University of Pittsburgh

11/08/2024 | Press release | Distributed by Public on 11/08/2024 06:48

This Pitt alumna uses state of the art technology to help patients navigate hearing loss

Audiologist Jennifer Raneri (SHRS '07G, '08G) is ensuring the level of audiological care found in many big cities is available to individuals in a more rural part of Eastern Pennsylvania.

"Hearing is a means of connecting people to the world around them, furthering relationships, fostering those connections and making those more impactful," Raneri, a doctor at Norriton Hearing in Montgomery County, said of her mission to help individuals navigating the complexities of hearing loss.

"When people have hearing loss, they can feel disconnected. That ease of communication can be something we with normal hearing take for granted. But technology can substantially improve quality of life."

Raneri's expertise spans two decades and centers on comprehensive audiological evaluation and incorporating assistive listening technologies like state-of-the-art hearing aids. These tools can help people in more intimate communications and contain features that improve quality of sound and comfort. Raneri's specialty is cochlear implants, which are considered for patients when hearing aids are no longer enough.

Cochlear implants can restore total sensorineural hearing loss. They use a microphone, speech processor, transmitter and receiver, and electrode array to bypass damaged portions of the ear and directly stimulate the auditory nerve so users can discern speech or sounds. Though part of the implant rests behind the wearer's ear, the other part is surgically placed beneath the skin.

"During the fitting process, we tune a large number of parameters in the sound processor and look at how much stimulation we need to provide to each implanted electrode to induce hearing sensation for the recipient. The process is 100% individualized," said Raneri.

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It was at Pitt that she began refining what is now her three-part evaluation process for patients, which includes an assessment of the outer ear and eardrum (otoscopy), a test that analyzes if the eardrum and bones in the middle ear that allow sound to move through are in good condition (tympanometry), and an assessment of the inner ear to determine if hair cells are functioning correctly (otoacoustic emission).

"We're testing all the frequencies, from low bass tones to higher frequency treble tones. It is essentially like turning up a volume control knob to see what level the patient detects the presence of sound for each specific frequency."

Only after these measures does she conduct more traditional hearing tests, such as raising one's hand at the sound of a beep. She also checks patients' ability to understand speech - for example, differentiating between knowing someone is speaking and understanding the words being said - to discern how they function in their environment.

Understanding a person's lifestyle and unique listening needs is essential for finding the right solution. Individuals have approached Raneri for various reasons: to hear their family members better or because of struggles at work or disruptions to an active social life. Some just want to avoid being snuck up on by a pet.

"What's important for one person is not important for another," said Raneri. "Everybody has certain sounds in their environment that are important to them, so taking the time to get to know your patients and their lifestyle can help on the journey to better hearing."

Long-term hearing health requires first understanding what causes hearing loss. While most people assume old age is a leading cause, Raneri said critical factors to consider, regardless of age, include genetics, how well we care for our ears, noise exposure and some medications. She advised approaching hearing loss prevention the way one would diet or exercise.

"I try to emphasize this to patients: the earlier you treat, the better outcomes you will have. Research has shown a strong correlation between cognitive function and hearing loss, so you must stimulate the brain. It is like any other muscle in the body. If you don't use it, you will start to lose it."

Providing care in rural Pennsylvania

Raneri's journey into audiology began during her high school years in Havertown, Pennsylvania, where various volunteer opportunities introduced her to physical, occupational, observational and speech therapies.

"From these experiences, I knew I wanted to work in health care," said Raneri, praising Havertown as the best of both worlds given its proximity to Philadelphia and suburban charm. "I'd recommend that to anyone in high school: If you want to do something, get out there and observe a professional in the field for a day; see what the patients are like."

When she was ready for master's and doctorate degrees, Pitt was Raneri's No. 1 choice.

"I visited many schools in and out of state, but Pittsburgh is a medical metropolis," she said. "The hospitals and professors were so dedicated to our education and there for us seven days a week. I can't think of a better place to receive training."

Despite the appeal of a city setting, Raneri always intended to take her talents home. While her location has led Raneri to exciting site visits and introduced her to clientele in industries like sportscasters and musicians, she also said working in a rural part of the state gives more patients access to care.

That includes patients like Jamie Komancheck, a PGA of America golf professional at a club near Philadelphia, who has worn a hearing aid since age 6. When he needed a new one, he visited several practices before deciding on Norriton.

"I could not be happier with my decision," said Komancheck. "Everyone there has shown me the utmost respect as a patient and person. Nothing I asked for in terms of my needs in a new hearing aid was too much. They made me feel completely comfortable getting the right hearing aid. They truly care about their patients, and that's what will keep me going back."

Photography courtesy of Jennifer Raneri