6 Signs That You Need a Hearing Test

Does it seem like you’re always asking people to repeat themselves? Maybe your friends complain that your TV volume is always high. Check out these warning signs, chances are, you may be experiencing hearing loss.


Hearing loss may cause you to lose more than you realize. When you cannot hear or respond to conversations, participate in social activities and interactions, you become reclusive and less motivated to participate in life.


According to statistics, over 37.5 million people report having trouble hearing. Further, the condition is spanning through generations as it is the third most prevalent condition among seniors in the country. It falls behind arthritis and hypertension. However, hearing problems among young adults is a cause for alarm.


Even though hearing aids can heal 95 percent of these conditions, only 23 percent of them use these aids. The following are the main signs that you can benefit from test hearing to check the status of this essential sense.


1. “What Did You Say”


The biggest warning sign is asking people to repeat themselves. At times, people may appear to be mumbling or their conversations are muffled.


In most cases, the high-pitched voices of children and women are difficult to hear. While you’ll suffer if you don’t hear what people are saying, the ones around you will also suffer. Your spouse, kids, and relatives are missing out on a positive relationship with you. Visit a test hearing facility to get an accurate diagnosis of your case.


2. Inability to Hear in Noisy Places


Are you having trouble hearing in areas with too much background noise? Well, this is a sign that you’re experiencing hearing loss conditions.


Hearing and understanding what other people are saying allows you to participate in family events and other activities. The inability to participate in social conversations may have dire mental consequences. There is evidence showing a strong correlation between hearing loss and cognitive decline. Visit a competent expert for hearing evaluations and possible treatment.


3. If You Notice a Cranking up Volume


Are you constantly turning up your TV volume to a point where others complain about how loud it is? Well, the issue may not be with your radio or TV.


It is a common warning sign that your hearing may have a problem. If you notice this, make arrangements for test hearing without delay. The experts attending to your case will conduct hearing tests before advising on the course of action.


4. A Ringing Sound in Your Ears


Exposing yourself to loud noises is harmful to your ears. Such may lead to tinnitus or a ringing sound in your ears. If the ringing persists, consider doing a test hearing.


A 2013 study done in Brazil concluded that 43 percent of those with hearing loss experience tinnitus. The experience can also be a warning sign in children too. If your kid is ever complaining about ringing in the ears, difficulty in hearing, or pain in the ears, take them for a test hearing. Let the doctor assess and prepare a diagnosis before coming up with the best solution.


5. Missing Out on Everyday Sounds


Well, this is the biggest red flags. For instance, do you sleep through your alarms or miss the call or texts on your phone? When was your last time to hear birds tweeting outside your house?


If you notice that you’re missing on one or more of these sounds, visit an expert. Let them handle the situation before it becomes too hard for you to handle.


6. You Experience Trouble When Talking on the Phone


Do you have challenges talking over the phone, especially in a noisy area? Do you find yourself avoiding calls from your friends and loved ones? Well, not anymore! Have a test hearing exercise done to determine the cause and extent of your problem. This is the first step to reclaiming your hearing. If possible seek intervention sooner rather than later.


You should never fear to seek treatment for hearing loss. It is a painless process.

How Does The Ear Work?

Approximately 15% of American adults (or 37.5 million people) report some trouble hearing. To many of us, hearing loss is understood as one condition; the truth of the matter is that hearing loss can manifest in a number of different ways, depending on what type of damage has occurred and where it has occurred in the ear. Let’s take a look at the anatomy and physiology of the ear to gain a better understanding of how hearing loss — and the ear in general — works.

Outer Ear

The outer ear consists of the pinna or auricle. This refers to the visible part of the ear, such as the earlobe and cartilage. The canal leading to the eardrum is referred to as the external auditory canal or tube. When a sound is made outside the outer ear, the sound waves, or vibrations, travel down the external auditory canal and strike the eardrum.

Middle Ear

The eardrum, or tympanic membrane, divides the outer ear from the middle ear. The middle ear (also called the tympanic cavity) is comprised of the following:

  • Ossicles: Ossicles describe the very small bones — malleus, incus, and stapes — that are connected and transmit and amplify sound waves to the inner ear.
  • Eustachian tube: The eustachian tube is a canal that links the middle ear with the back of the nose. It helps to equalize pressure (which is necessary for the proper transfer of sound waves) and also drains the middle ear of fluid.

Inner Ear

The inner ear consists of three components: the cochlea, which contains the nerves for hearing, and the vestibule and semicircular canals, both of which contain receptors for balance.

How Does It Work?

Once sound has entered the external auditory canal and struck the eardrum, the eardrum vibrates. These vibrations travel to the ossicles, which amplify the sound and send the waves to the inner ear and into the cochlea. The sound waves are then converted into electrical impulses, which the auditory nerve sends to the brain; the brain then translates these signals into sound.

If any damage at any point in this sound journey can disrupt the process in different ways. Some may be fixed or improved with the use of Lyric hearing aids or other forms of digital technology, some can be fixed or improved through surgery, and others cannot be changed. Only through hearing evaluations and hearing tests can ENTs determine the source of the problem and how to move forward.

ENT and Audiology Associates is happy to provide hearing evaluations for patients concerned about hearing loss. Whether for yourself or your child, our hearing evaluations will be able to determine the cause of the problem. Call us at (919)782-9003 to make an appointment today.

How to Care for Ear, Nose, and Throat Issues in Your Child

The ear, nose, and throat are common areas of trouble for children. To avoid further complications down the road, it’s often to handle problems with these areas as quickly and accurately as possible. Finding the right ENT for children is an important part of overall health and wellness. Follow our simple tips and you should be well on your way to establishing quality care.

In addition to assessing the health of your child’s nose and throat, ENT care facilities perform hearing tests. Hearing loss is a common affliction among children and adults alike. In the United States, about 2 to 3 out of every 1,000 children are born with a detectable level of hearing loss in one or both ears. A lot of hearing issues can be mitigated if they are detected and addressed early on in life. When you choose your ENT doctor, they will administer comprehensive hearing evaluations, and if necessary, provide recommendations on hearing aids. If hearing aids are needed, a reliable ENT can help you in customizing your hearing aid and providing ongoing care to monitor progress.

ENT for children also covers ear infections. Infections of the ear are one of the more common conditions that arise in children. There are many strategies for dealing with infections, as well as many factors that can cause them. Exposure to other viruses, such as respiratory viruses will be considered by your doctor, as well as environmental factors, family history, and the potential of infections that were experienced in the early life of your child.

Searching for the right ENT care provider does not have to be a complicated process. Begin by consulting with trusted friends and family, as word of mouth suggestions can often provide all the assurance you need. You can also reference the wealth of information and reviews available online. By establishing a relationship with a quality ENT care facility, you are taking the right steps toward providing your child with a happy, healthy life as they grow, learn, and develop.

Danger Signs that Your Children Has Hearing Problems

Studies show that 2 or 3 of every 1,000 children born in the United States have considerable hearing problems in one or both years. The studies continue to highlight that most of the children end up losing their hearing, especially if their problems are not detected by their parents. Therefore, parents have to observe specific hearing problems so that they can consult pediatric audiology and solve the hearing problem at an earlier stage.

Pediatric audiology will only help your child if you can detect hearing problems at an earlier stage. Here are some of the signs that should compel you to seek the services of pediatric audiology.

Delayed Language Development

Children are supposed to develop language at an earlier stage in life because they are interacting with older children who can speak. Moreover, they are constantly hearing their parents mention things followed with actions, which makes them name things. However, if your child demonstrates delayed language development, you need to consult pediatric audiology for an accurate diagnosis. Maybe the child is not hearing, which explains why he has not developed any language skills.

Consistent Ear Infections

Ear infections are not a sign of a hearing problem, but a probable cause of hearing problems. This is very difficult because a young child may not be able to show the actual cause of the problem. However, an observant parent can easily detect ear infections. Continues flow of fluids from the one or both ears is a clear sign of ear infection. A child putting fingers in the ears is an obvious problem that something is wrong. A pediatric ENT will easily detect ear infection and offer the necessary solution.


Daydreaming is a clear indication that the child is not hearing what is happening within the surrounding. Parents tend to confuse daydreaming with being inattentive. They could be right but consistent daydreaming for about a week is a danger sign that your child has hearing problems. A test hearing, done by experienced pediatric audiology could highlight the problem with your child. If diagnosed and treated properly, the child will start responding to the noises from the surrounding environment.

Turning to Face Sounds

This is a common aspect to many children because they are curious, and they want to see the source of the sound. However, it’s a clear indication that your child is having critical hearing problems. He could be hearing the sounds but not the actual words being pronounced. That’s why he is turning to face the movement of the lips to try and understand the meaning of the sounds. A pediatric is supposed to conduct hearing tests to the child before recommending hearing aids, which will help the child to listen to the words clearly without looking at the movement of the lips.

Grabbing/Pointing to Familiar Objects

It is the nature of young children to grab or point at familiar objects in the room. It is expected that a child will be highly interested in feeding cups, towels, and toys. Those are familiar objects. But it becomes critical when the child grabs or points it familiar objects when they are mentioned. This is a clear indication that the child cannot name the objects and cannot hear their names but can understand what others are saying through lip movement. This is a clear warning that your child needs hearing tests to determine whether he has hearing loss.

Reacting to Loud Sound

Reacting to loud sounds is a clear indication that the child did not hear before the sound was increased. He can now hear and deduce the meaning of the sound. That’s why he is reacting. Children with this type of hearing problem tend to remain calm while at the same time, paying huge attention to the person speaking. However, a slight increase in the volume of the sound makes them react. They can now hear without problems, and that’s why they are being excited or annoyed depending on the sounds produced.

There is a considerable number of people in the United States who have hearing problems. Most of these hearing difficulties started at an earlier stage but were not solved and were allowed to develop. It is upon you to take your children to pediatric audiology after detecting danger signs of hearing problems.

What are the symptoms of acute sinusitis and what does an ENT Specialist do to treat sinusitis?

Raleigh ENT Specialist treats sinusitis

Acute sinusitis, also known as a sinus infection, is not a pleasant thing to have. If you’ve ever had one, then you know what we mean. If you have, then you’ll agree that the extreme symptoms, which range from a feeling of fullness in the sinus cavity region to fatigue and aches and pains, all add up to a very unpleasant illness.

Thankfully, there are some symptoms to watch for, and if you catch your acute sinusitis early enough, you’ll be able to treat it before it gets worse. Here’s what you need to know about sinus infections.

It All Starts With a Sore Throat

In most cases, a sinus infection starts with nasal congestion followed by pain or pressure in your face.  There may also be colored nasal discharge.


Fatigue and a Fever Come Next

The very next symptoms of acute sinusitis involve your entire body. You’ll feel very tired and fatigued. You might be tempted to spend the day in bed recuperating. You might even have the aches and pains that tend to appear with illnesses like the flu, only you don’t have the flu – you have a sinus infection.

You might even have a minor fever, which can be treated with some over the counter medications, like Tylenol. All of these are signs that your body is fighting off an infection.

Additional Symptoms

On top of the symptoms listed above, there are many more that need to be mentioned. Your sinuses will feel full, and you might even notice that your face looks slightly swollen in the area under your eyes, and next to your nose. This means that your sinuses are filled with mucus.

You might also feel as though your ears are clogged. Your eyes might itch, and you’ll definitely feel as though you got hit by a bus or a train. You might even be a bit dizzy. Really, acute sinusitis can take a lot out of you.

How Are Sinus Infections Diagnosed?

There are many ways that an ENT expert can diagnose and treat a sinus infection. It all starts with a history (your story of your illness) and a physical exam. The doctor will ask you a number of questions and take note of your symptoms. They then conduct a physical exam, which involves looking into your ears, nose, and throat, and listening to your cough.

You’ll more than likely be very congested and have a slight fever. It’s easy to think that a sinus infection and a cold are one and the same, but they aren’t, as the sinus infection is much worse. Once you’ve been diagnosed with a sinus infection, the treatments can begin.

Medications Are Prescribed

Antibiotics, steroids, Afrin spray, and sinus rinses are all possible treatments.  The best combination will be individualized for you.


Douglas K. Holmes, MD, FACS ENT & Audiology Associates PLLC

3820 Ed Drive Raleigh, NC 27612

phone 919 782 9003 fax 919 782 9303

practice website:  www.drdougholmes.com



Help Our Patient Elizabeth Raise Money to Help Kids with Hearing Loss

Elizabeth is one of our amazing patients. She was diagnosed with hearing loss around age 4, and has been wearing hearing aids ever since. Next week is her birthday, and instead of presents, she wants to raise money for other kids like her to get hearing aids. We are so inspired by Elizabeth’s generosity, and proud to know her. Please consider donating to help her reach her birthday goal!


To help Elizabeth reach her birthday goal, please visit: https://support.starkeyhearingfoundation.org/fundraiser/1239076

What You Need to Know about Hearing Aids

If an audiologist has recently diagnosed you with hearing loss, you’re not alone. Hearing loss affects a significant number of Americans, so don’t be alarmed. With the help of ENT & Audiology’s Raleigh audiologists, you’ll be able to find the best solutions for your hearing loss.

If your audiologist confirms that your hearing problem stems from damaged hair cells found in the inner ear, you may have what is known as sensorial hearing loss, which is treated with hearing aids.

Why Do You Need Hearing Aids?

Hearing aids are small electronic devices worn inside or behind the ears, which consist of a microphone, speaker, and amplifier, and are useful for making sounds loud enough for the ears to hear clearly and the mind to comprehend in order for an individual to communicate effectively. Hearing aids also make it possible for people with hearing loss to hear clearly both in noisy and quiet environments.

As mentioned, hearing aids consist of three basic parts, each with a vital role to play.

i. Microphone – The microphone is what receives external sound. It then changes these sound waves into electrical signals before transferring them to the amplifier.
ii. Amplifier – Once the amplifier receives the electric signals, it multiplies the intensity of the signals accordingly.
iii. Speaker – The amplified sound is transferred to the ear through the speaker and once the remaining hair cells picks the sound, they convert them into neural signals which the brain is able to pick

The strength of a hearing aid amplification required by an individual is determined by the level of damage to the inner ear. However, there is a level at which even the largest amplification a pair of hearing aids can offer will not be of any assistance. In this case, your audiologist will make alternative recommendations e.g. having a cochlear implant.

Hearing Aid Styles

Hearing aids are classified into two major categories based on where they are worn.

  1. In-the-ear (ITE) Style Hearing Aids – These are designed to fit inside the outer ear and generally come with a hard plastic to house the hearing aid parts. They are ideal for mild to severe hearing loss complications with some having extra features such as a telecoli; a tiny magnet through which sound is received from the circuitry of the aid rather than through its microphone. They are good for telephone conversations and in places with induction loop systems.
  2. Behind-the-ear (BTE) Style Hearing Aids – BTEs on the hand are also designed with a hard plastic case that fits behind the ear. This case is attached to a plastic earmold which is what is fitted in the outer ear and transmits sound to the hair cells in the inner ear.  These too are ideal for mild to severe hearing loss cases.

Types of Hearing Aids

In-the-ear (ITE) Style Hearing Aids

ITE style hearing aids include:

  • In-the-canal Hearing Aids – these are placed on the lower side of the outer ear bowl. People prefer them because they are comfortable and do not block the ear canal.
  • Invisible-in-the-canal (IIC) and Completely-in-the-canal (CIC) Hearing Aids – These happen to be the smallest in size and as their names suggest, are not meant to be visible.
  • Low Profile Hearing Aids – unlike the IICs and CICs, the Low profile Hearing aids are for those who desire simple handling, therefore, they are slightly larger in size. They are designed to cover half or the entire outer ear bowl. A noteworthy advantage is that they can incorporate added features like volume controls and directional microphones.

Behind-the-ear (BTE) Style Hearing Aids

BTEs are more popular now than before because current hearing aids now come in a smaller size for those who prefer being discreet, which represents a significant percentage of people with hearing loss problems. Despite their size, they can still accommodate different features to suit specific hearing loss challenges.

Some include:

  • Mini BTEs – these come with a discreet ultra-slim tube to transmit sound into the ear.
  • Receiver-in-the-ear (RITE) or Receive-in-the-canal (RIC) hearing aids – The most distinct feature about the RITEs and the RICs is the fact that their speakers are designed to fit into the ear tip placing them at a closer distance to the eardrum.
  • BTEs with earmolds – these come with a longer shape and fits behind the entire outer ear. A distinctive advantage they have over the others is that they can accommodate more added features.

To ensure the best fit,  here are some things to consider:

Generally, hearing aids will vary with the extent of the hearing loss. However, other factors will certainly come into play.

These include:

  • Price
  • Ease of handling
  • Size Preference
  • The additional accessories required
  • Career

All in all, one needs to first get a recommendation from the doctor and then weigh the pros and cons of each option available before settling on what’s best for their specific needs.

How to Keep Your Hearing Aids in Good Condition

The most basic hearing aids maintenance practice is professional cleaning, you need to rid it of dust, moisture or wax using a soft dry cloth at least daily. Making regular appointments with your audiologist are also crucial to ensure your hearing aids are operating at the optimal levels.

What is Tinnitus?

Tinnitus can be diagnosed as hearing noise when there is no external noise present. It commonly affects 1 out of every 10 adults aged 60 and above. It is generally a symptom to an underlying ear complication, most likely a damaged cochlea.

The noise manifests as buzzing, whistling, roaring, clicking, hissing, or other noises that vary in pitch and frequency from one person to another. Continuous tinnitus can be very bothersome and cause stress for the patient.

Tinnitus is divided into two categories

Subjective Tinnitus: This is the most common form of tinnitus in which only the patient can hear the noises.

It has several causes including:

  • An affected inner, middle, or outer ear
  • The auditory nerves or pathways


Objective Tinnitus: Objective tinnitus can be heard by the patient and their medical doctor during check up. This form of tinnitus is not as common as subjective tinnitus.

This can be caused by:

  • A problem with a blood vessel
  • Muscle contraction

Some Common Causes of Tinnitus are

  • Aging accompanied by damage to the inner ear
  • Continuous exposure to noise
  • Injuries to the head or neck
  • Infections inside the ear
  • Change to the ear bone structure
  • Blockage of the ear by excess earwax

 Effects of Tinnitus

Those suffering from tinnitus can experience symptoms of:

  • Depression
  • Insomnia
  • Anxiety
  • Lack of concentration
  • Irritability

Treatment of Tinnitus

Tinnitus currently has no cure, however, there are some new treatments available to help control tinnitus and drastically improve a patient’s life.

Some tinnitus management tips include:

  • Avoiding medications like aspirin or ibuprofen that are known to damage the inner ear.
  • Address conditions linked to tinnitus such as insomnia, depression, and anxiety.
  • Coping with the noise if the tinnitus is caused by age.

When is it time to see the doctor?

  • If tinnitus is causing symptoms of anxiety or depression.
  • If tinnitus is noticeable after an infection, particularly ENT related.
  • If the noise causes hearing loss.

Some of the causes of tinnitus can easily be prevented, like smoking or exposure to loud noise. It is better to address risk factors early before they cause permanent damage.

May is Better Hearing & Speech Month

Leisure Activities Rife With Loud Noise

With more than half of Americans who experience noise-induced hearing loss not working in noisy jobs, the spotlight turns to what Americans are doing in their leisure time. May 1 marks the beginning of Better Hearing & Speech Month—a time to assess lifestyle habits that may be contributing to hearing loss as well as schedule a hearing evaluation for anyone with concerns about their hearing.

About 40 million U.S. adults aged 20–69 years have noise-induced hearing loss, a form of hearing damage that results from exposure to loud noise. This could be cumulative harm that developed from exposure over time, or it could occur from one severe episode. Although completely preventable, once it occurs, it is irreversible. Far from simply being an annoyance, hearing loss can affect almost all aspects of life, including physical health, mental health, employment status and success, social functioning and satisfaction, and much more. Hearing loss can be treated through various technologies and techniques under the care of a certified audiologist, but hearing is never fully restored.

In addition to the dangers posed by listening to ear buds or headphones at too-loud volumes and for too long, noisy settings are commonplace in today’s society, including in Raleigh. Many restaurants are specifically designed to elevate noise levels to make establishments feel more energetic. Similarly, some sports stadiums have been built with sound elevation in mind, thought to improve the fan experience and serve as a home-team advantage. Coffee shops, fitness classes, and more all make modern society a collectively loud place.

“Although many people report concern about noisy environments, not nearly enough take protective steps,” said Raleigh-based audiologist Lena Kyman, AuD. She offers some simple ways that the public can take charge of their hearing health—this month and always:

• Wear hearing protection. Earplugs and earmuffs are cheap, portable, and (with a good fit) offer excellent hearing protection. Bring them along when you know you’ll be in a noisy setting. Better yet, keep them on you at all times!

• Reduce exposure. Take steps to reduce your exposure to noisy settings. Visit noisy establishments during off times, consider quieter settings, and talk to managers if you find the noise level uncomfortable.

• See a certified audiologist for a hearing evaluation. A recent government report stated that 1 in 4 U.S. adults who report excellent to good hearing already have hearing damage. Many adults don’t routinely get their hearing checked, and even those who are concerned often delay treatment for years. Postponing treatment can have serious medical and mental health repercussions in addition to reducing a person’s quality of life, so visit a certified audiologist if you have any concerns.

“This advice about hearing protection goes for just about everyone, from the youngest of children to older adults, from those with excellent hearing who want to maintain it, to those who already have some hearing loss and don’t want to make it worse,” notes Lena Kyman, AuD. “As a society, everyone needs to prioritize hearing protection.”

World Hearing Day 2017

Every year on March 3, the World Health Organization (WHO) celebrates World Hearing Day. This day was created to help raise awareness and draw attention to the importance of prevention, screening and rehabilitation of hearing loss. The theme for this year’s World Hearing Day is ‘Action for hearing loss: make a sound investment’.
Read More »

Sublingual Immunotherapy – Alternative to Allergy Shots

Less than five percent of US allergy sufferers receive immunotherapy. The other 95% take medications to temporarily reduce symptoms, try to avoid their allergens, or just continue to suffer.

Read More »

James T.

Ear, Nose & Throat patient testimonial from James T. as he discusses his treatment experience with Dr. Douglas K. Holmes at ENT & Audiology. Dr. Holmes is a prominent Otolaryngologist (Ear, Nose & Throat) located in the Raleigh, North Carolina area.

Auditory Brainstem Response (ABR)

What is an Auditory Brainstem Response (ABR) Test?

The Auditory Brainstem Response (ABR) test provides both quantitative and qualitative data for doctors who want to assess the status of a patient’s brainstem pathways and auditory nerves.

Read More »

Tinnitus Evaluations

tinnitus-evaluationWhat is a Tinnitus Evaluation?

It is important to have your tinnitus evaluated by a professional who can help you manage the irksome symptoms. Primary Tinnitus is a medical symptom that is characterized by persistent noise in one or both ears that can only be heard by the affected individual.

Read More »