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Anatomy of Hearing
Acoustic signals, or sound waves, enter the auditory system through the outer ear, funneled by the pinna (the external part of the ear) and external ear canal. This funneling causes a resonance which boosts energy in high frequencies, about 2000-3000 Hz. The sound waves reach and vibrate the eardrum which in turn vibrates the middle ear bones, or ossicles, which amplify the vibrations and carry them to the inner ear, specifically the cochlea, which is a fluid-filled chamber. Vibration from the middle ear to the inner ear causes motion in the inner ear fluid. The cochlea contains rows of microscopic sensory cells, called hair cells, that are stimulated by the movement of the fluid which results in a chemical change that produces nerve impulses. The nerve impulses are carried along the hearing nerve to the brain, where they are interpreted as sound. Noise or sounds that are too loud or long-lasting can damage the hair cells, causing hearing loss. Recent research also indicates that noise or loud sounds can damage or sever the connections between the hair cells and the brain.
Hearing healthcare is as much about enjoying sounds as it is about protecting hearing from dangerous levels.
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Noise Induced Hearing Loss
The effects of noise are often underestimated. A 2017 study by the Centers for Disease Control and Prevention indicated that nearly one in four adults in the U.S. adults aged 20-69 show signs of possible noise-induced hearing loss, a form of hearing damage that results from exposure to loud noise. This could be cumulative harm that developed from exposure over time, or it could occur from one severe episode. Although completely preventable, once it occurs, it is irreversible. Hearing loss can affect almost all aspects of life, including physical health, mental health, employment status and success, social functioning and satisfaction, and much more. Hearing loss can occur gradually and the serious impact of noise induced hearing loss is often not appreciated until daily life is impacted by the permanent communication problem. In addition to communication problems, hearing loss and loud sound exposure can lead to health difficulties such as cardiovascular effects and mental health effects, tinnitus (ringing or noises in the ears), hyperacusis (increased sensitivity to certain pitches and volume ranges), diplacusis (abnormal pitch perception), and loudness recruitment (an abnormal increase in perceived loudness). Hearing loss can be treated through various technologies and techniques under the care of a certified audiologist, but hearing is never fully restored.
Noisy settings are commonplace in today's society, including in St. Louis. Many restaurants are specifically designed to elevate noise levels to make establishments feel more energetic. Similarly, some sports stadiums have been built with sound elevation in mind, thought to improve the fan experience and serve as a home-team advantage. Fitness classes, bars, clubs, concerts, street noise, construction noise, workplace noise, and many other daily environments all make modern society a collectively loud place.
Although many people report concern about noisy environments, not nearly enough take protective steps. There are some simple ways to take charge of your hearing health.
This advice about hearing protection goes for just about everyone, from the youngest of children to older adults, from those with excellent hearing who want to maintain it, to those who already have hearing loss and don't want to make it worse. Protecting ourselves from noise induced hearing loss should begin in childhood, but it's never too late to start protecting our hearing. Hearing protection cannot get back what may have already been lost, but we can prevent future accumulative damage. As a society, everyone needs to prioritize hearing protection.
Temporary Threshold Shift
Temporary threshold shift (TTS) is a temporary shift in auditory threshold, meaning your hearing temporarily gets worse. TTS is typically caused by exposure to intense and/or loud sounds or noise. TTS is often accompanied by temporary tinnitus (ringing/noises in the ears). You may also experience a pain sensation and/or a feeling of aural fullness or pressure in the ear canal, not unlike the pressure felt during an airplane descent. TTS and temporary tinnitus are your body's early warning signs!
If you experience a temporary threshold shift, it is recommended that you spend some time in a quiet place and not expose yourself to loud sounds and take precautions to avoid future exposure to loud sounds or over exposure to sounds. The recovery time for TTS varies. Your ears should recover within 16 hours, but it may take 48-72 hours to be restored. If after two weeks your normal hearing still has not returned, seek medical advice as you may have experienced a degree of permanent hearing damage. If you suffered a complete loss or near complete loss of hearing seek medical attention immediately. Even if your hearing recovers, research suggests that permanent damage to the auditory system may have taken place and this damage is cumulative over time and can result in a permanent threshold shift, permanent tinnitus, and/or difficulties understanding speech in noise.
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