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.
Speech perception is another aspect of hearing which involves the perceived clarity of a word rather than the intensity of sound made by the word. In humans, this is usually measured with speech discrimination tests, which measure not only the ability to detect sound, but also the ability to understand speech. There are very rare types of hearing loss that affect speech discrimination alone. One example is auditory neuropathy, a variety of hearing loss in which the outer hair cells of the cochlea are intact and functioning, but sound information is not faithfully transmitted by the auditory nerve to the brain.[22]
Very regularly we see people who, after exposure to sudden and loud noise, are bothered by tinnitus, hyperacusis, hearing loss, pressure in the ear, aversion and fear of sounds, depression, etc.. However, a hearing test does not show signs of hearing damage or a noise trauma. This is characteristic of an "Acoustic Shock". Usually the symptoms disappear quite quickly, but when the symptoms persist, they speak of an Acoustic Shock Disorder (ASD).

The inner ear contains a group of interconnected, fluid-filled chambers. The snail-shaped chamber, called the cochlea (KOK-lee-uh), plays a role in hearing. Sound vibrations from the bones of the middle ear are transferred to the fluids of the cochlea. Tiny sensors (hair cells) lining the cochlea convert the vibrations into electrical impulses that are transmitted along the auditory nerve to your brain.


Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.
Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. For many, it's a ringing sound, while for others, it's whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating.
Psychological research has focussed on the tinnitus distress reaction (TDR) to account for differences in tinnitus severity.[16][19][20][21] These findings suggest that among those people, conditioning at the initial perception of tinnitus, linked tinnitus with negative emotions, such as fear and anxiety from unpleasant stimuli at the time. This enhances activity in the limbic system and autonomic nervous system, thus increasing tinnitus awareness and annoyance.[22]

Hello when I stand after sitting and driving I fell like unstedy I can’t hear properly like sounds getting high and low each seconds …after 2 or 3 minutes only I came back normal hearing sounds…I have this problem from last 2 years …on starting stage I got ear infection and undergo nose operation they removed my inside nose tissues still i have this problem what can i do..
Most causes of conductive hearing loss can be identified by examination but if it is important to image the bones of the middle ear or inner ear then a CT scan is required. CT scan is useful in cases of congenital conductive hearing loss, chronic suppurative otitis media or cholesteatoma, ossicular damage or discontinuity, otosclerosis and third window dehiscence. Specific MRI scans can be used to identify cholesteatoma.
Outer ear infection: otitis externa – usually affects adults aged 45 to 75. It affects the ear canal and is often caused by bacterial infection of the skin of the canal, or a fungus or a yeast. It can also be caused by an irritation such as wearing earplugs or a hearing aid. It is common in people who suffer from skin problems such as eczema, psoriasis or dermatitis but also in people who are keen swimmers.

Vinodh and Veeranna9 argue that pure tone audiometry is an insensitive method of detecting subtle cochlear damage and if a more sensitive technique such as distortion product otoacoustic emission testing is used cochlear defects can be found in many patients with acoustic shock. Some workers have noted a high prevalence of previous mental health symptoms among people with acoustic shock leading to the suggestion that there is a psychological component.7 One recent publication has suggested that the condition is usually psychogenic in origin and malingering or hysteria may be involved.9 This latter theory is opposed by the majority of workers in the field.

Hearing loss is defined as diminished acuity to sounds which would otherwise be heard normally.[15] The terms hearing impaired or hard of hearing are usually reserved for people who have relative inability to hear sound in the speech frequencies. The severity of hearing loss is categorized according to the increase in intensity of sound above the usual level required for the listener to detect it.
Vertigo is the subjective sensation of the surroundings moving or spinning. It is a symptom of inner ear disease (peripheral) or disorders associated with the brain (central). The cause of many cases of vertigo are unknown (idiopathic) although peripheral vertigo may be related to infection, trauma or chemical irritation of the semicircular canals. Central vertigo may be seen in conditions like multiple sclerosis or strokes.

A lot of people have found that using background sound helps them – this can be a radio, music, or using natural sounds. People are really good at figuring out ways of making things better for themselves and you might already be aware that you generally don’t notice the tinnitus as much when there is background noise. By using sound at other times, you’re just using other ways of doing what you already know to be helpful.
Acoustic shock is a recently recognised clinical entity: following an abrupt, intense and unanticipated acoustic stimulus, usually delivered by a telephone handset or headset, some individuals report a symptom cluster that includes otalgia, altered hearing, aural fullness, imbalance, tinnitus, dislike or even fear of loud noises, and anxiety and/or depression. Symptoms start shortly after the triggering acoustic incident and can be short-lived or can last for a considerable time. If persistent, the condition can lead to significant disability. Proposed mechanisms include involvement of the tensor tympani muscle, hyperexcitability of central auditory pathways, and a precursive state of raised anxiety or arousal. A formal treatment programme has not yet been proposed, but the potential utility of modern therapeutic techniques for tinnitus and hyperacusis are considered. Given the large number of UK residents working in telephone call centres, this condition is of considerable clinical importance.
Hyperacusis escalation is common with ASD so that an increasing range of sounds become intolerable, with a corresponding escalation in TTTS symptoms, potentially leading to TMD. For this reason, a detailed history is essential in tracking the order of development and escalation of symptoms, and their relationship to acoustic incidents/headset use, prior to making a responsible and considered diagnosis of ASD.
Hearing loss in both ears can be either conductive, sensorineural, or a mixture of both. It’s best to see an audiologist whenever you think there is a noticeable change in both your ears. They’ll fully assess your ears and perform a number of tests to determine the type of hearing loss you may have, and they’ll be able to recommend the best treatment option to help.

i am currently studying acoustic shock for a course i am taking. i do also work in a headset environment in a large office. I would be interested to hear of anyones experiences of acoustic shock, temporary real or perceived. i myself suffer from the confused hearing loss, unable to clearly know which direction noises are coming from. especially dangerous when you have police, ambulance or fire engine sirens coming close to you. not knowing the direction they are coming from makes it difficult to remove yourself from their way eg at a roundabout… my sleep is also disturbed on occassion, by low drumming noises. this has only happened over the past 5yrs whilst working a lot on the telephone section of my department. a lot of customers answer the phone whilst holding a screaming baby or have a parrot screeching behind them, some shout down the phone suddenly, the noise seems intensified when it is held in a headpiece….


A cochlear implant uses a sound processor that you wear behind your ear. A transmitter sends sound signals to a receiver and stimulator implanted under the skin, which stimulate the auditory nerve with electrodes that have been threaded into the cochlea. Some types of cochlear implants have one external unit that has a speech processor, microphone and transmitter combined (lower left), while others have these as separate external parts (upper left and on right).
Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.
As of 2018 there were no medications effective for idiopathic tinnitus.[3][74][94] There is not enough evidence to determine if antidepressants[95] or acamprosate are useful.[96] There is no high-quality evidence to support the use of benzodiazepines for tinnitus.[3][94][97] Usefulness of melatonin, as of 2015, is unclear.[98] It is unclear if anticonvulsants are useful for treating tinnitus.[3][99] Steroid injections into the middle ear also do not seem to be effective.[100][101] There is no evidence to suggest that the use of betahistine to treat tinnitius is effective.[102]
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus"). These cells help transform sound waves into nerve signals. If the auditory pathways or circuits in the brain don't receive the signals they're expecting from the cochlea, the brain in effect "turns up the gain" on those pathways in an effort to detect the signal — in much the same way that you turn up the volume on a car radio when you're trying to find a station's signal. The resulting electrical noise takes the form of tinnitus — a sound that is high-pitched if hearing loss is in the high-frequency range and low-pitched if it's in the low-frequency range. This kind of tinnitus resembles phantom limb pain in an amputee — the brain is producing abnormal nerve signals to compensate for missing input.
An outer ear infection is sometimes called swimmer’s ear. That’s because it often starts as a result of water that remains in your ear after swimming or bathing. The moisture becomes a breeding ground for bacteria. If your outer ear is scratched or if you irritate the outer lining of your ear by putting your fingers or other objects in your ear, a bacterial infection can occur.
Falls have important health implications, especially for an aging population where they can lead to significant morbidity and mortality. Elderly people are particularly vulnerable to the consequences of injuries caused by falls, since older individuals typically have greater bone fragility and poorer protective reflexes.[35] Fall-related injury can also lead to burdens on the financial and health care systems.[35] In literature, age-related hearing loss is found to be significantly associated with incident falls.[36] There is also a potential dose-response relationship between hearing loss and falls---greater severity of hearing loss is associated with increased difficulties in postural control and increased prevalence of falls.[37] The underlying causal link between the association of hearing loss and falls is yet to be elucidated. There are several hypotheses that indicate that there may be a common process between decline in auditory system and increase in incident falls, driven by physiological, cognitive, and behavioral factors.[37] This evidence suggests that treating hearing loss has potential to increase health-related quality of life in older adults.[37]

Tinnitus remains a symptom that affects the lives of millions of people. Research is directed not only at its treatment, but also at understanding why it occurs. Research by doctors at the University at Buffalo, The State University of New York, Dalhousie University (Canada), and Southeast China University have published research using electrophysiology and functional MRI to better understand what parts of the brain are involved in hearing and the production of tinnitus. Their research has found that much larger areas of the brain are involved with the process of hearing than previously believed, which may help direct future diagnostic and therapeutic options.
"We're looking at the threshold that which you can hear sounds the softest, and you're usually pressing a button or raising your hands or somehow responding to when you hear those sounds. And we're evaluating the entire auditory system in that process - not just with the earphones, but we do some other tests to evaluate your middle ear and the inner ear, as well."
The remedy depends on the cause of the tinnitus. There are several drugs that are used to help relieve constant ringing such as nicotinic acid, vasodilators, tranquilizers, antidepressants and seizure medications. Many times treatment is unsuccessful. Biofeedback may help in certain cases when tinnitus is related to stress. There is also tinnitus retraining therapy. You may want to explore information and support provided by the American Tinnitus Association.
When we hear, sound travels into the ear and then the hearing nerves take the signals to the brain. The brain is then responsible for putting it all together and making sense of the sound. Because the ears don’t know what’s important and what’s not, they send a lot of information to the brain. This is too much information for us to process, so the brain filters out a lot of unnecessary ‘activity’ and background sound, such as clocks ticking or traffic noise.
Call centre staff are therefore particularly vulnerable: the workplaces are often large, open plan environments with high levels of ambient noise, requiring the operator to turn up the volume of their headset, increasing vulnerability to acoustic incident exposure. Additionally, the workplace environment is potentially stressful: the job requirements are often competitive, monitored and repetitive, with the calls made frequently unwelcome
Dr. Ramasamy was asked if it was possible that the machine could titrate the dosage up on its own or whether it had a built-in governor that would keep the energy at a certain level, the 10 percent of what is used for kidney stones. “We keep all maintenance records in an FDA-required format,” he said. “The device has a shut-off point. You can keep turning the dial as much as you want and there will be no higher intensity. The machine will cut off — like a hot water heater in your house.”
Depending on the cause of your deafness, your doctor may suggest you have a cochlear implant. This device turns sounds into electrical signals and uses them to directly stimulate your auditory nerve, allowing you to hear. One part of the device is put behind your ear on the outside of your head. The other part is surgically implanted in a bone (called the mastoid bone) behind your ear. It will take time and help from a therapist to get used to using a cochlear implant.
Some people experience a sound that beats in time with their pulse, known as pulsatile tinnitus or vascular tinnitus.[39] Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow, increased blood turbulence near the ear, such as from atherosclerosis or venous hum,[40] but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[39] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[41] or carotid artery dissection.[42] Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis. Pulsatile tinnitus may also be an indication of idiopathic intracranial hypertension.[43] Pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for irregular noises of blood flow (bruits).[44]
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