The 2000 Military Audiology Short Course (MASC) was held at the Sheraton Norfolk Waterside Hotel, Norfolk, VA, during 1 - 3 February 00 in conjunction with the Fortieth Navy Occupational Health and Preventive Medicine Workshop. The theme for this Workshop was “FORCE HEALTH PROTECTION: PREPARE & PROTECT.” Thanks go out to Mr. John Page who organized this year’s event and to all who presented at the meeting. [Special thanks to Capt Jill Juvan, USAF, for her assistance with this portion of the web site. -Editor]
Joint Service Presentations
Audiology Support Following the Bombings of US Embassies in Africa
Presenters: Jenny Rainwater, Maj, USAF
David Chandler, COL, USA
Lynnette Bardolf, CPT, USA
On 7 August 1998, terrorist bombs were exploded outside US Embassies in Nairobi, Kenya and Dar Es Salaam, Tanzania. Five months after the Kenya bombing and eight months following the Tanzanian bombing, a team from Landstuhl Regional Medical Center, Germany, was tasked to provide ENT/Audiology support to the victims who worked at the embassies. Over 200 individuals were evaluated, and recommendations were made for further follow-up and rehabilitation. Despite the severity of the blast, fewer traumatic losses and more chronic losses were encountered than expected. Data will be presented, as well as an overview on blast injury. The nature of the mission, the logistical support of such a mission, and lessons learned will also be discussed.
The CMU/Vanderbilt University Distance-Learning Based Au.D. Degree Program for Government Audiologists
Brian E. Walden, Ph.D., Executive Secretary,
Joint Services/Department of Veterans Affairs Au.D. Steering Committee.
Daniel F. Konkle, Ph.D., Director,
Distance-Learning Doctor of Audiology (Au.D.) Degree Program,
Central Michigan University
A distance-learning based Au.D. degree program for government audiologists is available through Central Michigan University’s College of Extended Learning. The development and characteristics of this program will be described, and government participants will discuss their experiences in the program. Ample time will be provided for questions and answers.
Audiologic Management of Patients with Methisillin-Resistant Staphylococcus aureus (MRSA)
Sharon Beamer, Army Audiology and Speech Center,
Walter Reed Army Medical Center (WRAMC), Washington, D.C.
LCDR Frank Weaver, USPHS, Indian Health Service (IHS),
National Navajo Medical Center, Shiprock, New Mexico
Antibiotic-resistant bacteria such as Methisillin-Resistant Staphylococcus aureus (MRSA) is a growing public health issue in the United States and abroad. MRSA infections are increasingly common in hospitals and among patients with depressed immune systems. The percentage of nosocomial MRSA increased from 2% in 1974 to approximately 50% in 1997 (Lowy, F. 1998). Factors such as recent hospitalization or surgery, residence in a nursing home or intravenous drug use place the patient at risk for MRSA. MRSA, however, is also emerging as a community-acquired pathogen among patients without depressed immune systems or established risk factors.
Since the staphylococcus bacteria can produce a variety of diseases ranging from skin lesions to pneumonia, patients with MRSA are often treated with ototoxic medications and may present with vestibular or otologic symptoms. In addition, MRSA may be present in patients with otitis externa that has been recalcitrant to medical intervention. This presentation will review the issues and challenges faced in the audiologic mangement of patients with MRSA. Case studies of patients with MRSA will be used to illustrate the issues.
Recent Advances in Understanding and Alleviating Sensorineural Hearing Loss
Richard Hallworth, Ph.D.
Department of Otolaryngology-Head and Neck Surgery
University of Texas Health Science Center at San Antonio
San Antonio TX 78284
Sensorineural hearing loss is the most intractable of hearing loss types because its fundamental cause is hair cell death. Spectacular advances have recently been made in our understanding of hair cells physiology and molecular biology that offer new hope of alleviating sensorineural hearing loss. In this talk, I will highlight four areas of very promising research. First, about 40 genes for hereditary hearing loss have now been described, 10 of these in 1998-1999 alone. I will discuss four of these genes and show how identification of their gene products have taught us much about progressive sensorineural hearing loss and, by inference, about traumatic hearing loss. Second, a new method of introducing genes selectively into hair cells by viral transfection has been described. The method could be used to “repair” defective genes in hereditary hearing loss or to turn off the response to acoustic trauma. Third, I will discuss the promotion of hair cell regeneration by targeted blockade of the gene p27Kip1. Finally, I will describe new work that shows that the ototoxicant quinine has effects on hair cells as well as the central nervous system.
Life and Death in the Cochlea
Nancy G. Hight1
Sandra L. McFadden1
and Richard Kopke2
(1) Center for Hearing & Deafness
State University of New York at Buffalo
215 Parker Hall
Buffalo, New York, 14214
(2) Naval Medical Center
Neurotology/Skull Base Surgery
34800 Bob Wilson Drive
San Diego, CA
The military has been very successful in developing hearing conservation programs that are built upon education of personal protection devices. Unfortunately, military personnel can be found in situations where hearing protection devices are impartial; consequently, alternative protection strategies need to be developed. Our approach to this problem begins with an evaluation of the processes of cell death associated with noise exposure and understanding the ear’s natural defense system. This presentation will review the effects of noise - especially, impulse noise - on the cochlea. We are now learning that immediately after an exposure cochlear lesions are relatively small and expand, involving additional hair cells over 2 to 15 days after an exposure. The mode of cell death includes both necrosis and apoptosis. The stress of a noise exposure increases the concentration of endogenous antioxidants. The ear can be made more resistant to noise by either prophylactic noise exposures that enhance the natural defense system or by increasing cochlear antioxidants by direct application to the cochlea. Basic science information on the effects of noise will serve as the foundation for the development of clinical procedures to protect and rescue the ear by using drugs that prevent the initial attack on cochlear hair cells or block their death after an exposure.
(Research supported by NIH/NIDCD #DC0360001A1)