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Otology/Neurotology

Audiometric Profiles and Treatment Efficacy in Acute Noise-Induced Hearing Loss

Tuesday, October 3, 2023
1:42 PM - 1:48 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • JA

    Jason K. Adams, MD

    Neurotology Fellow
    Mount Sinai Icahn School of Medicine
    New York , NY, United States

    • Co-Author(s)

  • Ronit E. Malka, MD

    Dr.
    Brooke Army Medical Center
    Fort Sam, TX, USA

  • John P. Marinelli, MD

    Resident Physician; Editor, Headmirror's ENT in a Nutshell & OtoRecall
    Brooke Army Medical Center
    San Antonio, TX, United States

  • IE

    Isaac D. Erbele, MD

    Chief of Neurotology, Associate Program Director
    Brooke Army Medical Center, Joint Base San Antonio, TX
    San Antonio, TX, United States

  • Samuel A. Spear, MD

    Chief, DoD Hearing Center of Excellence
    Defense Health Agency Hearing Center of Excellence
    San Antonio, TX, United States

    • Senior Author(s)

  • Carlos R. Esquivel, MD

    Chief Medical Officer for the DOD Hearing Center of Excellence
    DoD Hearing Center of Excellence, DHA
    San Antonio, TX, United States

Disclosure(s):
Jason K. Adams, MD: No relevant relationships to disclose.
Samuel A. Spear, MD: No relevant relationships to disclose.
Carlos R. Esquivel, MD: No relevant relationships to disclose.
Introduction: While diagnosis and treatment of idiopathic sudden sensorineural hearing loss is well described, there is a paucity of data available for noise-induced hearing loss. This study aims to characterize audiometric profiles of sudden sensorineural hearing loss after acoustic trauma, and describe audiometric changes seen after various treatment modalities.

Methods: This is a retrospective review of 195 patients within the Department of Defense diagnosed with noise-induced hearing loss between January 2008 and December 2019. All patients received an audiogram at time of diagnosis, which was compared when possible, to pre-diagnosis baseline screening audiograms. Post-treatment audiograms after steroid or hyperbaric oxygen therapy were obtained and compared to post-diagnosis audiograms. All comparisons of pure tone average (PTA) and thresholds across all frequencies were calculated using Wilcoxon rank sum tests for unpaired data and Wilcoxon signed rank tests for paired data.

Results: Left sided injuries were approximately twice as common as right sided or bilateral injuries, but no significant difference was noted in severity based on sidedness. Mean hearing loss across all affected ears was a mild down sloping to moderate sensorineural hearing loss primarily located in the 2000-8000Hz range (p < 0.01). Acoustic trauma related to munitions demonstrated significantly more severe injury in the 4000-8000Hz range (p < 0.03). Patients treated with steroids had significant improvement at all thresholds over patients not treated with steroids, but there was no significant difference between patients treated within 14 days of symptom onset or patients with delayed steroid therapy. No significant difference was seen in improvement with steroids based upon severity of initial hearing loss.

Conclusions: These data represent the first description of noise-induced sudden sensorineural hearing loss audiometric profiles and provide evidence for altered treatment outcomes compared to patients with idiopathic sudden sensorineural hearing loss.