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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 in hearing, 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 noise induced hearing loss or permanent music induced hearing loss), permanent tinnitus, and/or difficulties understanding speech in noise.
Normal Hearing Thresholds -10 to 20 dB HL
Slight Hearing Loss Thresholds 21 to 25 dB HL
Mild Hearing Loss Thresholds 26 to 40 dB HL
Moderate Hearing Loss Thresholds 41 to 55 dB HL
Moderately-Severe Hearing Loss Thresholds 56 to 70 dB HL
Severe Hearing Loss Thresholds 71 to 90 dB HL
Profound Hearing Loss Thresholds 91+ dB HL
Types and degree of hearing loss
Ways to help prevent sensorineural hearing loss
Presbycusis
Presbycusis, also referred to as age-related hearing loss, is the gradual loss of hearing in both ears that can occur as a person ages. This loss usually presents in the high frequencies first and is typically progressive. Age-related hearing loss most often occurs because of changes to the inner ear, changes to the nerve pathway from the ear to the brain, and/or changes to the middle ear associated with the aging process. Not everyone will experience age-related hearing loss and it is not a typical or even inevitable consequence of the normal aging process. In fact, most of the hearing loss we associate with aging is actually related to sociocusis, or noise induced hearing loss from every-day sound exposure. It's important to remember that even if you loose hearing as you age, you should not ignore it or brush it off as a "normal" part of the aging process, you should have your hearing tested and discuss your treatment options with an audiologist.
Noise Induced Hearing Loss
A 2017 study by the Centers for Disease Control and Prevention indicated that nearly one in four adults in the U.S. aged 20-69 show show signs of possible noise-induced hearing loss, a form of permanent sensorineural hearing damage that results from exposure to loud sounds. This could be cumulative harm that developed from exposure over time, or it could occur from one severe episode of exposure. Although completely preventable, once it occurs, it is irreversible. Noise induced hearing loss often occurs gradually and the serious impact of the hearing loss is often not appreciated until daily life is impacted by a permanent communication problem.
Music Induced Hearing Loss
Music induced hearing loss (MIHL) is a form of permanent, sensorineural hearing loss resulting from prolonged, repeated exposure to loud music. MIHL occurs when the delicate structures of the inner ear are damage due to prolonged exposure to high-volume music, leading to gradual deterioration of hearing abilities. Music induced hearing loss can be prevented by the proper use of hearing protection and the implementation of effective safe listening practices.
Hidden Hearing Loss
Hidden hearing loss has become a blanket term to characterize the hearing loss of someone who presents with a hearing problem or complaint, but normal hearing sensitivity across the frequencies tested on an audiogram. For individuals with hidden hearing loss, the audiogram indicates normal hearing, but there is damage to the auditory system resulting in subjective hearing complaints such as difficulty understanding speech in noise. Research is still emerging as to the mechanism for hidden hearing loss and there may even be multiple pathologies that could be the cause or contributors. One suggested mechanism is cochlear synaptopathy, damage to auditory fibers causing the connection between the inner ear and the brain to be compromised. Another suggestion is subclinical outer hair cell damage. Noise exposure does appear to be a significant risk factor in individuals with hidden hearing loss. Hidden hearing loss occurs due to a problem in the peripheral auditory system, differentiating it from auditory processing disorder, which is a deficit in the central auditory system in which your brain does not hear things in the usual way.
It is better to treat hearing loss sooner rather than waiting, even if you have a mild hearing loss and your hearing loss is not severe. If you wait to treat your hearing loss, your brain has to go longer missing all the sounds that fall in the range of your hearing loss. The brain stops putting resources into understanding things it can't hear, which means the neural pathways do not stay strong in these areas and over time you could loose your ability to understand these sounds, even after you are given proper amplification. Hearing loss can impact almost all aspects of life, including physical health, mental health, employment status and success, social functioning and satisfaction, and much more. Early, effective management of hearing loss can help mitigate some of these adverse impacts of hearing loss.
Even if you do not suspect that you have a hearing loss, it is important to establish a relationship with an audiologist, especially if you have risk factors such as exposure to loud sounds. You can talk to your audiologist about getting a baseline hearing test to establish current hearing sensitivity and to develop a plan that will help you protect your hearing. This plan should include annual hearing tests (but do not hesitate to get a hearing test sooner if you develop new or worsening symptoms of hearing loss). Annual hearing testing can help detect small changes in hearing that might go unnoticed in our day-to-day. Hearing loss often occurs so slowly that the first symptoms are easily ignored.
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In addition to communication problems, sensorineural hearing loss, particularly from loud sound exposure, can be associated with hearing disorders such as:
- Tinnitus: ringing, buzzing, cicada, chirping, or other noises in one or both ears not caused by an external noise source
- Hyperacusis: increased sensitivity to certain pitches and/or volume ranges
- Diplacusis: abnormal pitch perception; dissonance in pitch or timing of a sound in which the ears perceive the same sound as having a different pitch
- Loudness recruitment: an abnormal perception of sounds becoming rapidly louder with increase in sound level which can occur with hearing loss, either in specific frequencies or overall volume
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Three Main Types of Hearing Loss
1. Conductive Hearing Loss: A conductive hearing loss results from a problem in the outer ear, ear canal, or middle ear that prevents sound from from being properly relayed to the inner ear. Conductive hearing losses are frequently temporary and can often be treated with a medical procedure, medications, or surgery. Common causes are impacted cerumen (ear wax); ear infections; allergies; fluid in the middle ear; perforated eardrum (a hole in the eardrum); benign tumors; swimmer's ear; structural absence or malformation of the outer ear, ear canal, or middle ear.
2. Sensorineural Hearing Loss: Sensorineural hearing loss results from a problem in the inner ear and/or the auditory nerve. Sensorineural hearing loss occurs when there is damage and/or a structural problem with the tiny sensory cells, called hair cells; the auditory nerve; the synapses between the nerves; and/or the central nervous system. Sensorineural hearing loss is generally permanent. Sensorineural hearing loss can typically be treated through various technologies and techniques under the care of a certified audiologist, but hearing is never fully restored. Common causes are aging (presbycusis), loud sound exposure, genetics, pregnancy and birth complications, head injury, Ménière's disease, ototoxicity (exposure to medications or chemicals that cause hearing loss), viral illnesses of the inner ear, systemic conditions. Noise induced hearing loss, music induced hearing loss, and hidden hearing loss are all types of sensorineural hearing loss.
3. Mixed Hearing Loss: Mixed hearing loss is a type of hearing loss in which a person presents with a combination of conductive hearing loss and sensorineural hearing loss.
temporary threshold shift
Sensorineural Hearing loss
Degrees of Hearing Loss
Hearing loss is classified into degrees of loss. Hearing loss may be mild, moderate, moderately-severe, severe, and profound. A person with normal hearing has hearing thresholds (the softest level the person can hear) at or less than (better than) 20 dB HL on the traditionally tested frequencies (250-8000 Hz) of a hearing test and they do not have any significant speech understanding difficulties. A person has hearing loss when their hearing thresholds at any one or more of the traditionally tested frequencies (250-8000) falls at or greater than (worse than) 16 dB HL.
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If you have experienced a sudden change in your hearing, seek medical attention immediately.
- Lower your risk of hearing loss from loud sound exposure. Protecting your hearing in loud environments is an effective ways to take a proactive step toward improving your hearing health.
- Stop smoking and limit alcohol consumption. Research indicates that cigarette smoke, both direct or secondhand, can have a negative impact on a person's hearing health. Likewise, heavy alcohol use can create a toxic environment in the ear.
- Be aware of drugs and medications that cause hearing loss. Hundreds of over-the-counter (OTC) and prescription drugs drugs are linked to hearing loss and/or tinnitus. Talk to your doctor or pharmacist to determine if any OTC or prescription medications you take could damage your hearing or cause tinnitus. If you are on such medications, speak to your doctor to find out if there are alternative medications or doses that could reduce the risk of medication related hearing loss and tinnitus.
- Exercise, practice stress reduction, and eat healthy. These recommendations are made in general for healthier lifestyles, but they can also help your hearing health. Exercise increases blood flow which helps your ear health and functioning. Chronic high stress isn't good for your overall health or your hearing and it can be associated with increased severity of tinnitus symptoms. Eating foods rich in B12, magnesium, iron, and potassium can be beneficial to hearing health.
- Manage your blood pressure and cardiac health and manage diabetes. High blood pressure, heart disease, and diabetes are associated with hearing loss. Studies have shown that that people with diabetes are twice as likely to have hearing loss. If you have high blood pressure, high cholesterol, or diabetes, follow your doctor's recommendations to help you manage your condition.
- Know your family history. While this won't prevent sensorineural hearing loss, it will help you know if you are at elevated risk which can help with early detection of hearing loss, which in turn leads to better outcomes when treatment is also started early.
- Get your hearing tested regularly. This won't prevent sensorineural hearing loss, but it can help with early detection of hearing loss and, when paired with early treatment, can lead to improved outcomes. Small changes that might otherwise be missed in a person's day-to-day might be detected with annual testing which can assist in guiding your hearing protection efforts, which could help prevent further damage.
Resource: https://www.healthyhearing.com/help/hearing-loss/prevention
Hearing Disorders