Celene McNeill
Audiologist
Healthy Hearing & Balance Care
Bondi Junction

Exposure to loud noises can destroy the delicate cells in the cochlea (part of the inner ear) diminishing the ability to hear high pitch sounds. This condition is known as “high frequency hearing loss” which may also be accompanied by tinnitus. Tinnitus is a noise that is heard in the ears which is generated within the hearing system unrelated to an external sound source.

When environmental sounds are diminished to the ears the brain starts focusing on the tinnitus - noise generated by the ear itself. Tinnitus can cause a lot of distress if not dealt with appropriately. Some tinnitus sufferers have significant problems with sleep and concentration leading to anxiety and depression, affecting work, family and social life. A high frequency hearing loss also makes speech unclear especially in noisy environments. To carry on a conversation at a party or a restaurant may be very difficult to someone with a high frequency hearing loss although they may hear reasonably well in quiet situations.

On the other hand, excessive protection against sounds may also damage the auditory system in a different way. Earplugs worn inappropriately, when the environmental sounds are not harmfully loud, results in unnecessary strain to hear. This may lead to hyperacusis – an extreme sensitivity to sounds, and may also cause tinnitus.

As an audiologist with special interest in tinnitus I see many clients referred to me for tinnitus management. I thought I should share with you these two very interesting cases that I treated in recent times of two young women with similar symptoms but due to totally opposite causes. Knowing these cases may help some people prevent what I call “self-inflicted tinnitus”.

The first case is a 29 year old musician who developed a high frequency hearing loss and tinnitus after standing next to loud speakers during several music concerts over the years.

The second case is her sibling; a 23 years old student who after witnessing the distress her sister was going through started wearing earplugs constantly in order to prevent a noise induced hearing loss and tinnitus. She would only take the plugs off very occasionally when having a conversation in quiet surroundings. She even slept with the plugs as she lived in a noisy neighbourhood. Six months after she started with the earplugs she came to see me with screaming tinnitus. How could that be? She was sure that no loud noise had gone passed her earplugs...

The two sisters were now going through the same distress. There was a ringing sound in their ears that wouldn’t go away. One was the result of being exposed to very loud music that damaged her hearing system and impaired her ability to hear high frequency sounds; the other one was the result of not exposing her ears to any noise at all!

The second woman had also developed hyperacusis- a hypersensitivity to sounds. Sounds that are not particularly loud became intolerable to her. The auditory system straining to hear through the earplugs became more acute and sensitive.

Both women went through a tinnitus management program designed for their individual needs. They are no longer disturbed by their tinnitus. They still wear earplugs but only when they go to loud concerts. But this time they are custom made with appropriate filters. These are called musician's ear plugs and attenuate the music evenly without causing distortion.

Both of these women had a successful outcome after treatment. But the bottom line is that both could have prevented the problem if they had known better.

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©2007, Celene McNeill