Surveys estimate that noise-induced hearing loss (NIHL) affects 10 to 15 million people in the United States. The excessive motion caused by loud sound can cause a plethora of damage in the delicate cochlear sensory cells and the nearby supporting pillar cells of the hearing organ. Noise can rupture the tips of the cells, fuse sensory cells together, damage the area that the cells transmit signals through and even change the vascular pathways inside the organ. The vulnerability of the inner ear is dependent upon several factors, such as smoking, hypertension, lipid levels, age, gender, eye color and other genetic factors.
Noise damage usually causes difficulty hearing particular pitches of sound. Compounding this issue is the common side effect of recruitment. Recruitment occurs as sound is increased above what you barely hear and you suddenly feel that it is extremely loud. This exaggerated response to sound levels, or recruitment, significantly compromises the ability to understand speech, especially in noise. Noise-induced hearing loss may also cause tinnitus, a ringing, roaring or cricket like sound in your ears or head.
Causes of Noise-Induced Hearing Loss
There are two types of noise-induced hearing loss: gradual and traumatic. Many people think that shooting a gun once or twice as a child does not count as having been exposed to noise. However, the long-term side effect of even one significant occurrence of noise may cause permanent, irreversible damage. Recreational and work related hearing loss is common. The sound from a shop vac, leaf blower, hair dryer, skill saw, chainsaw or any motorized equipment are just a few culprits of hearing loss.
Musicians should protect their hearing, as should the music lover! It only takes one loud concert without hearing protection to permanently change your ability to hear. If you want to see what the inside of the hearing organ looks like after noise exposure, do a web search for “images of noise damage in cochlea.” Those pictures are worth a thousand words! Show them to your kids!
Prevention
To prevent hearing loss, you must be proactive and use hearing protection each time you are exposed to noise. Cotton in your ears will not provide any protection. You can wear either earplugs or earmuffs. Standard ear plugs are nice because they are small and do not interfere with glasses. It is important to insert the plug deep into the canal. If you have very small or very large ear canals, earmuffs would be a better choice. Earmuffs should not touch the ear but rather make a seal around the sides of your ears. There are electronic earmuffs that amplify the sounds around you until the loud sound begins. There are also custom electronic in-the-ear hearing protectors. The custom products will require an earmold impression of your ear canals. The impressions are sent to the manufacturer to make custom fit hearing protection. The in-the-ear custom fit technology works well for rifle hunters. Earmuffs get in the way of the gun while shooting. If you are going to invest in electronic technology, do your homework and see what the reviews are prior to making a purchase.
Treatment
The treatment/management of noise-induced hearing loss and tinnitus is twofold: protect what you have and amplify what you need. Auditory rehabilitation and counseling works very well with managing hearing impairment. The sessions will focus on understanding your hearing loss, controlling the environment to facilitate better speech understanding, using visual cues, and the best use of your hearing aids or other assistive technology. You learn the importance of reducing background noise and modifying the main living area to reduce reverberation. Proper lighting in the main living area is important to aid understanding during conversations.
If you have difficulty understanding speech consistently, hearing aids are a great option. The new digital hearing aids are very good at increasing sound in a comfortable manner. The directional microphones and noise cancelling algorithms have brought relief to many hearing impaired people (and their family members).
If you are withdrawing from social activities because of your hearing, then it is time to do something about it. Speak to an audiologist about your hearing options. FBN
By Dr. Karon Lynn, Au.D.