Healthy vs Damaged Ear

This comes up a lot so just want to gauge what the general consensus is.

Many believe that if you have damaged hair cells/cochlea as a result of acoustic trauma for example, then that individual is more susceptible to further damage being caused at lower volumes than a healthy ear could tolerate.

In theory this sounds logical, but there's just as much evidence to suggest those with "damaged" ears are no more susceptible to further damage than the next guy. Furthermore, if yhose of us with Tinnitus stemming from acoustic Trauma were to go with the first train of thought and over protect your ears surely you would become over sensitive to every day sounds?

 

I had wicked H for 2 weeks after my T started. Anything louder than a whisper would make my eyes water with pain.

Obviously this meant I wore ear plugs everywhere out of fear of pain. I did a bit of reading and people seemed to suggest that over protecting your ears is bad and that it's better to have some form of broad spectrum noise at somewhere close to your tolerance threshold but not at painful or dangerous level so that you don't become over-sensitised.

This all sounds very reasonable but might be complete hogwash though - there no good science around it either way as far as I can tell.

I kept myself in pretty quiet surroundings for 3 weeks. H is not nearly as bad but still have to wash up and ride the underground with ear plugs.

 

Sometimes I think it really is a case by case basis..and to be honest after a year and ALOT of research online, I really just don't know.

Some have said overprotection made them more sensitive, some claim it helped them and prevents worsening.

I believe regardless it's a fine balance...and a hard one to walk daily.

 

@Greg Clarke
I voted yes; but with the understanding that the way the question is posed is basically impossible to answer with any real accuracy. Other variables and factors, such as age and lifestyle, must be taken into account; nonetheless, if all things were equal I would lean toward 'yes' just because an injury is always more susceptible to greater damage than a healthy vessel.

 

My T is constant now (if I listen for it) but years ago it would come and go. And when it came back it always came back right where it left off. So it was a gradual 'scab picking' kind of thing. I could have avoided it but I wouldn't stay away from loud music.
https://www.tinnitustalk.com/threads/back-to-silence.7172/#post-81351

 

Not sure, I think I read somewhere that it doesn't matter.
Tinnitus or not loud sounds will always suck for your ears but I don't think a Tinnitus having guy has ears which are more prone to damage.

I have Tinnitus and I can take people yelling in a class room with a 1 hour spike and nothing more.

 

Answer is yes. ENT told me (one of best ENTs in Canada).

 

I wish I had that ENT, I wouldn't have sustained all this additional damage following the regular healthy ear noise guide lines.

 

I haven't seen the science to confirm it. It depends on many factors as well, what kind of damage as well? We've all experienced temporary spikes. The two different are on two different stages and surely a spike feels more apparent than someone gradually breaking down their ears. That doesnt mean damage cant equal out.

 

"Answer is yes. ENT told me (one of best ENTs in Canada)"

I don't know if anyone can stand behind that statement and claim it as a fact.

Maybe I worded my initial post badly. It's a given that a "damaged" ear will be more susceptible to further damage if you don't take the correct precautions. I was referring really to a damaged ear and everyday volumes really. I.e. Will a damaged ear be prime to further damage at reduced volumes.

Having looked into it quite a bit since my initial post, I don't think anyone can say for sure. There's plenty of evidence to suggest it can go either way.

 

I have done a ton of additional damage exposing myself to normal noise levels after the onset of my T. I didn't want to believe that this could happen, I also wanted to believe what the experts told me- live life and protect your ears under noisy situations like chain saws, concerts, clubs etc. This turned out to be bad advise. I would go for dinners, play hockey, walk downtown around noise, basically trying to get back to life. Every time I did this I would experience a lot of ear pain and increased tinnitus that would subside ( but not quite back to baseline). I thought I must be imagining things, I kept this up for months. Every time feeling like my ears were bleeding after this so called normal every day noise. I finally could not ignore it anymore, it was plain and simple, I could not tolerate what others considered normal noise and was doing permanent damage over and over again. My ears are many times worse than after the original onset of my T. I do not expose myself to much of any noise these days and they are at constant level now. Never again for me personally.

 

@Telis Sorry to hear that was your experience and hope you are managing ok. If you don't mind me asking, these increases were a result of day to day noises? Anything you can recall specifically?

When I posted the poll, I presumed a lot here would vote yes. The question is being put to a forum of people who would have largely had a negative experience, but I'm sure there are as many out there that have found the exact opposite to be the case for themselves. An example would be professional musicians that continue within their profession with seemingly no worsening effects.

Take someone like James Hetfield for example, has had Tinnitus for over a decade yet continues to perform. (obviously uses protection now). A Metallica show would surely register pretty high on the decible scale so even protecting his hearing surely he is taking a big risk, yet he keeps performing and apparently has T in both ears. There are plenty of other examples like that too. And that's before you take into account all the Joe Public's who have Tinnitus but don't post on forums etc.......

Some may ask, why bother asking the question in the first place. I guess I'm still figuring out what I feel comfortable doing going forward. Music is a big part of my life but I don't know if I'm willing to take any "risks". There's so much conflicting reports especially regarding this question it's hard to know what to do. Thanks for all the replies.

 

I guess it could have something to do with the cause and the extent of ones damage. In my case I have extremely bad H as well as severe T. I did a serious number on my ears and brain. I had very mild T in my right ear from performing the Valsalva method due to a plugged ear. I then proceeded to see a few doctors trying to fix the issue...I was handed a serious combo of ototoxic drugs including antibiotic ear drops that fried a large portion of my hearing. I'm not sure about noise induced tinnitus, maybe it's a totally different animal, I have no idea.

 

Thanks for the response @Telis .

This is it in a nutshell though

"I'm not sure about noise induced tinnitus, maybe it's a totally different animal, I have no idea"

Same goes for Tinnitus from Ototoxic Drugs, Stress the list goes on.

 

Just to further the point I made earlier. Lars Ulrich claimed to have developed Tinnitus in 1988, meaning he has persevered with his career for almost 30 years.............

 

Yeah I'm sure if you have minor damage you could go on for ages with very little worsening. My gf has had minor tinnitus since she was 20 (from working in the night club industry) and she still goes to clubs with no ear protection to this day (she is now 32). I'm sure it depends on the extent of the original damage.

My ears-burned up from ototoxic poison, no chance. Not being a wuss, I have tried exposing myself to moderate noise more than a few times after my T onset. Very bad choice for me. Believe me, if I could I would, living like this is not what I want.

I think you have to be reasonable based on the condition of your ears. Just because Lars and my gf can do it, doesn't mean I can get away with it.

 

@Telis Of course man, not suggesting you could. I was thinking out loud really. Wondering about the many cases like your girlfriends even where things like clubbing and concerts are still possible.

 

I've been thinking about this particular subject tonight a lot. I have JUST started reaching a point where I don't obsessively monitor my tinnitus and don't react with fear and despair every time I hear it or if my hyperacusis give me a little bump. I also agree that I don't think there's a simple answer to this problem. I think that one thing that everyone can agree on is that hearing damage is cumulative. Which to me seems to imply that a damaged ear(with damage to the hair cells as determined by an Otoacoustic Emission Test/CAE etc...)would run a greater risk of sustaining more damage from noise than a non-damaged ear. If that damaged ear gets further damaged the sensation of tinnitus or hyperacusis could seem louder.

I feel like I have been doing much better this past week and finally starting to accept my sounds/not react as much and tonight I taught a piano lesson with a small console spinet piano and I was done I was talking and felt like I had a spike that was accentuated by my own voice (when I spoke I heard the tone louder). Now I would be totally ok with this and could deal as long as I knew I wasn't doing any damage to my ears by teaching a lesson. (I had already taught 4 lessons that today but they were spaced out and this was the only one that made me a bit sensitive to the sounds).
My tinnitus didn't stay spiked and by the time I was home (20 minutes later) it was down closer to base line.
I really think that I need to get an OAE to put my mind at rest. I spent two months using ear plugs for every lesson that I taught to just "always protect" but I feel like I was doing more damage by always hearing the t with the plugs in and when the sound wasn't that loud.
@Dr. Charlie @Dr. Nagler --- Maybe you guys could chime in on this thread? I have spoken to about 2-4 audiogists about the question of the "reacting" or my tinnitus to sounds and whether or not it is doing damage and one said any time your tinnitus flares up after sound it is cause you are irritating you ear. I'm just as confused as @Greg Clarke on this subject.

Thanks and thank you in advance to any intelligent responses you guys could give!

 

I had mild tinnitus for 25 year from concerts at the Fillmore East. Jonny Winter, Allman Brothers...first row seats. Then add in playing in bands, audio engineering and lots of drugs. Fast forward 20 years, and hearing loss is greater from more bands, a gun shot by my ear, feedback, etc. hearing loss is greater but mild.
Then add in antibiotics from infection in bladder and my Harley Davidson....hearing loss is progressed in one ear but the other is just "aged".
At some point 7 months ago the bad ear dipped to moderate, boarder line severe and the good ear went to moderate. This I learned after I had some sinus issue and without much notice or significant event, my very mild tinnitus went hyper. Hearing test indicated the additional loss.
But for 25 years my hearing was abused and I didn't have additional loss till much older. So add in age to the equation and you are much more susceptible.

Your age and genetics surely play a part in adding damage. It's always a matter of time and abuse. Even at lower volume if your listening with closed earbuds the chances are greater for more loss, I would think. But everyone is different.
I'm surprised I held out this long. There's a lot of variables.

 

Larry may I ask how old you are? I'm 31

 

I am 58

 

First 6-12 months following trauma

Apoptosis in the inner ear is a prolonged process. Any hair/supporting cells that may survive an acoustic trauma may not survive if they encounter additional noise exposure. Although hearing loss can be acute it is generally accepted that it is a cumulative process...this is well established within scientific literature.

 

So, the general understanding of how long a human´s maximum exposure (time/loudness) may be, to avoid risk of hearing damage, is not to be taken as valid for one with (noise induced) tinnitus?

I´ve always understood it as exposure per 24 H, and then your ears/cells get rested, and are ready to go again, the next day. This is since it´s not really a mechanical damage, but more of a cell dying from burning out, so to say... Using up all it´s nutrients (sorry, can´t explain it better in English).

Meaning, as long as you stay within safe levels of exposure, you should not run any risk of accumulative damage?

 

You're asking the question everybody here would like to be answered by science.

You might get a lot of responses to your question, but if anyone will claim anything - it's all based on anecdotal evidence and personal experiences.

No one knows for sure.

 

My personal opinion: OSHA's 85dB risk criteria is not ok for us. We should use WHO risk criteria instead of those developed by OSHA.

75dB for 8h,
78dB for 4h,
81dB for 2h,
83dB for 1h


Are we safe with those?. No one knows.

 

From the text below:

"When setting this limit, NIOSH acknowledged that approximately 8% of workers could still develop hearing loss."

Understanding Noise Exposure Limits: Occupational vs. General Environmental Noise

https://blogs.cdc.gov/niosh-science-blog/2016/02/08/noise/

"The NIOSH REL is an occupational exposure limit, and was set to protect workers from developing hearing loss –substantial enough to make it difficult to hear or understand speech – over the course of a forty-year working career. Risk of hearing loss from noise exposure is a complex issue. Some single, brief intense exposures (such as a gunshot going off near your ear) can cause immediate hearing loss; however, these cases are rare. Most noise-induced hearing loss is a result of accumulated damage from repeated exposures to hazardous noise. In addition, the risk of noise damage depends on several factors: how loud the noise is, how long you listen to it, how much rest your ears get between exposures, and your individual susceptibility to noise.

Occupational noise exposure limits are established to simplify the complex question of risk and protect as many workers as possible from the effects of noise. The NIOSH REL is not designed to protect all workers from all hearing damage. When setting this limit, NIOSH acknowledged that approximately 8% of workers could still develop hearing loss. In order to protect the most sensitive 8% of the population, NIOSH recommends that hearing protection be worn whenever noise levels exceed 85 dB(A) regardless of duration."

 

How is 8% even acceptable when you are setting standards for employers who don't care what happens to their workers? What if the set the standard that it was acceptable for 8% of employees to have perminant vision loss as a result of their job? The whole thing reeks of corruption. More likely they did not want to limit industry too much so they set the standards a little high. NIOSH standards are actually much stricter than OSHA too, and OSHA is what most American companies are regulated by.