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.
A 2005 study achieved successful regrowth of cochlea cells in guinea pigs.[119] However, the regrowth of cochlear hair cells does not imply the restoration of hearing sensitivity, as the sensory cells may or may not make connections with neurons that carry the signals from hair cells to the brain. A 2008 study has shown that gene therapy targeting Atoh1 can cause hair cell growth and attract neuronal processes in embryonic mice. Some hope that a similar treatment will one day ameliorate hearing loss in humans.[120]
There is a strong relationship between hearing loss and tinnitus. Any ear problem but particularly hearing loss can 'unmask' the perception of tinnitus, but some patients with tinnitus have no hearing loss. Correction of hearing loss with hearing aids is known to have a beneficial effect upon tinnitus, but sometimes simple reassurance alone is sufficient.
Tinnitus may be classified in two types: subjective tinnitus and objective tinnitus.[3] Tinnitus is usually subjective, meaning that the sounds the person hears are not detectable by means currently available to physicians and hearing technicians.[3] Subjective tinnitus has also been called "tinnitus aurium", "non-auditory" or "non-vibratory" tinnitus. In rare cases, tinnitus can be heard by someone else using a stethoscope. Even more rarely, in some cases it can be measured as a spontaneous otoacoustic emission (SOAE) in the ear canal. This is classified as objective tinnitus,[3] also called "pseudo-tinnitus" or "vibratory" tinnitus.
If you are referred to a specialist tinnitus clinic, and your tinnitus is particularly troublesome, you will be introduced to more formal or structured ways of managing tinnitus. Most centres use a combination of approaches. You may come across some terms before, or hear them when you get there, and it helps to have some understanding of what these terms are.
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]
Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level. But tinnitus may originate in other places. Our bodies normally produce sounds (called somatic sounds) that we usually don't notice because we are listening to external sounds. Anything that blocks normal hearing can bring somatic sounds to our attention. For example, you may get head noise when earwax blocks the outer ear.
Conductive hearing loss results when there is any problem in delivering sound energy to your cochlea, the hearing part in the inner ear. Common reasons for conductive hearing loss include blockage of your ear canal, a hole in your ear drum, problems with three small bones in your ear, or fluid in the space between your ear drum and cochlea. Fortunately, most cases of conductive hearing loss can be improved.
^ Langguth B, Goodey R, Azevedo A, et al. (2007). "Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006". Tinnitus: Pathophysiology and Treatment. Progress in Brain Research. 166. pp. 525–36. doi:10.1016/S0079-6123(07)66050-6. ISBN 978-0444531674. PMC 4283806. PMID 17956816.
Ringing, buzzing, or roaring in the ears is often used to describe tinnitus, which can be extremely annoying and occur without any reason. Tinnitus may signify underlying nerve damage or an issue with your circulatory system, or there may not be a clear reason for the problem, so it is best to consult your doctor.[1] One way to stop ringing in your ears is prevention, but the issue may also be genetic and you cannot control this. There are steps that you can take to treat the ringing buzz even after the damage is done. Read on for helpful hints and tips.

Sensorineural causes of hearing loss involve the inner ear or brain and are usually, but not always, permanent. Implants and more invasive procedures may help to restore hearing. Birth defects (prenatal infection, injury during childbirth, and genetic disorders), infections particularly in childhood and age-related degeneration (presbycusis / presbyacusis) are more frequent causes of this type of hearing loss. Sudden, unilateral hearing loss may be related to conditions like a stroke.
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.
Tell people that you have hearing loss. Ask people to face you directly when they speak to you, and to slow down if they are speaking too fast. When you are in a group setting, sit in a location where you can clearly see the faces of the people who are speaking. Ask people not to speak loudly or shout when they are speaking to you. Try to talk with others in a quiet place. Background noise makes it harder for you to hear.
Your ear has three main parts: outer, middle and inner. You use all of them in hearing. Sound waves come in through your outer ear. They reach your middle ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, in your middle ear. The vibrations travel to your inner ear, a snail-shaped organ. The inner ear makes the nerve impulses that are sent to the brain. Your brain recognizes them as sounds. The inner ear also controls balance.
We know ads can be annoying, but they’re what allow us to make all of wikiHow available for free. Please help us continue to provide you with our trusted how-to guides and videos for free by whitelisting wikiHow on your ad blocker. If you really can’t stand to see another ad again, then please consider supporting our work with a contribution to wikiHow.

Tympanometry, or acoustic immitance testing, is a simple objective test of the ability of the middle ear to transmit sound waves from the outer ear to the middle ear and to the inner ear. This test is usually abnormal with conductive hearing loss. A type B tympanogram reveals a flat response, due to fluid in the middle ear (otitis media), or an eardrum perforation.[4] A type C tympanogram indicates negative middle ear pressure, which is commonly seen in eustachian tube dysfunction[4]. A type As tympanogram indicates a shallow compliance of the middle ear, which is commonly seen in otosclerosis[4].
There is a progressive loss of ability to hear high frequencies with aging known as presbycusis. For men, this can start as early as 25 and women at 30. Although genetically variable it is a normal concomitant of ageing and is distinct from hearing losses caused by noise exposure, toxins or disease agents.[46] Common conditions that can increase the risk of hearing loss in elderly people are high blood pressure, diabetes, or the use of certain medications harmful to the ear.[47][48] While everyone loses hearing with age, the amount and type of hearing loss is variable.[49]
There are three parts to your ear: the outer ear, middle ear and inner ear. The outer ear is the part you can see. It is shaped to focus sound waves into your ear canal, so they travel to your eardrum. The sound waves make your eardrum vibrate. This vibration passes to your middle ear, which contains three small bones (ossicles) called the hammer, anvil and stirrup (named after their shapes). These strengthen the vibrations as they conduct them to your inner ear.
If you have good hearing, your doctor may suggest a sound generator. These used to be called masking devices. There are two main types. One is a portable machine that produces calming sounds. The other fits to your ear like a hearing aid and produces a constant low-level noise or tone, sometimes called white noise, masking (covering up) the tinnitus. This may also help your brain get used to the tinnitus. Some people find that sound generators interfere with their hearing while they’re using them.
Prolonged exposure to loud sounds is the most common cause of tinnitus. Up to 90% of people with tinnitus have some level of noise-induced hearing loss. The noise causes permanent damage to the sound-sensitive cells of the cochlea, a spiral-shaped organ in the inner ear. Carpenters, pilots, rock musicians, street-repair workers, and landscapers are among those whose jobs put them at risk, as are people who work with chain saws, guns, or other loud devices or who repeatedly listen to loud music. A single exposure to a sudden extremely loud noise can also cause tinnitus.
If your hearing loss is caused by a build-up of earwax, it will need to be removed. You may be able to have this done at your surgery by syringing. Warm water is flushed into your ear canal to remove the wax. But first the wax has to be softened by applying olive oil or almond oil drops, or drops containing sodium bicarbonate, for several days beforehand. You can buy these drops from your local pharmacy. In some cases, you may have to go to a specialist clinic to have wax removed by syringing or with microsuction.
A study of ASD symptoms in 103 call centre operators exposed to 123 acoustic incidents is reviewed. The proposed neurophysiological mechanism of ASD is discussed, in particular tonic tensor tympani syndrome (TTTS) and temporomandibular disorder (TMD). An understanding of TTTS provides insight into the neurophysiological basis of tinnitus and hyperacusis escalation, in association with high levels of emotional trauma and anxiety. Audiological assessment, diagnosis, rehabilitation and workplace management of ASD is discussed.
Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:
In a medical context, deafness is defined as a degree of hearing loss such that a person is unable to understand speech, even in the presence of amplification.[1] In profound deafness, even the highest intensity sounds produced by an audiometer (an instrument used to measure hearing by producing pure tone sounds through a range of frequencies) may not be detected. In total deafness, no sounds at all, regardless of amplification or method of production, can be heard.
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.
Since most persons with tinnitus also have hearing loss, a pure tone hearing test resulting in an audiogram may help diagnose a cause, though some persons with tinnitus do not have hearing loss. An audiogram may also facilitate fitting of a hearing aid in those cases where hearing loss is significant. The pitch of tinnitus is often in the range of the hearing loss.
Prolonged exposure to loud sound or noise levels can lead to tinnitus.[74] Ear plugs or other measures can help with prevention. Employers may use hearing loss prevention programs to help educate and prevent dangerous levels of exposure to noise. Groups like NIOSH and OSHA help set regulations to ensure employees, if following the protocol, should have minimal risk to permanent damage to their hearing.[75]
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.
Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments. A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent. Some management options include hearing aids, cochlear implants, assistive technology, and closed captioning.[9] This choice depends on the level of hearing loss, type of hearing loss, and personal preference. Hearing aid applications are one of the options for hearing loss management.[82] For people with bilateral hearing loss, it is not clear if bilateral hearing aids (hearing aids in both ears) are better than a unilateral hearing aid (hearing aid in one ear).[9]
Tinnitus is the perception of sound when no corresponding external sound is present.[1] While often described as a ringing, it may also sound like a clicking, buzzing, hiss, or roaring.[2] The sound may be soft or loud, low or high pitched, and appear to be coming from one or both ears.[2] In some people, the sound may interfere with concentration or increase feelings of anxiety or depression.[2] Tinnitus may be associated with some degree of hearing loss and with decreased understanding in noise.[2]

The most distressing and persistent ASD symptoms tend to be aural pain and hyperacusis. Sharp stabbing aural pain and numbness/burning in and around the ear are consistent with trigeminal nerve irritation. If pain levels are severe, treatment for trigeminal neuralgia, TMD and/or referral to a pain management clinic is indicated. Hyperacusis desensitisation therapy and massage of the muscular trigger points around the neck and shoulder will reduce TTTS symptoms, but progress can be slow once symptoms become entrenched.


Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments. A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent. Some management options include hearing aids, cochlear implants, assistive technology, and closed captioning.[9] This choice depends on the level of hearing loss, type of hearing loss, and personal preference. Hearing aid applications are one of the options for hearing loss management.[82] For people with bilateral hearing loss, it is not clear if bilateral hearing aids (hearing aids in both ears) are better than a unilateral hearing aid (hearing aid in one ear).[9]
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.

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.
^ Jump up to: a b Schecklmann, Martin; Vielsmeier, Veronika; Steffens, Thomas; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias; Andersson, Gerhard (18 April 2012). "Relationship between Audiometric Slope and Tinnitus Pitch in Tinnitus Patients: Insights into the Mechanisms of Tinnitus Generation". PLOS ONE. 7 (4): e34878. Bibcode:2012PLoSO...734878S. doi:10.1371/journal.pone.0034878. PMC 3329543. PMID 22529949.
×