Delayed Reaction to Noise Exposure?

On Monday, 3 weeks ago, I went to pharmacy for a consultation which took place in a small glass room, not bigger than 2 x 2 m, glass door closed.

As the pharmacist was going through the cupboard to get a book, something (I think it was a plastic protein shaker) fell out of the cupboard onto "something" (can't be the floor because it's a carpet and it would not make that much noise), resulting in a very loud BANG!

The spike started 4 days later (Saturday), and is still going on 3 weeks later.

My healthy ear now has a "bubble bursting" sound every time I swallow or yawn.

Could this be delayed damage and reaction? Is the new sound tympanic muscle damage? Is this now permanent?

 

Sorry to hear about your spike. I had 2 bad tinnitus spikes in the last few months, and both took about a day before they started. Like yours, both were due to loud noise exposure. The spikes were so bad that I thought they were permanent and each lasted about 2 weeks but in both cases the spikes eventually settled down. I also took Magnesium and NAC supplements and was put on a course of Methylprednisolone.

I can't imagine yours from the sounds of it would cause any permanent damage though I would at least take supplements.

 

I’m 3 weeks on from loud noise exposure in a club when my new super custom fit earplugs didn’t fit properly and now I’m in a really bad spike :-(

 

Your earplugs not fitting properly may not be the reason you are now experiencing a spike. Some people believe wearing earplugs, even high-end custom types, will keep them safe from spikes, but this is not necessarily true. If external sound is loud enough, it will pass through the head and transfer to the inner ear by bone conduction and cause the tinnitus to spike.

If a person is fortunate, the spike will reduce, and the tinnitus return to baseline. However, the spike can increase the tinnitus to a new permanent level or completely change the tinnitus to variable. If you keep having spikes, you run the risk of the tinnitus increasing or developing variable tinnitus, so be careful. Don't put your trust in earplugs and be mindful of going to places where sounds are loud.

Michael

 

Hey Michael,

Do you know how much sound can enter from bone conduction? I’ve heard from audiologists that sound via bone conduction is about 40 dB below the level outside your body. At least in the higher frequencies. So at 110 dB it’s still sitting around 70 dB. I can somewhat attest to this as I have a distortion above 75 dB and I don’t get that with -30 dB earplugs until sound reaches about 105-110 dB.

 

Thank you for the figures. Exposure to loud noise is one of the most common causes of tinnitus. Most (but not all) of the people that visit this forum developed tinnitus in this way. Typically, it was brought on by regularly listening to audio through some type of headphones at too high a volume or attending places where loud music was played. Working in a noisy environment can cause it too or engaging in a sport such as shooting a gun. A person can also develop noise-induced tinnitus, from sustaining a trauma to the head.

Although it reads on @Ryan Edwards's profile cause of tinnitus unknown, I suspect the original cause back in 2013, was noise-induced, brought on in one of ways I have described above which he may not have been aware of. Spikes are a further indication of noise-induced tinnitus and I suspect Ryan Edwards has experienced them more than once.

A person can recover from noise-induced tinnitus in various ways. The best is to fully habituate where the person can comfortably live with the tinnitus and all traces of hyperacusis and oversensitivity to sound are cured. However, once the auditory system has been affected by loud noise trauma and the onset of tinnitus occurs, it is never quite the same as before. It is similar to being cut by a knife; the wound may heal but a scar remains. Therefore, the figures you have quoted from your audiologists don't mean much, because the auditory system will always be vulnerable or more sensitive to external sound. This will vary from person to person since no two people are the same.

Please peruse some of the posts in this forum and you'll read where a person has habituated to their tinnitus, then noticed at some time in the future it has spiked or increased. Type headphones in the search box at the top of this page and read the posts.

I mentioned there are various ways to recover from noise-induced tinnitus. Some people can habituate but if hyperacusis or oversensitivity to sound isn't completely cured, either naturally or they have had treatment under the care of an audiologist and wearing white noise generators to desensitize the auditory system, spikes in the tinnitus can become a long-term problem. This usually makes the auditory system more sensitive and vulnerable. Some people try to deal with this by wearing earplugs but over time this often exacerbates the problem, which I have covered in my thread, Hyperacusis, As I See It.

Michael

 

Hey, I totally understand this. I’ve read many of your posts and agree with the likeliness of noise-induced damage (headphone use, etc.) for most people.

My question is more so if you know specifically about how much sound can enter through the scull via bone conduction?

For example, if a person’s ear canals are fully blocked, how much sound will be received via bone conduction when exterior noise is 100 dB on average? As mentioned, audiologists and the scientific experiments that have used model skulls suggests about 40 dB of reduction in high frequencies before sound hits the cochlea. Which should significantly reduce harm in most scenarios at 100 dB and below.

As you said, the effect loud sound has on a person depends on how sensitive or damaged their auditory system is. However, I’m trying to understand whether you disagree with the amount bone conduction reduces exterior sound vs. it entering ears via air conduction.

Can we even consider 90 dB of external sound “loud” when using 30 dB reduction earplugs if the cochlea is receiving under 70 dB?

 

You raise some interesting points but unfortunately, I don't know how much sound or decibels enters through the skull via bone conduction. I do know that many people that have noise-induced tinnitus and used earplugs or custom moulded earplugs at venues where loud music was played found their tinnitus either spiked or increased to a new permanent level. It is not a good idea to think wearing earplugs will always protect you in very noisy environments.

I don't know the answer.

It is all well and good for audiologists to be carrying out scientific experiments on model skulls, however, this is not the same as a human skull. When a person is wearing earplugs in a club, sound is being reflected off the walls, ceiling and the floor, so it's not the same as sound coming from one direction. In addition to this, low frequency bass in music, if loud enough, can irritate the inner ear and spike the tinnitus.

I neither agree nor disagree and ask anyone that has to answer to please tell me. All I will say, anyone that has noise-induced to tinnitus, should be careful when in overly loud surroundings for long periods of time and not put total trust in hearing protection, because there are no guarantees that your tinnitus won't be affected.

In theory I agree with your analysis and believe it to be correct. However, tinnitus can be very complex. Trying to apply science to it in order to find definite answers is not easy.

Best of luck,
Michael

 

Thanks for your insight Michael, my onset was probably triggered by too much going to loud nightclubs, although having said that, my uncle lives like a monk and yet also has tinnitus.

I guess the question is what do I do now? My GP is sending me to an audiologist and I’m wondering if I should try and get tinnitus maskers to wear as apparently over time they can help?

 

You are welcome Ryan. Many things can cause tinnitus but one of the most common is exposure to loud noise. Your uncle's tinnitus was probably caused by something else.

My advice is to listen to whatever treatment your audiologist recommends and not say anything at this stage, as you could come across as a know-it-all, which might not go down well. I think white noise generators are the right treatment for you, but for best results counselling is advised with an audiologist that specialises tinnitus and hyperacusis management.

White noise generators are not to be used as maskers. Their volume should always be kept below the tinnitus to provide sound enrichment and to treat hyperacusis if it's present.

Best of luck,
Michael