Clinical Presentation, Diagnostic Evaluation, and Management of Noise-Induced Hearing Loss

Pathophysiology of Noise-Induced Hearing Loss

Noise-induced hearing loss (NIHL) is caused by prolonged exposure to loud sounds, leading to damage in the cochlear hair cells and auditory nerve pathways. This irreversible condition is categorized into acute and chronic forms based on exposure duration and intensity.

Clinical Presentation

Common symptoms of NIHL include:

• Progressive sensorineural hearing loss
• Tinnitus (ringing in the ears)
• Difficulty in speech comprehension, especially in noisy environments
• Hyperacusis or sensitivity to loud sounds

Diagnostic Evaluation

Accurate diagnosis requires a combination of clinical evaluation and audiometric testing:

• Pure-tone audiometry for hearing thresholds
• Speech audiometry for speech recognition ability
• Otoacoustic emissions (OAE) testing for cochlear function analysis
• Auditory brainstem response (ABR) for neural integrity assessment

Management and Prevention

While NIHL is irreversible, management strategies focus on mitigating symptoms and preventing further damage:

• Use of hearing aids for auditory amplification
• Counseling and auditory rehabilitation
• Noise protection measures, such as earplugs and noise-canceling devices
• Public awareness campaigns to reduce occupational and recreational noise exposure