SAN ANTONIO — Among those who are exposed to combat, it’s the weapons fire that does it. In the Navy, it’s the noise levels in engine rooms and on the decks of carriers. In the Air Force, it comes from the engines of helicopters and fighter planes.
While the cause differs, the result remains the same: damage to the sensitive mechanics of the ear and the loss of hearing or other chronic hearing-related maladies. In 2014, there were nearly one million veterans receiving disability compensation for hearing loss and 1.3 million for tinnitus—the chronic ringing in the ears that can be a symptom of hearing loss or other injuries.
“Noise is ubiquitous and hearing is a critical sense,” explained Col. LaKeisha Henry, MD, Division Chief of the Hearing Center of Excellence (HCE)—a joint venture between VA and the Air Force located at Joint Base San Antonio-Lackland, TX. “With the continued rising numbers of veterans with tinnitus and hearing loss, it is important to give voice to auditory system injury and disorders.”
The HCE’s mission is to do just that: to become the preeminent authority on hearing and balance health for the nation’s military and in doing so, advocate for research, education, and prevention. That advocacy is important because, in the presence of more visible, dramatic injuries, something like hearing loss can be easily missed.
“The nature of polytrauma often necessitates the prioritization of trauma care, and auditory system injuries may go unrecognized,” Henry explained. “Hearing loss, especially noise-induced hearing loss, and auditory system disorders may be hidden, which may delay evaluation and treatment.”
Henry, who began a career in the Air Force in program management in 1994, was encouraged by West Point classmates to attend medical school at the Uniformed Services University of the Health Sciences (USUHS). While there, she became intrigued by the complexity of otolaryngology—head and neck surgery—and made that her specialty. After finishing her residency in 2005, Henry moved up the ranks of medical leadership positions, including surgical specialties flight commander, surgical operations squadron commander and otolaryngology consultant to the Air Force Surgeon General—a role she still holds.
Her position at the HCE—one she’s held since March 2017—is simply stated but daunting in its breadth: reverse the rise of hearing loss and hearing disorders among servicemembers. It’s a mission that puts as much a focus on prevention and diagnosis as it does on treatment. “Hearing loss and auditory system injury may not be recognized early on, as its symptoms may initially be silent. Prevention and protection, detection and diagnosis are just as important as mitigation, treatment, and rehabilitation and restoration,” Henry explained.
“We are a highly productive but lean organization,” Henry added. “The spectrum of care is broad, and research across the entire spectrum of auditory-vestibular disorders is critically needed. Though we continue to advocate for funding for auditory-vestibular research, this remains a challenge in a setting of limited funds and resources.”
One cost-effective way of promoting better care and prevention is to get clinicians and researchers together in the same room to talk about the pressing issues surrounding hearing loss. Every year, the HCE brings together about 100 clinicians, scientists, researchers and subject matter experts for the Collaborative Auditory & Vestibular Research Network (CAVRN) Meeting. The meeting puts experts from DoD and VA together to discuss research goals, share expertise and promote resource sharing across the departments.
“How can you not be proud of the efforts to coordinate, encourage, facilitate and advocate for research, knowledge products and technological solutions for hearing loss and auditory system injury?” Henry asked. “I most certainly am.”
To really push the needle on hearing loss in the military, that conversation and awareness can’t stay inside the clinical community, Henry noted. “We need to increase the awareness of commanders, warfighters and leadership concerning the impact that hearing loss and auditory system injury have on readiness, operational performance, effective communication and mission accomplishment, both in the deployed and garrison environments.”
The end goal is a servicemember who can enter the military feeling confident that he or she will exit with undamaged hearing, Henry explained. “Ideally, a servicemember should be able to enter military service and retire or separate with the same level of hearing and auditory-vestibular system function. Until we truly right the rising prevalence of injury and achieve sustained decreased incidence or a definitive prevention or cure for hearing loss, we need to stay the course of the mission.”
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