Manchester Centre for Audiology and Deafness (ManCAD) in the United Kingdom reviewed seven studies in June 2020 that indicated a correlation between COVID-19 and hearing and balance problems, or audiovestibular problems.

However, the evidence suggesting a potential connection at the time was of low quality.

The same researchers have revised their study to include 56 studies that were released in 2020.

The researchers estimated the prevalence of audiovestibular problems in people who have recovered from a SARS-CoV-2 infection, despite the evidence being preliminary.

According to their results, 14.8 percent of patients have tinnitus, or ringing in the ears, 7.6 percent have hearing loss, and 7.2 percent have rotatory vertigo, or spinning sensations.

The journal International Journal of Audiology published the study.

Possible overestimates

The authors point out that these statistics may be exaggerating the true scope of the issue.

This is due to the fact that the reports they looked at did not always indicate if the symptoms were new or whether they were preexisting symptoms that had temporarily intensified.

Furthermore, rather than using accurate hearing tests, the majority of the research relied on medical reports or questionnaires in which patients recorded their own symptoms.

“A carefully performed clinical and diagnostic research is urgently needed to clarify the long-term effects of COVID-19 on the auditory system,” says senior author Kevin Munro, an audiology professor at ManCAD.

“Though this review provides further evidence for an association, the studies we looked at were of varying quality, so more work needs to be done,” he adds.

Prof. Munro is leading a year-long study in the United Kingdom that will compare control patients to COVID-19-hospitalized patients who recovered.

He and his colleagues want to learn more about the prevalence and severity of COVID-related hearing problems, as well as which areas of the auditory system are impaired.

They’ll also look at potential connections between audiovestibular issues and other factors like lifestyle, other medical conditions, and the intensive care services the patients got.

Prof. Munro explains:

“Over the last few months, I have received numerous emails from people who reported a change in their hearing, or tinnitus after having COVID-19. While this is alarming, caution is required, as it is unclear if changes to hearing are directly attributed to COVID-19 or to other factors, such as treatments to deliver urgent care.”

Potentially harmful factors

The spiral cavity of the cochlea, which senses sound, and the fluid-filled semicircular canals, which are involved in balance, are both located in the inner ear.

The researchers mention some of the proposed reasons for the damage to the inner ear that occurred in people who had COVID-19 in their report.

These include:

  • direct viral infections of the inner ear or the nerve that carries sensory signals from it
  • autoimmune attack by antibodies or immune cells, or damage caused by excessive production of cytokines, which are immune signaling molecules that cause inflammation
  • blood clots that block the blood supply to the cochlea or semicircular canals, depriving them of oxygen

The authors advise readers to use caution when interpreting their estimates of the prevalence of COVID-19-related hearing problems.

They write that some of the issues may have been pre-existing, pointing out that about 11% of the adult population in the United Kingdom has hearing loss, and 17% has tinnitus.

Furthermore, they say that they were unable to decide whether the writers were documenting a new symptom or a worsening of an existing one in roughly half of the studies they looked at.

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