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doi: 10.1097/01.HJ.0000327755.09592.77
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It's not often that the subject of an article in HJ is also covered by Newsday, TheChicago Tribune, The Santa Fe New Mexican, TheDallas News, and over 100 other newspapers in the U.S. and in countries around the world, including India, New Zealand, and the United Arab Emirates. Nor do many of our authors get invited to appear on two national news programs, as did Levi Reiter, PhD, head of the audiology program at Hofstra University in Hempstead, NY. However, Reiter's case study (see his “Kiss of Deaf” article on page 32), of a woman in Hicksville, NY, who suffered hearing loss, tinnitus, and other problems as the result of a kiss on the ear from her 4-year-old daughter, had a certain piquancy that proved irresistible to the mainstream media.

Levi Reiter

While the damaging kiss occurred in 2006, it was not until this spring when Hofstra sent out a press release about Reiter's involvement in the case that the press caught wind of it. The first story ran June 8 in Newsday, which covers Long Island where Hofstra and Hicksville are located. The provocative headline, “Girl gives mother a ‘kiss of deaf’: Experts puzzle over peck that packed an auditory punch,” obviously caught people's attention, as did the reporter Delthia Ricks's compelling lead: “This is a story about a kiss—an expression of love so potent from a little girl that it caused her mother to lose her hearing and gain a place in medical history.”

Ricks interviewed Reiter, whom the victim had sought out for help about a year after the kiss. While other professionals she had consulted were puzzled by her case, Reiter, who lives in Brooklyn and has a private practice there, theorized (as he explains in his article) that it was not the sound of the little girl's kiss, but the suction that resulted in a disruption of the stapedial musculature of her mom's left ear.

The day after the article appeared, Reiter, an observant Chassidic Jew, was walking back from Shavuot services at his temple when he was surprised to find a CBS-TV news truck parked outside his home surrounded by a group of his neighbors. Because of the holiday he couldn't give an interview on the spot, but he agreed to appear on a New York City CBS news program, where an interview with him about the “Kiss of Deaf” was featured twice on June 11. One thing led to another, and the next day Reiter was a guest on a live news show on MSNBC, where he used the model of an ear to show anchorwoman Contessa Brewer how the mother's ear was damaged.

On his way back home to Brooklyn in an NBC limo, Reiter got a call on his cell phone from CBS, which wanted to book him on its nationally broadcast Early Show. The driver obligingly turned around and drove him to the CBS studio, where he waited for the audiologist as he was interviewed by Tracy Smith.

Not surprisingly, the “Kiss of Deaf” has also received attention from the professional media, including Audiology Online, whose staff writer Carolyn Smaka coined a name for the syndrome: Reiter's Ear Kiss Syndrome or REKS, an acronym that Reiter says accurately describes what a misdirected kiss can do to the ear.

Apart from making him something of a celebrity, all the media attention on this case has helped Reiter in his research into the dangers of ear-kissing. While very little had been written about the topic in the past, since this case hit the news, the Hofstra professor has heard from more than 10 people from as far away as Italy who told him they suffered intense pain and permanent damage after being vigorously kissed on the ear. Even if their condition can't be fixed, some of those who have contacted Reiter are grateful simply to have their situation acknowledged and taken seriously. In some cases, they said, physicians have dismissed their accounts of being hurt by a kiss.

The media coverage has also enabled Reiter to get the message out to the public to be careful with their loved ones. When Tracy Smith of CBS asked him how people could avoid this kind of incident while kissing, he advised, “Avoid that little hole. It's a big ear! Concentrate on a different part.”

Not his first time in the spotlight

Levi Reiter is no stranger to public attention. A few years ago, he wrote Say Whut, a rap promoting audiology, which he performed at freshman orientation and on the first day of classes at Hofstra. The composition included such lyrics as

“Ya see,

Hearin good is critical

God knows dat I'm not jokin

If you're deaf and get no help

Den no word will be spoken”

The rap came to the attention of the American Speech-Language-Hearing Association, which began using it to recruit undergraduates into audiology. Meanwhile, Reiter, who is very likely the only full-bearded, yarmulke-wearing grandfather of 19 who is also a rapper, recorded Say Whut with full instrumental backup and made it available for download from his web site (


Thanks to strong community advocacy efforts on behalf of hearing-impaired people, Gerald R. Ford International Airport in Grand Rapids, MI, has become the first airport in the U.S. to install a hearing loop system. This system, which is available in all airline gate areas, enables people with telecoil-equipped hearing devices to have PA system announcements transmitted directly to their hearing aids.

David Myers, PhD, a psychology professor at Hope College in nearby Holland, MI, and a dedicated advocate for his fellow hard-of-hearing people, stated, “This is a pioneering and model installation, the only airport in America to broadcast announcements throughout its concourses via people's own hearing aids. It puts the airport loudspeakers right in our ears!” He added, “West Michigan has become the leading edge of a national movement to provide hearing aid-compatible assistive listening to people with hearing loss.” Currently, some 250 places of worship and public facilities in the area have loop systems.

Vic Krause, a former president of the Grand Rapids chapter of the Hearing Loss Association of America (HLAA), and Myers made a presentation to the Kent County Aeronautics Board in December 2006 arguing the case for looping the airport, which is the second busiest in Michigan, serving 2 million people a year.

In New York taxis, too

In another transportation-related development, a roll-out of induction loops in New York City taxis is under way. It began with installation of loops in six taxis with more to come in the near future. The New York City Taxi & Limousine Commission launched this pilot program in response to advocacy efforts by the Hearing Access Program Consortium, which is chaired by Janice Schacter and represents the Alexander Graham Bell Association for the Deaf and Hard of Hearing, the League for the Hard of Hearing, and HLAA.


Smoking and excess weight (and occupational noise exposure) are risk factors for age-related hearing loss, according to a presentation made in June at the International Society of Audiology Congress in Hong Kong and published online by Journal of the Association for Research in Otolaryngology (JARO). On the bright side, the study led by Erik Fransen of the University of Antwerp, in Belgium, found that moderate alcohol consumption (at least one drink a week) had a protective effect on hearing.

The study involved nine audiological centers in seven countries in Europe and 4083 participants between 53 and 67 years of age. Participants filled out questionnaires on their exposure to potential environmental risk factors and their medical history. They also had their hearing tested and, after their pure-tone averages were adjusted for age and sex, the researchers analyzed the data in search of risk factors for hearing loss.

The data showed that smoking significantly increased hearing loss in frequencies over 1000 Hz, with the degree of damage being dose-dependent. The effect of smoking on hearing remained significant even after cardiovascular disease was factored in.

A high body mass index (BMI) also correlated with increased incidence of hearing loss across the frequency range tested. On the other hand, taller people were found to have better hearing on average, with a more pronounced effect at low frequencies (<2000 Hz). And moderate alcohol consumption was inversely correlated with hearing loss in both high and low frequencies.

The new research also confirms many earlier findings that exposure to noise contributes to hearing loss in later life. Exposure to excessive noise is the major avoidable cause of permanent hearing loss worldwide, according to the World Health Organization.

In their article, Fransen and colleagues concluded, “Hearing loss has always been considered an inevitable part of aging, but more and more studies seem to indicate this is not necessarily true. Apparently a healthy lifestyle can be beneficial for hearing conservation at higher ages.”


Another factor that correlates with hearing loss was identified in a study funded by the National Institutes of Health (NIH). The study, published online on June 17 in the Annals of Internal Medicine, reported that hearing loss is about twice as common in adults with diabetes as in those who do not have the disease.

While a link between diabetes and hearing loss has been suspected for decades, this study is the first to show that a relationship exists even after such factors known to affect hearing as age, income level, noise exposure, and the use of certain medications were accounted for.

The researchers discovered the higher rate of hearing loss in persons with diabetes after analyzing data from hearing tests administered from 1999 to 2004 to participants in the National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC).

The link between diabetes and hearing loss was evident across all frequencies, with a stronger association in the high-frequency range. For high-frequency sounds, mild or greater hearing impairment in the worse ear was found in 54% of 399 adults with diabetes compared to 32% of 4741 adults who did not have the disease. In the low- or mid-frequencies, hearing loss was found in the worse ear of about 21% of adults with diabetes and about 9% of those without.

Adults with pre-diabetes, whose blood glucose is higher than normal but not high enough for a diabetes diagnosis, had a 30% higher rate of hearing loss compared to those with normal blood sugar.

Catherine Cowie, PhD, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the senior author, advised, “Hearing loss may be an under-recognized complication of diabetes,” and she suggested that people with diabetes consider having their hearing tested.

The researchers suggested that diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear. Autopsy studies of diabetes patients have shown evidence of such damage.

Copyright © 2008 Wolters Kluwer Health, Inc. All rights reserved.