Q&A

Subject: Noise loss

From: RT

Dear Mrs. Ingersoll:

Can hearing loss and Tinnitus result from a two day exposure to very loud noise? That is what happened in my case. My right ear was damaged, while my left ear is almost perfect. After being examined and tested by two separate ear specialists, one concludes that the noise exposure caused my problem, while the other one says it did not cause my problem because the chart form the hearing test does not look like a typical one. He goes on to claim that it is congenital, or I have a tumor.

Up to the day that I was exposed to the noise, my hearing was perfect. I explained to both doctors that the reason only one ear was damaged is that I was sitting sideways on a huge grinding machine with my right ear facing directly at the noise. After two days on this machine, my ears began to ache. I stopped operating the machine that day because I knew it was damaging my hearing. Since that time, I have had Tinnitus and a 50% hearing loss in my right ear.

One of the doctors claims my hearing problem is congenital, even though no one else in my family (I have eight brothers and sisters) has this problem. I am 46 years old, never had surgery for any reason, never had any dizziness, headaches, or any other symptoms that might be ear related.

The following are the numbers from the hearing test chart for my right ear.
At 250--35 500--20 1k--30 1.5k--65 2k--55 3k--40 4k--15 6k--20 8k--25
The numbers for my left ear are:
At 250--15 500--15 1k--15 1.5k--15 2k--15 3k--20 4k--15 6k--30 8k--20

I would like your opinion and comments about my problem. I will be looking forward to your response.

Sincerely, RT

Dear R,
Certainly exposure to loud noise can cause permanent hearing loss. I have one patient who suffered significant hearing loss after attending a pop music concert at which he was seated near the banks of loud speakers. Certainly two days of exposure can lead to significant and permanent damage.

However, I must agree with one of your consultants who said that the hearing loss does not look like that typically associated with acoustic trauma. In those cases, the poorest hearing generally falls between 3k and 6k Hz and traces a notching pattern...essentially normal hearing in the low frequencies, dropping to a notch and then recovering in the higher frequencies. The amount of hearing loss across the range in your right ear and with poorest hearing at only 1.5k, it really doesn't look like noise. If it was so loud to cause that much damage to your right ear , why so little involvement in the left? In fact, the dip in your LEFT ear and the pattern traced there is much more typical of exposure to high noise levels!

There are certainly other possible causes for sudden decrease in hearing other than tumors. People with high cholesterol levels can have "ear attacks" when circulation is impaired. Reducing cholesterol levels can result in improved hearing as circulation to the ear is restored. Diabetes (because of its effects on circulation) can also be the cause of sudden changes in hearing. Not to totally disregard the specter of tumor, did either of those physicians recommend an MRI with contrast?

It seems to me that you don't yet have enough information. In many cases like this, it is a matter of ruling out one possible cause after another to finally arrive at a diagnosis. This is one of the reasons why we recommend that everyone at some time should have a baseline audiogram which they keep in their personal files so that when changes in hearing are noted, you have a reference to use to measure those changes. You might check with your family doctor to see if such a record exists to prove that this is a new problem and not a congenital loss.

Sorry not to be of more help.

Solveig