After a three-hour concert by her favorite TV band show, Linda finds it difficult to hear her husband's rave about the show. It sounded like he was speaking from across the room, thereby making it difficult for her to correctly understand all he was saying as a result of the ringing in her ears. By the next morning, the ringing in her ears had stopped but Linda still has questions.
What caused the symptoms? Is her hearing going to fully recover? Can she still go to concerts without damaging her ears?
To answer these questions, we first need to understand what sound is all about and how we hear it.
Like a pebble creating ripples in water, sound is created when displaced molecules vibrate through space. While sound vibrations can travel through solids and liquids, our ears have evolved to process vibrations even in the air. These waves of air pressure enter our ear canals and bounce off the eardrum. A trio of bones called the ossicular chain then carries those vibrations into the cochlea, transforming waves of air pressure into waves of cochlear fluid. At this juncture, our perception of sound begins to take form. The waves of fluid move the basilar membrane, (a tissue lined with tens of thousands of hair cells) The specific vibration of these hair cells and the stereocilia on top of each one determine the auditory signal our brain perceives. Unfortunately, these essential cells are also quite vulnerable, they can be damaged by high volume because the louder a sound is, the greater the pressure of its vibrations. While the ear’s upper limits vary from person to person, close range exposure to sound exceeding 120 decibels can instantly bend or blow out hair cells, resulting in permanent hearing damage. and can be easily damaged. The pressure of more powerful sounds can even dislocate the ossicular chain or burst an eardrum.
The other side of this equation is the sound’s duration. While dangerously loud sounds can injure ears almost instantly, hair cells can also be damaged by exposure to lower sound pressure for long periods. For example, hearing a hand dryer is safe for the 20 seconds you’re using it. But if you've listened for 8 consecutive hours, this relatively low-pressure sound would overwork the stereocilia and swell the hair cell’s supporting tissue. Swollen hair cells are unable to vibrate with the appropriate speed and accuracy, making hearing muffled.
This kind of hearing loss is known as a temporary threshold shift, and many people will experience it at least once in their lifetime. In Linda’s case as we read above, the loud sounds of the concert only took three hours to cause this condition. Fortunately, it's a temporary ailment that usually resolves as swelling decreases over time.
In most cases, simply avoiding hazardous sounds gives hair cells all they need to recover. One temporary threshold shift isn’t likely to cause permanent hearing loss. But frequent exposure to dangerous sound levels can lead to a wide range of hearing disorders or difficulty in understanding speech in loud environments.
There are numerous strategies you can adopt to prevent hearing loss. Current research around earbud headphone use suggests keeping your volume at 80% or less if you’ll be listening for more than 90 minutes throughout the day. Noise-isolating headphones can also help you listen at lower volumes. Getting a baseline understanding of your hearing is essential to protecting your auditory system. Just like our eyes and teeth, our ears also need annual check-ups. Not all communities have access to audiologists, but organizations around the world are developing portable hearing tests and easy-to-use apps to bring these vital resources to remote regions. Finally, wear earplugs when you’re knowingly exposing yourself to loud sounds for extended periods. An earplug’s effectiveness depends on how well you’ve inserted it, so be careful to read the instructions carefully because when worn correctly, they can ensure you'll be able to hear your favorite band for many nights to come.
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