Noise-induced hearing loss (NIHL) typically manifests as elevated hearing thresholds (i.e. less sensitivity or muting). Noise exposure is the cause of approximately half of all cases of hearing loss, causing some degree of problems in 5% of the population globally.[50] The majority of hearing loss is not due to age, but due to noise exposure.[51] Various governmental, industry and standards organizations set noise standards.[52] Many people are unaware of the presence of environmental sound at damaging levels, or of the level at which sound becomes harmful. Common sources of damaging noise levels include car stereos, children's toys, motor vehicles, crowds, lawn and maintenance equipment, power tools, gun use, musical instruments, and even hair dryers. Noise damage is cumulative; all sources of damage must be considered to assess risk. In the US, 12.5% of children aged 6–19 years have permanent hearing damage from excessive noise exposure.[53] The World Health Organization estimates that half of those between 12 and 35 are at risk from using personal audio devices that are too loud.[11] Hearing loss in adolescents may be caused by loud noise from toys, music by headphones, and concerts or events.[54]
Disorders responsible for hearing loss include auditory neuropathy,[57][58] Down syndrome,[59] Charcot–Marie–Tooth disease variant 1E,[60] autoimmune disease, multiple sclerosis, meningitis, cholesteatoma, otosclerosis, perilymph fistula, Ménière's disease, recurring ear infections, strokes, superior semicircular canal dehiscence, Pierre Robin, Treacher-Collins, Retinitis Pigmentosa, Pedreds, and Turners syndrome, syphilis, vestibular schwannoma, and viral infections such as measles, mumps, congenital rubella (also called German measles) syndrome, several varieties of herpes viruses,[61] HIV/AIDS,[62] and West Nile virus.
A conductive hearing loss reduces the ability to hear at a normal hearing level. The symptoms of a conductive hearing loss are therefore partial or full loss of hearing. The hearing loss can be in one ear or both ears. If a conductive hearing loss occurs suddenly or the hearing is reduced more and more over a short time, you should see a doctor to get your ears examined.
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The use of sound therapy by either hearing aids or tinnitus maskers helps the brain ignore the specific tinnitus frequency. Although these methods are poorly supported by evidence, there are no negative effects.[3][86][87] There are several approaches for tinnitus sound therapy. The first is sound modification to compensate for the individual's hearing loss. The second is a signal spectrum notching to eliminate energy close to the tinnitus frequency.[88][89] There is some tentative evidence supporting tinnitus retraining therapy, which is aimed at reducing tinnitus-related neuronal activity.[3][90][89] There are preliminary data on an alternative tinnitus treatment using mobile applications, including various methods: masking, sound therapy, relaxing exercises and other.[91][92] These applications can work as a separate device or as a hearing aid control system.[93]
Assessment of psychological processes related to tinnitus involves measurement of tinnitus severity and distress (i.e., nature and extent of tinnitus-related problems), measured subjectively by validated self-report tinnitus questionnaires.[16] These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning.[63][64][65] A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual.[66] Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness.[67] Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures.[68]
Ramirez et al (14) aimed to explore the anatomical and physiological connections in TMD patients with secondary aural symptoms and the central and peripheral mechanisms involved. The authors carried out an extensive peer-reviewed literature search, using data from (12), 436 patients in 49 papers, to analyse aural symptoms (otalgia, tinnitus, vertigo, subjective hearing loss and aural fullness) exacerbated by dysfunctional mouth and jaw dynamics. They proposed a range of muscular, bone communication and neural scenarios to explain this relationship, placing emphasis on tensor tympani muscle involvement and trigeminal nerve dysfunction.
People with extreme hearing loss may communicate through sign languages. Sign languages convey meaning through manual communication and body language instead of acoustically conveyed sound patterns. This involves the simultaneous combination of hand shapes, orientation and movement of the hands, arms or body, and facial expressions to express a speaker's thoughts. "Sign languages are based on the idea that vision is the most useful tool a deaf person has to communicate and receive information".[113]

Noise exposure is the most significant risk factor for noise-induced hearing loss that can be prevented. Different programs exist for specific populations such as school-age children, adolescents and workers.[87] Education regarding noise exposure increases the use of hearing protectors.[88] The use of antioxidants is being studied for the prevention of noise-induced hearing loss, particularly for scenarios in which noise exposure cannot be reduced, such as during military operations.[89]

Watery or serous discharge may be due to local inflammation and sometimes due to fungal infections. More purulent discharge, which is often yellow to brown with an offensive odor, may arise with bacterial infections. A more sticky, mucoid discharge is seen with a CSF leak and perforated eardrum. Blood-tinged discharge may be seen in more severe infections and injury.

Boosting your immune system may also stop ringing in your ears. This will help to protect you from infections and diseases that may increase the level of unwanted sound. Also, an improvement in your health can mean an improvement in your tinnitus. Have a healthy lifestyle, which especially includes a healthy diet, proper and regular exercise, and enough sleep at night.
i have just read the comment already posted and like yourself, wish to remain anonymous. Please read up on acoustic shock.. I worked from a company and had exactly the same symptoms, nausea, head pain and dizziness. I eventually got tinnitus six months later and two years on i still have it and it has got louder and my concentration is severely affected. I carried on using a headset and became so ill i had to give up work for a long time. I would never wear a headset again and have had to change careers because of it. If youn want my advice, act now..
Some medications may reversibly affect hearing. These medications are considered ototoxic. This includes loop diuretics such as furosemide and bumetanide, non-steroidal anti-inflammatory drugs (NSAIDs) both over-the-counter (aspirin, ibuprofen, naproxen) as well as prescription (celecoxib, diclofenac, etc.), paracetamol, quinine, and macrolide antibiotics.[63] Others may cause permanent hearing loss.[64] The most important group is the aminoglycosides (main member gentamicin) and platinum based chemotherapeutics such as cisplatin and carboplatin.[65][66]
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Acoustic shock disorder (ASD) is an involuntary response to a sound perceived as traumatic (usually a sudden, unexpected loud sound heard near the ear), which causes a specific and consistent pattern of neurophysiological and psychological symptoms. These include aural pain/fullness, tinnitus, hyperacusis, muffled hearing, vertigo and other unusual symptoms such as numbness or burning sensations around the ear. Typically, people describe acoustic shock as feeling like they have been stabbed or electrocuted in the ear. If symptoms persist, a range of emotional reactions including post traumatic stress disorder, anxiety and depression can develop.
For clients with severe ASD, listening to sounds via headphones during a hearing assessment can be highly threatening and often leads to a significant increase in symptoms, which can persist for days. I consider that frequent audiological testing should not be carried out for these clients. Suprathreshold audiological testing should be limited and loudness discomfort testing, in particular acoustic reflex testing due to the volume levels required, is contraindicated. Some ASD clients have unfortunately had their symptoms permanently exacerbated as a result of a traumatic response to acoustic reflex testing.
When the sound waves reach the inner ear, they travel through the fluids of the cochlea. The cochlea is a snail-shaped structure in the inner ear. In the cochlea, there are nerve cells with thousands of miniature hairs attached to them. These hairs help convert the sound wave vibrations into electrical signals that then travel to your brain. Your brain interprets these electrical signals as sound. Different sound vibrations create different reactions in these tiny hairs, signaling different sounds to your brain.
The first person to talk to is your GP. You may need to be referred to an Ear, Nose and Throat (ENT) Surgeon or an Audiovestibular Physician, who will rule out any medical factors, assess your hearing and probably give you some information about what tinnitus is and how best to manage it. Some hospitals have hearing therapists or specially trained audiologists who are available to offer more support if you need it.
Acoustic shock is an involuntary response to a sound perceived as traumatic (acoustic incident), which causes a specific and consistent pattern of neurophysiological and psychological symptoms (1).  The degree of trauma is influenced by the psychological context of the workplace and/or environment where the acoustic incident exposure occurred. Acoustic shock symptoms are usually temporary, but for some the symptoms can be persistent, escalate and result in a permanent disability. The term acoustic shock disorder (ASD) is used to identify this persistent symptom cluster.

Hearing loss is associated with Alzheimer's disease and dementia. The risk increases with the hearing loss degree. There are several hypotheses including cognitive resources being redistributed to hearing and social isolation from hearing loss having a negative effect.[27] According to preliminary data, hearing aid usage can slow down the decline in cognitive functions.[28]

There can be damage either to the ear, whether the external or middle ear, to the cochlea, or to the brain centers that process the aural information conveyed by the ears. Damage to the middle ear may include fracture and discontinuity of the ossicular chain. Damage to the inner ear (cochlea) may be caused by temporal bone fracture. People who sustain head injury are especially vulnerable to hearing loss or tinnitus, either temporary or permanent.[73][74]
As ASD symptoms are subjective, they are easily misunderstood, misdiagnosed or not believed. An inadequate understanding of the symptoms often exacerbates anxiety, and can lead to confusion and distress. The long term symptoms of severe ASD are consistent with severe hyperacusis, or category 4 according to the Tinnitus Retraining Therapy (TRT) system of classification. Some of the most severe cases of hyperacusis seen in my clinic are those with ASD.
In cases of infection, antibiotics or antifungal medications are an option. Some conditions are amenable to surgical intervention such as middle ear fluid, cholesteatoma, and otosclerosis. If conductive hearing loss is due to head trauma, surgical repair is an option.[5] If absence or deformation of ear structures cannot be corrected, or if the patient declines surgery, hearing aids which amplify sounds are a possible treatment option.[2] Bone conduction hearing aids are useful as these deliver sound directly, through bone, to the cochlea or organ of hearing bypassing the pathology. These can be on a soft or hard headband or can be inserted surgically, a bone anchored hearing aid, of which there are several types. Conventional air conduction hearing aids can also be used.
These symptoms often happen all at the same time and last anything from minutes to hours. It is a very distressing condition because it is so unpredictable. Furthermore, it can take a day or two for the symptoms to completely disappear and sufferers often feel drained after an attack. Additionally, although the condition usually starts in one ear, it can spread to both over time.
Is conductive hearing loss curable? Yes, often. Most cases of conductive hearing loss are temporary and are cured by means of appropriate medical treatment, so it is important to seek immediate medical assistance. Other types of conductive hearing losses can be treated with hearing aids or types of hearing implants. Finally, some types of conductive hearing loss can be treated through surgery.
Pure tone audiometry, a standardized hearing test over a set of frequencies from 250 Hz to 8000 Hz, may be conducted by a medical doctor, audiologist or audiometrist, with the result plotted separately for each ear on an audiogram. The shape of the plot reveals the degree and nature of hearing loss, distinguishing conductive hearing loss from other kinds of hearing loss. A conductive hearing loss is characterized by a difference of at least 15 decibels between the air conduction threshold and bone conduction threshold at the same frequency. On an audiogram, the "x" represents responses in the left ear at each frequency, while the "o" represents responses in right ear at each frequency.
Call centre staff using a telephone headset are vulnerable to ASD because of the increased likelihood of exposure, close to their ear(s), to an acoustic incident randomly transmitted via the telephone line. In the early 1990s, co-inciding with the rapid growth of call centres in Australia, increasing numbers of employees were reporting acoustic shock symptoms (2). A similar pattern was being noticed overseas (3, 4).
A 2017 report by the World Health Organization estimated the costs of unaddressed hearing loss and the cost-effectiveness of interventions, for the health-care sector, for the education sector and as broad societal costs.[103] Globally, the annual cost of unaddressed hearing loss was estimated to be in the range of $750–790 billion international dollars.

Besides research studies seeking to improve hearing, such as the ones listed above, research studies on the deaf have also been carried out in order to understand more about audition. Pijil and Shwarz (2005) conducted their study on the deaf who lost their hearing later in life and, hence, used cochlear implants to hear. They discovered further evidence for rate coding of pitch, a system that codes for information for frequencies by the rate that neurons fire in the auditory system, especially for lower frequencies as they are coded by the frequencies that neurons fire from the basilar membrane in a synchronous manner. Their results showed that the subjects could identify different pitches that were proportional to the frequency stimulated by a single electrode. The lower frequencies were detected when the basilar membrane was stimulated, providing even further evidence for rate coding.[130]


About half of hearing loss globally is preventable through public health measures.[2] Such practices include immunization, proper care around pregnancy, avoiding loud noise, and avoiding certain medications.[2] The World Health Organization recommends that young people limit exposure to loud sounds and the use of personal audio players to an hour a day in an effort to limit exposure to noise.[11] Early identification and support are particularly important in children.[2] For many, hearing aids, sign language, cochlear implants and subtitles are useful.[2] Lip reading is another useful skill some develop.[2] Access to hearing aids, however, is limited in many areas of the world.[2]
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[112][113] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[114] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere's disease or chronic suppurative otitis media.[115] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[116]
Ginkgo biloba does not appear to be effective.[94][108] The American Academy of Otolaryngology recommends against taking melatonin or zinc supplements to relieve symptoms of tinnitus, and reported that evidence for efficacy of many dietary supplements—lipoflavonoids, garlic, homeopathy, traditional Chinese/Korean herbal medicine, honeybee larvae, other various vitamins and minerals—did not exist.[74] A 2016 Cochrane Review also concluded that evidence was not sufficient to support taking zinc supplements to reduce symptoms associated with tinnitus.[109]
An assessment of hyperacusis, a frequent accompaniment of tinnitus,[57] may also be made.[58] The measured parameter is Loudness Discomfort Level (LDL) in dB, the subjective level of acute discomfort at specified frequencies over the frequency range of hearing. This defines a dynamic range between the hearing threshold at that frequency and the loudnes discomfort level. A compressed dynamic range over a particular frequency range is associated with subjectve hyperacusis. Normal hearing threshold is generally defined as 0–20 decibels (dB). Normal loudness discomfort levels are 85–90+ dB, with some authorities citing 100 dB. A dynamic range of 55 dB or less is indicative of hyperacusis.[59][60]
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