Have you lost your hearing due to loud noise? (Noise-Induced Hearing Loss - NIHL) Let's talk about this!

Have you ever been to a loud music show or party and heard a "R..." sound in your ears? Or have your ears felt heavy and blocked? Most of the time, we don't pay much attention to these things. We think, "It'll be okay in a while." But did you know that constant exposure to loud noises like this can gradually, without you even realizing it, permanently damage your hearing? That's what we medically call 'noise-induced hearing loss' (NIHL).

Simply put, what is NIHL?

Okay, let's put it this way. Inside our ears, we have very fine, hair-like structures that capture sound waves and send messages to the brain. We call these 'hair cells.' Think of it like a beautifully manicured lawn. When you hear normal sound, it's like a gentle breeze blowing over the grass. It doesn't hurt.

But if you suddenly hear a loud noise, like a cannon going off, it's like a heavy vehicle driving over that lawn. Some of the grass blades bend, and after a while they straighten up again. That's why after a sound, your hearing decreases for a while, and then it recovers. But when you keep getting exposed to loud noises like this, those grass blades die permanently. That's how these delicate hair cells in our ears die, they don't grow back. That's when you permanently lose your hearing . This is called NIHL.

The special thing about this is that it is the only preventable hearing loss. That means, if we are a little aware, we can protect our ears.

How common is this condition?

This is more common than you might think. Research has found that this condition:

• 5.2 million children and young people between the ages of 6 and 19 have been affected.
• It has affected 26 million adults between the ages of 20 and 69.

These statistics show that this is a problem that can affect anyone, regardless of age.

What are the symptoms of NIHL?

There are several signs that you may notice that your hearing is being affected by loud noise. Sometimes these symptoms may appear suddenly, or they may develop gradually over time.

• Pressure or fullness in the ear: A feeling of heaviness, as if water has entered the ear.
• High-pitched sounds become muffled: birds chirping, soft sounds like a baby crying become muffled.
• Inability to hear what is being said clearly: When someone speaks, the words sound unclear, as if they are being swallowed.
• Tinnitus: As many of us know, it is a constant ringing sound in the ears .

Sometimes, after exposure to loud noise, these symptoms can last for a few minutes, hours, or even days and then go away. Then we think, "Oh... it's okay." But what really happened was that the ear was damaged, but it has since recovered. But with continued exposure to these types of noise, that damage becomes permanent.

Main causes and types of NIHL

As we discussed earlier, the main cause is damage to the delicate hair cells inside the ear. NIHL can be divided into two types depending on how this damage occurs.

1. Acoustic Trauma (Sudden Hearing Loss): This occurs when a person is exposed to a single, very loud, sudden sound. For example, a firecracker, a gunshot, or a bomb exploding right next to their ear. In such cases, hearing can be lost immediately and permanently .

2. Chronic NIHL (Non-specific hearing loss): This is caused by exposure to low-intensity noise over a long period of time. For example, someone who wears headphones and listens to music at maximum volume all day, or someone who works in a noisy factory. For these people, it can take weeks, months, or even years for symptoms to appear. Therefore, hearing loss gradually occurs without them realizing that the damage is happening.

What kind of noise is harmful to our ears?

The unit of measurement for sound intensity is called a decibel (dB). Generally, prolonged exposure to noise levels of 85 decibels (85 dB) or higher can damage our hearing. Even a single exposure to noise levels of 120 decibels (120 dB) or higher can cause immediate damage.

Let's see what the decibel levels of some of the sounds we hear in everyday life are like.

Who is most at risk for this?

In fact, anyone can develop NIHL. However, some people are at higher risk. This is especially true for those who work in noisy environments.

• Agriculture (machine sounds like tractors)
• Carpentry (wood chipping machine sounds)
• Construction field (excavator, grinder sounds)
• Military service (gunshots, explosions)
• Mining industry
• Oil or gas extraction

It is mandatory for those engaged in such jobs to wear hearing protection devices (ear plugs, earmuffs). Also, this risk is present for those who frequently go to music concerts, DJ, and work in nightclubs.

What other complications can occur due to NIHL?

Hearing loss doesn't just mean you can't hear sounds. It can have a big impact on your quality of life. You may feel less inclined to socialize, feel irritable, and feel frustrated by everything.

Other problems that can occur due to NIHL include:

• Tinnitus: Hearing a constant "ringing" sound in the ears.
• Hyperacusis: Hearing even normal sounds so loud that they are unbearable.
• Stress and Anxiety: Constantly feeling stressed because you can't hear what others are saying.
• Depression: Depression due to social isolation.
• Insomnia: Disturbance in sleep, especially due to tinnitus.
• High Blood Pressure: A condition that can be caused by prolonged stress.

How to recognize this condition?

If you have even the slightest suspicion that you have NIHL, the best thing to do is to see your family doctor (GP) . He or she will examine you and, if necessary, refer you to an ear, nose, and throat specialist (ENT surgeon) or an audiologist.

Specialists perform various tests to check your hearing.

• Pure-tone testing: In this, you put on two headphones and listen to very subtle sounds of different high and low tones. You should give a signal as you hear the sound. This will help you find the lowest sound level you can hear.
• Speech audiometry: This measures how clearly you can hear and understand spoken words.
• Auditory brainstem response (ABR): This tests how your auditory nerves and brain respond to sounds.
• Otoacoustic emissions: A test that measures the activity of hair cells in the inner ear.
• Tympanometry: Measures the movement of the eardrum and the function of the middle ear.

These tests can accurately identify whether the cause of your hearing loss is NIHL or another cause.

What are the treatments for NIHL?

Unfortunately, it is not possible to regrow hair cells in the ear that have been damaged by noise, meaning this condition cannot be completely cured. Prevention is the best treatment.

However, if you already have hearing loss, there are treatments that can help you hear better.

• Hearing aids: These are the most commonly used devices. They amplify outside sounds and help you hear clearly.
• Cochlear implants: If hearing loss is severe enough that hearing aids are no longer helpful, doctors may recommend this option. This is a surgically implanted device.

In some cases, especially in cases of immediate damage such as acoustic trauma, doctors may prescribe medications such as corticosteroids to reduce swelling in the ear.

Can't it be prevented? Of course it can!

This is the most important part. While you can't undo the damage that has already been done, there are many things you can do to prevent further damage.

• Reduce the noise: Avoid loud noises whenever possible. Turn down the volume on the TV, radio, and music player.
• Move away: Move a little further away from a loud noise (e.g., near a speaker, near a machine). The farther away, the less effective the sound.
• Wear protective gear: Wear ear plugs or earmuffs when going to places like music concerts, construction sites, and factories. There are even ear plugs specifically for music concerts that reduce noise without compromising the quality of the music.
• Give your ears a break: If you have been exposed to loud noise for a long time, give your ears a break by staying in a quiet environment for a few hours.
• Protect your children: Young children have very sensitive ears. When taking them to places with loud noises, don't forget to cover their ears.

When should you see a doctor?

If any of the following apply to you, see a doctor as soon as possible.

• If you are regularly exposed to loud noise due to your job or hobbies.
• If you experience a "ringing" sound (tinnitus) in your ears after a loud noise.
• If you notice any changes in your hearing.
• If you experience sudden or rapid hearing loss.
• If family members or friends often say, "You can't hear what we're saying right now."

Hearing is a precious gift we have been given. Rather than regretting it later, it is wiser to protect it while we have it.