On the Mark: Dr. Chhayakanta Patro

President Mark Ginsberg welcomes TU faculty member Dr. Chhayakanta Patro, an expert in auditory science whose research focuses on noise exposure, cochlear implants and childhood hearing health. 

Transcript

0:00

You're listening to a Towson University podcast. Welcome to On the Mark, where we have candid conversations about meaningful and consequential work happening here at Towson University. I'm Mark Ginsberg. It's my honor to serve as President of Towson University, located, of course, in Towson, Maryland. And on this podcast, we're introducing you to members of our university community who are engaged in high impact teaching, research, and student success practices. Joining me today is Doctor Chhayakant Patro, an expert in auditory science whose research focuses on noise exposure, cochlear implants, childhood health and hearing, and many other issues in the audiology space. We'll be talking about many of these things and others on this conversation. Doctor Patro, who I'm delighted is with me today, is dedicated to improving hearing health and advancing auditory protections. We're fortunate that he's taking time to be with us today to discuss these important topics. And I should say to that Doctor Patro is an assistant professor in our Department of Audiology. He joined our faculty at Towson University in the fall of 2021, in our College of Health Professions, in our Department of Speech, Language Pathology and Audiology. His doctoral degree is from the University of Memphis, awarded in 2017 after receiving masters and bachelor's degrees in his native home country of India. Having worked at TU for three years. Doctor Patro, it's great to have you with us Chhayakant. I really look forward to this conversation, and I know that there are many areas that you study, and many areas that you research, and perhaps even more importantly, the impact of your research has really practical applications for people around the country with different forms of hearing loss. I wonder if we could start with one of those areas, and to just ask the general question, you can help us understand otitis media. The first thing is what is it? Well, otitis media refers to infection of the ear, middle ear in particular. The ear has three parts, outer ear and middle ear and inner ear. Otitis media refers to the infection of the middle ear. Media is middle ear and otitis is the infection of the ear. So, well, otitis media is prevalent among children. 90% of the children by the age of five years, they get at least a single episode of otitis media 90%, 90% that’s almost all children. All children. So when a child has a well, we might call as a parent, having children myself, an ear infection. What they may be experiencing is otitis media. Yes, yes. Yeah. Yeah. I mean, younger the kids are they are more prone to, infection, various viral infections, bacterial infections, and that can cause middle ear infections and that can affect their hearing. Some of the, hearing loss caused by otitis media may be temporary. It can resolve as soon as the infection is gone. And some of the, hearing loss caused by otitis media may be permanent. What are some of the symptoms that parents might look for if the child has those kinds of issues. Yeah. In the kids they tend to be more visual. They will ask you to repeat, they find it difficult to follow the conversations in the classroom. They find it difficult to understand the teacher in the classroom. Overall, the developmental milestones, of their speech language development is significantly impaired and delayed. And these are kids where they may have the infection that becomes more chronic, more chronic and recurrent. That is happening regularly, repeatedly, and more severe. You know, a lot of people in the reading area, the, folks who study reading. Right, oftentimes talk about the importance to learn phonics, and phonics is also based in large part about hearing. Yes. Hearing sounds, Yeah. Differentiating sounds. Yes. So I'm wondering too and hadn’t thought about this until right now that otitis media may actually have an impact on development of reading as well. Sure, sure. Yes. If you know overall cognitive development, reading skills, and speech language development in general, they, cannot hear the sounds properly, so they will not learn to differentiate between sounds. So that takes, longer for them to acquire new sounds and understand new sounds and so on. And imagining is there are different types of hearing loss in children. Right. Talk a little bit about the different kinds of hearing losses that that children might experience. Sure. Well, the hearing loss caused, may be caused by different, all different kinds of issues, but broadly speaking, there are three different, hearing loss categories. Conductive hearing loss, sensorineural hearing loss and mixed hearing loss. So conductive hearing loss is caused by otitis media, middle ear infections., any other disease or the condition affecting outer ear or the middle ear. Sensorineural hearing loss is permanent. It is not reversible in that it's not reversible. Yeah. In those cases they have to use hearing aids or cochlear implants. And mixed hearing loss is the combination of both. They have an outer ear or middle ear pathology. And on top of that they have a permanent sensorineural hearing loss. What are the prevalence of these kinds of disorders in children, I would say about 1%. 1%. Yes. Yeah. So, yes, most children I would guess would experience otitis media at some point during their childhood. Well, otitis media is very prevalent, very common. That doesn't necessarily cause a permanent hearing loss, but most children will have some kind of hearing or ear infection over time. Yes, maybe 1% of children would develop something that's more permanent, more severe. They need to go to see an audiologist and use hearing aids and so on. So that's a pretty large number when you think about yes, yes. So let's take the case of a child who has been identified as having hearing loss. Right? Sensory, sensory, acute, how did you call it, sensorineural, sensorineural hearing loss Right. Which is potentially more permanent and even more significant. Right. Temporary loss. Yes. What are some of the interventions and treatments that that are used? To assist these children. Well, it depends on the degree of hearing loss. Right. If, the hearing loss is mild to moderate or moderately severe, then typically they go for hearing aids. So hearing aids will amplify the sounds and it will kind of compensate for the hearing loss. And they'll be able to hear appropriately. However, if the hearing loss is more severe or profound, they have to go for cochlear implants. And we'll talk about cochlear implants in, detail. But there are surgical devices that are, meant for restoring a sense of hearing. So I was going to ask you, you're you're an audiologist, right, and we have a magnificent training program here at Towson University. Yes. Training audiologists. Yes. At multiple levels of the graduate level. Yes. When is it that a person should actually seek the consultation of a professional in the field, a person like yourself? Sure, sure. Well, the first sign is that you do all right when you try to communicate in quiet listening environments, when you go to a crowded restaurant or trying to understand speech in noisy backgrounds, that's when you'll start to struggle to understand speech. Those are one of the earliest signs that you should see an audiologist, in order to understand whether there is something wrong with the hearing on that. Well, let's talk about cochlear implants. Those are, it seems to me, not just reserved for, but specifically are helpful for those whose hearing loss is quite profound. Yeah, cochlear implants are meant for individuals who have severe to profound hearing loss. They are surgically placed inside the inner ear. The surgery now is getting more and more sophisticated individuals with severe to profound hearing loss, are getting a lot of benefit from cochlear implants. But it has not at the stage where we can, tell that, you know, we can, restore normal hearing. They continue to struggle to understand music. Perception of music is still a challenge. People with the implants. Yeah, yeah. Music has not been a priority for the developers of cochlear implant. They wanted to, you know, if the priority was in order to restore verbal mode of communication, speech understanding and so on. So music perception continues to remain a challenge. Speech understanding and background noise continues to remain a challenge. And my dissertation focused on addressing this individual variability. A lot of individuals with cochlear implants do extremely well. Their speech understanding scores are close to 100%, but a lot of individuals who are in the Who suffer from the flow effect that their scores are close to 0%. Just imagine the device is the same. The surgeon implanting the implant is the same. Clinician programing the device is the same, but one patient is getting a lot of benefit from cochlear implant, and the other person is not getting any benefit. So in those cases, what are the factors that are contributing to this individual variability or individual? And then it's is very interested in this kind of questions. And so, trying to identify those issues remains the focus of my research. Great. As I was trying to do a little bit of research on cochlear I found a couple of articles of people who had them, who had some comments. One person wrote, I'm quoting this person“getting a cochlear implant was the best decision I ever made. Yes, it gave me access to a world of sound I never knew existed.” Yes. Opened up a whole new door. Opened up a door to a world they hadn’t known. Yes, yes. So, yeah, our conversational level is around 60 to 70dB, and they have severe to profound hearing loss means are hearing sensitivity is around 90 to 100dB of, hearing loss. So they will not be able to follow a conversation. You have to shout in order for them to hear. So using cochlear implants, for them is basically restoring a sense of hearing. Yeah. They have not heard the sounds for a long time. I can imagine when somebody first hear sound to the revelation that that must be the sense of, joy. Really the sense of difference. Yes. It must be truly remarkable. Yeah. The that was one of the reasons why I got interested in this area. I was watching YouTube videos and, there are so many YouTube videos on, getting the experience of sound for the first time, the newborn infants, and they start smiling as soon as you activate the implant. Yeah. I was going to ask you how it is that you became so interested and yes, decided to devote your career and your life to this work. Yeah, those expressions are priceless. And I wanted to do something in that, that area in order to improve the performance in individuals with cochlear implants. Cochlear implants also have some controversy as I understand it. As I mentioned, it requires a lot of refinement. The signal transduced through cochlear implant is requires, you know, it's not that clear yet. There is a lot of, research going on, to improve the signal processing, improve the surgical approach in order to improve speech understanding. A deaf educator wrote an article too“that, a cochlear implant is not a cure. It's a choice.” Yeah.“..and that choice should be made with a full understanding of of deaf culture and deaf identity.” Right. And so I also understood that there there's not a one size fits all perspective on a cochlear implant. Right, right. Some of the deaf community feel it might be taking away from the culture and the sense of self and identity of the deaf. Yes. People with deafness may have. Yes. How does that fit in all this? Well. Because that’s a piece of the puzzle. Yeah. I tell all of my, patients that, you know, the candidacy of cochlear implant is should be driven by the patient, himself or herself. First of all, you should be able to take care of the device, and you should be able to use the device. And the choice is, after all, yours. If you are willing to adopt the verbal mode of communication and use one to communicate, and understand speech, then you should be choosing cochlear implants. If you want to go another route, the design language, then you don't have to go for a cochlear implant. So as an audiologist you're not making a value judgment, You're providing patients with options that provide different opportunities. Right. As a health professional. Yeah. Yes, yes. Yeah. Let's talk a little bit. We're talking a lot about hearing loss in children. But lets talk a little about adults sure adolescents and adults. Sure. One of my colleagues having been for many, many years of my career at Johns Hopkins, one of my colleagues there once wrote that hearing loss is not just a problem of the ears, but a problem of the brain. Yeah, and the brain doesn't age gracefully as the rest of the body. So it suggested to me that hearing loss has a, developmental if you will. Yes. Many people do experience hearing loss. Yes.. And. Well, I'm sure it came from Johns Hopkins. They are running a huge, clinical trial on age related hearing loss. The entire auditory system degenerates as we get older, and the, neurons in the brain also degenerate with aging. So, ear is responsible for sending the sound to the brain. The brain has to ultimately interpret the sound it is receiving from the ear. So in order for you to understand speech, you have to understand, what the spoken message is. That's why, you know, ear and the brain work together to accomplish speech understanding. One of the people at the NIDCD the National Institute on Deafness and Communication Disorders had mentioned that hearing loss is often seen as a normal part of aging, but it can have a significant impact on quality of life. And that person, professional audiologist like yourself, said it's important to address it rather than to ignore it. Yes, how If people are experiencing adults and most people, as we say, it's a normal part of aging, probably most people will experience some decline in their ability to hear, yeah, what's the best way to go about addressing that? And how can they access services from a person like yourself? Early identification. You know, as soon as, as I mentioned you, you're struggling to understand speech and background noise. You are asking people to repeat themselves, and you are turning the volume of the TV, to be louder. That is when you should consult an audiologist. And hearing loss is the only modifiable, aspect of aging. You cannot control the degeneration of the brain, but, by providing amplification, you are ensuring that the brain, the brain is getting appropriate input from the ear. So there are studies that have suggested that, hearing, hearing aids can decelerate the rate of change in the cognitive mechanism. Wow yeah. That's that's really profound. Yeah. So, treating hearing loss and for folks who are listening to our podcast today who are maybe a little bit older, maybe close to my age, then they should not be reticent or, they shouldn't avoid going to try to address this actually could help in many ways. Yes, yes. Some data. I think this suggests that hearing loss has an impact on quality of life. Quality of life. Yes, yes, yes, overall quality of life. And there was a study suggested that it can, reduce the chances of getting cognitive decline. And you can, as I mentioned, you can slow down the process of cognitive decline. Some, I think, have suggested to that with hearing loss, it's easy to become socially isolated. Yeah. To not engage as much of people because it's more difficult to do so. Yes. You know, a lot of older adults, would like to avoid social situations because, well, I would like to avoid that situation where I don't understand anyone speaking. In those cases, using hearing aids can be a lot of help. Yeah. You know, I'm a psychologist by training your an audiologist, but I think in my domain, it's not uncommon for people who experience hearing loss to, to actually experience some bouts of depression or anxiety or difficulties. Yes, as a result of difficulties communicating without making a value judgment. True. But then that impact on relationships, Yes, yes. As I mentioned, if, they are not getting appropriate input through the ear. You know, there is a lot of, structural and functional changes in the brain, right? Yes. And then you would suggest, I would think as an audiologist, that for people who might be experiencing or feeling in their own behavior or their own experiences, that hearing loss is part of what is happening for them to not be at all reticent to contact an audiologist and to be assessed and to be able to consider what the alternative’s for treatment might be. Sure, sure. Yeah, yeah, they should consult the audiologist as soon as possible. And if if they feel that they have a hearing loss, definitely they have a hearing loss. And we have here at Towson University, for those who are here in our region, we have a clinic. We have a clinic. On campus. with the doctoral program Yes, yes, we have both fully credentialed professionals and professionals in training. Yes. Who are here to to do those kinds of assessments. Yes. We have highly skilled supervisors, world renowned researchers, in our department and we are here to help. And it’s a tremendous program and for those people who want to do that, they can contact the department. You may tell them how to do that. Sure, sure they can. Contact the Hearing and Balance Center at Towson University. The Hearing and Balance center here at Towson University. Yes. Let's talk about one more subject. We have a couple minutes left. And, I'm curious about psycho acoustics. So another area you study, so many interesting areas, but from hearing loss in children to the impact of cochlear implants, the decline in hearing and aging. But one of the things that I found really fascinating is, is psycho acoustics, right. What is psycho acoustics? Well, understanding perception and processing of various, aspect, of sounds such as overall temporal variations in the sound, the overall loudness, changes in the sound, various changes in the spectral composition of the sound. So these are like the basic aspects of auditory processing. And for those who are familiar with psycho acoustics, just the general concept, we know too that there's this decline, that the loud noise, I guess, is that part of psycho acoustics loud noise has an impact. Is that right? Well, psycho acoustics is a very broad area, but, yeah, indeed. Exposure to loud noise for a long time can, impair the psycho acoustical abilities. So talk a little bit about this, this is an area that I just find fascinating because there's so many people in our society who are exposed to noise, right? Whether you're in at an Oriole’s game and you're hearing the loud crowd, or whether you're in a music venue and the sound is at a high level, what's the impact of all of that? Both in the immediate sense, but also over time. Sure. So there are two dimensions to noise induced hearing loss, how loud the sounds are and how long you are spending, in that loud environment. So louder the sounds are you can afford to spend a shorter amount of time without getting a hearing loss. So, about 90 DB you can afford to spend eight hours, eight hours, eight hours at 90dB. 90dB. Yeah, yeah. How loud? Just to give us a sense of how loud is 90dB? Let me put it this way. A lot of, individuals who listen to music to their headphones, they listen to music at 90 DB. That's kind of a normal. Yeah. Preferred loudness level for listening to music is around 90 DB. So don't listen to music at louder volumes. So, yeah, getting noise induced hearing loss, as I mentioned in the beginning, is one of the prevalent causes of, permanent hearing loss. So one of the areas I know that you study is musicians. Yes. We all love music. Music is such a wonderful thing for all of us. Yes. But musicians might be at a certain risk. Yes, yes. Well, musicians, you know, noise induced hearing loss, is, prevalent among a lot of professions, certain frequencies are more damaging than the others. But mostly I would say the level of the noise and the duration of the noise that decides the, whether or not you are going to get hearing loss. But yeah, but mostly, low frequency sounds are more damaging, such as the drums and so on, than, say, a flute, but then they're less damaging to the hearing. Flute would be less damaging than a bass drum. Yes, Yeah. What about some of the other professions that might be most at risk for, these kinds of hearing related impairments? Industry workers, you know. Yes, in factories that are very noisy and, they have guidelines. They have, regulations that that protects them. They are not allowed to spend a certain amount of time in the factories. And they use protection devices. But unfortunately, musicians, are not aware of the risk of hearing loss. Wow, yes, Chhayakant we've talked about many things. It's been really a wide ranging and fascinating conversation. I think you're almost making me want to become an audiologist. Because the work that you do, it seems to me, really does have such a profound impact on the life experience that people have. Yes. It's so important to our life experience. Absolutely. But also those who who are unable to hear hearing loss, you're giving me great optimism that there are ways to go about helping people to develop the opportunity to to hear. Yes, yes, that's correct. Yeah. Excited to be in this profession. And my goal is to help individuals who have hearing loss and improve their quality of life,. Well Chhayakant Patro, Assistant Professor of Audiology here at Towson University, Doctor Patro, thank you so much for being with me. On On the Mark. This has been a fascinating conversation and I know that people listening will enjoy it and learn and have an opportunity to have a greater understanding about what hearing loss is, as well as some of the many very important topics that you're researching. Well, thank you so much for having me. And thank you for listening to On the Mark, a podcast here at Towson University. This is Mark Ginsburg, president of Towson University saying, thank you for joining me. Doctor Patro you thank you for being with me. And thank you for joining me those who are listening, thank you. Thanks for having me. Thank you for listening to on the Mark. If you like what you've heard, please give us a follow or leave a review. It helps to ensure that we can keep bringing you more candid conversations about the consequential work of higher education. If you have feedback about our podcast, I'd welcome hearing from you. Please feel free to send me a message at. onthemark@towson.edu. Founded in 1866, Towson University is a top ranked comprehensive public research university, recognized as Maryland's number one public institution by The Wall Street Journal. As Greater Baltimore's largest university TU, proudly serves as an engine of opportunity for nearly 20,000 students, the state of Maryland and beyond. Explore more than 190 top ranked undergraduate and graduate degree programs and make our momentum yours at towson.edu.