AFFECTED ANATOMY

Diagram of the Human Ear Anatomy Note: The complete anatomy of the ear is extensive, and can be divided into the inner ear and outer ear.
The remainder of this article mainly references the cochlea, outer hair cells, and Organ of Corti. In general, structural damages to any anatomical part of the ear can cause hearing-related problems. Usually, minor bending of the stereocilia (inner ear) is associated with temporary hearing loss and is involved in auditory fatigue. Complete loss of the stereocilia causes permanent hearing damage and is more associated with noise-induced hearing loss and other auditory diseases. The outer hair cells, or OHCs, can be thought of as microamplifiers that provide stimulation to the inner hair cells. The OHCs are the most fragile of the hair cells, hence their involvement in auditory fatigue and other hearing impairments.

Temporary Threshold Shift

Temporary threshold shift is a protection mechanism that allows our hearing to adapt to the environment. This mechanism is in play all of the time, especially in the recording studio.
Noise exposure and intense sounds can cause two main types of hearing loss, namely temporary threshold shift and permanent threshold shift. Temporary threshold shift is mostly experienced as a temporary dullness in your hearing after exposure to loud noises. Your hearing will subsequently recover - depending on how loud the noises have been and how long you have been exposed to them. Permanent threshold shift is first experienced 48 hours after exposure to excessive noise. Permanent threshold shift can occur if you have been regularly exposed to excessive noise for long periods of time. It can also occur if you are exposed to very high sound levels for a short period of time. This type of hearing loss will normally continue to increase for up to five years after exposure to the noise. Exposure to noise and high sound levels can also result in Tinnitus - a constant sound in your ears or head. Temporary Loss of Hearing

If your ears are ringing or sounds seem muted and distant after you've been in a noisy environment, you are experiencing a type of hearing loss, which is probably temporary. This happens because the delicate hair cells in your inner ear have been overworked and are fatigued, and are not functioning as well as usual.

A temporary loss of hearing is sometimes called "temporary threshold shift." This refers to your hearing threshold, which is the softest sound that you are able to hear. If the decibel level of the softest sound audible to you is higher than usual, your threshold of hearing has shifted upward. Restoring Your Normal Hearing If a hearing loss is temporary, your hearing can recover if you give it the chance. That means leaving the noisy environment, or using hearing protection if leaving is not immediately possible. Then you'll want to rest your ears, avoiding high levels of noise for 24 hours, ideally keeping your noise exposure below 70 decibels. Your ears should normally recover within 16 hours. If your hearing has not returned

to normal after 48 hours, the hair cells have been unable to recover. Since hair cells do not grow back, you've experienced permanent hearing damage.

Auditory fatigue is defined as a temporary loss of hearing after exposure to sound. This results in a temporary shift of the auditory threshold known as a temporary threshold shift (TTS). The damage can become permanent (permanent threshold shift, PTS) if sufficient recovery time is not allowed for before continued sound exposure. When the hearing loss is rooted from a traumatic occurrence, it may be classified as noise-induced hearing loss, or NIHL. There are two main types of auditory fatigue, short-term and long-term.These are distinguished from each other by several characteristics listed individually below. Short-term fatigue

full recovery from TTS can be achieved in approximately two minutes the TTS is relatively independent of exposure duration TTS is maximal at the exposure frequency of the sound

Long-term fatigue

recovery requires a minimum of several minutes but can take up to days dependent on exposure duration and noise level

On exposure to NOISE, the ear's sensitivity level will decrease as a measure of protection. This process is referred to as a shift in the THRESHOLD OF HEARING, meaning that only sounds louder than a certain level will be heard. The shift may be temporary, chronic or permanent. Susceptibility to TS varies greatly from person to person, men generally being more sensitive to low frequency sounds, and women more susceptible to high frequencies. Sounds in the 2 - 6 kHz range seem to induce greater temporary threshold shift (TTS) than other frequencies. Also called aural fatigue. Thus, TTS implies a temporary HEARING LOSS for low level sounds One of the body's reactions to loud sounds is a constriction of the blood vessels (vasoconstriction) which reduces the blood supply reaching the hair cells of the ORGAN OF CORTI. The outer rows of hair cells respond mainly to low intensity sound levels and thus are easily saturated by loud sounds, particularly when their source of blood is diminished. This leaves only the inner rows of hair cells working since they need a higher intensity for stimulation.

If the outer hair cells are not allowed to recover through periods of quiet, they gradually lose their ability to respond and eventually die. TTS may also be accompanied by TINNITUS, a ringing in the ears. Temporary Threshold Shift (TTS): During short exposure to noise, most people experience a rise in the auditory threshold which normally disappears in 24 hours, but may last as long as a week. Permanent Threshold Shift (PTS) or Noise Induced Permanent Threshold Shift (NIPTS): After prolonged exposure to noise, permanent hearing damage may result in the INNER EAR (see ACOUSTIC TRAUMA, ORGAN OF CORTI, PRESBYCUSIS). Chronic Threshold Shift or Compound Threshold Shift: If exposure to noise occurs repeatedly without sufficient time between exposures to allow recovery of normal hearing, TS may become chronic, and eventually permanent. This is a particular danger when people who work in noisy environments are exposed to further noise afterwards in driving, at home and at places of entertainment (see SOCIOCUSIS).

Permanent Threshold Shift

PTS may occur as a result of long-term exposures and/or extremely loud noises. Repeated exposures that cause to temporary threshold shift (TTS) can induce PTS, as well. It is an unrecoverable deafening due to physiological damage to the hearing organs that does not diminish with time.
Permanent threshold shift is first experienced 48 hours after exposure to excessive noise. Permanent threshold shift can occur if you have been regularly exposed to excessive noise for long periods of time. It can also occur if you are exposed to very high sound levels for a short period of time. This type of hearing loss will normally continue to increase for up to five years after exposure to the noise. Exposure to noise and high sound levels can also result in Tinnitus - a constant sound in your ears or head.

Acceptable Noise - dBA - Levels

Acceptable noise - dBA - levels at some locations

LOCATION

EFFECTS

MAXIMUM (dBA)

TIME (HOURS)

TIME OF DAY

Bedroom

sleep disturbance, annoyance annoyance, speech interference moderate annoyance serious annoyance sleep disturbance, with open windows speech interference, communication disturbance sleep disturbance, communication interference

30

night

Living area

50

16

day

Outdoor living area Outdoor living area

50 55

16 16

day day

Outdoor living area

45

night

School classroom

35

day

Hospitals patient rooms

30 - 35

day and night