ENT specialist's story about ears, nose, and throat. This is Ears, Nose, and Throat TV. I am Dr. Park Min-hyun, an ENT specialist at Boramae Hospital, who will be hosting today. Professor Im Ki-jeong, who will give us helpful insights, is here. Hello, I am Professor Im Ki-jeong from the Department of Otorhinolaryngology at Korea University. Loud noises that are disturbing and unwanted are called noise. The sensorineural hearing loss caused by such noise is called noise-induced hearing loss. Today, we will introduce in detail the symptoms, diagnosis, and treatment of noise-induced hearing loss. Shall we start right away? Noise-induced hearing loss occurs when the organ that detects sound, namely the cochlea or the snail-shaped tube, is damaged. In particular, the outer hair cells are often damaged, indicating that a part of the nerve is affected. Since the cochlea, where transmitted vibrations of the eardrum are detected as sound, is connected to the auditory nerve, damage occurs there.

It is waking up. When damage occurs to the sensory nerves, what symptoms do patients experience? When damage occurs to the vestibular nerve, they may have difficulty hearing directions well. Therefore, they tend to show a tendency to keep the TV or radio on loudly. They have trouble understanding their friends' words well, so the other person ends up hearing those words. Even with a little noise around, they often cannot hear the other person's story accurately and end up talking about something else. Due to decreased hearing, many people complain of tinnitus, where their ears ring. In addition to this hearing impairment and tinnitus, they may suffer from discomfort, anxiety, insomnia, fatigue, stress, headaches, and various symptoms, making it difficult for them to lead a normal life. Therefore, in severe cases, it can also affect heart rate and blood pressure, as well as be related to digestive disorders and autonomic nervous system abnormalities.

There are numbers, so it becomes very significant. Noise-induced hearing loss that causes inconvenience in daily life occurs when exposed to sounds of 85 decibels or higher for a long time. Therefore, you should always be careful of sounds above a certain decibel level. However, even if I mention 85 decibels like this, it seems that there are not many people who understand. So, most people may not know what this number means. Therefore, how about explaining the degree of hearing loss more easily by comparing it to sounds we hear in everyday life? Let's express the volume of sounds we hear in daily life in decibels and give an example. For example, whispering is around 0 to 140 decibels, segmented, to see what range of sounds can be heard, and why this can help estimate hearing loss. Sounds that are not heard at all are around 25 decibels, and the sounds we

You can enjoy the sounds of nature, such as bird sounds, the sound of streams, the sound of footsteps in the snow, and so on. In an office or during a conversation, the environment is around 40 to 60 dB. On a bus, subway, or in a restaurant, the noise is around 60 to 80 dB. When using earphones to enjoy music loudly on platforms like YouTube, the maximum volume reaches around 90 to 100 dB. So, if you think about it, if a sound is loud enough to be heard by the person next to you, it's considered to be over 100 dB. When a motorcycle passes by making a loud noise, it reaches around 120 dB, and the noise from an airplane reaches around 140 dB. The total sound reaches 170 dB. By observing how sounds are categorized from loud to soft, we can understand how much sounds vary in intensity. Therefore, by looking at the standards from very loud sounds to very soft sounds, we can understand how sounds are represented. So, not being able to hear the gentle sounds of nature, around 0 to 25 dB as mentioned earlier, is something we miss out on.

If you experience hearing loss of 25dB or more, it is called mild hearing loss, and now you need a hearing test. It means you have hearing loss. If it is difficult to hear sounds above 40dB, conversations on the phone or in noisy environments become uncomfortable. In such cases, you may hesitate to use a hearing aid. Sounds below 75dB usually do not cause noise-induced hearing loss. However, continuous exposure to noise above 85dB can damage the ears, leading to noise-induced hearing loss. Exposure to sounds above 100dB for more than 15 minutes without protection or above 110dB for more than 1 minute regularly can pose a risk of hearing loss. The higher the volume, the greater the damage to our ears. Nowadays, it is difficult to find people without earphones, as more and more people listen to music with earphones.

I am used to listening, especially many young people listen. However, Professor, there is a reason why young people have to listen so loudly. Yes, these days, it is truly an era of well-being. So, now, even young people use public transportation buses or subways a lot to go to school or work, right? But now, within buses or subways, the noise level is usually around 60 to 80 dB. So, trying to listen to music in such places, overcoming this noise of 60 to 80 dB, one must enjoy music or video content at 90 or over 100 dB to be heard now. However, if you continue to be exposed to such loud sounds for a long period, it will inevitably lead to serious hearing loss. Hearing is more likely to deteriorate quickly when exposed to very loud sounds for a long time. This is true not only for public transportation but also.

In noisy PC rooms, children who play games for hours are also exposed to many risks. Therefore, guardians should pay more attention to these issues. According to the announcement of the National Health Insurance Service, about 38% of patients with noise-induced hearing loss are in their 30s or younger. So, noise-induced hearing loss in youths and young adults is very serious. It seems to be a very serious figure. In addition, there is concern about occupations exposed to mechanical noise, similar to those working in industrial sites. If continuously exposed to noise like this, not only noise-induced hearing loss but also tinnitus can occur, right? Professor, could you please explain the relationship between noise-induced hearing loss and tinnitus? The tinnitus we hear in our ears is caused by various factors related to the nerve pathways that detect signals from the auditory nerve, brain, and so on.

Abnormal hypersensitivity occurs due to noise exposure, and many causes of tinnitus are related to hearing loss. Noise-induced hearing loss can lead to some types of tinnitus because hearing loss is a result of decreased hearing. Severe tinnitus ultimately indicates signs of hearing loss. Therefore, it is important to accurately assess hearing and tinnitus through proper hearing tests and diagnostic tests to cope with the current auditory status and hearing loss. So, since we mentioned testing, how about explaining the diagnostic process once? It would be nice to know what tests are used to diagnose noise-induced hearing loss. The tests include pure tone audiometry, tinnitus tests, otoacoustic emission tests, and auditory brainstem response tests or auditory steady-state response tests, which can objectively measure hearing at different frequencies. Various tests that can accurately measure hearing are conducted, and in addition, fundamentally.

When examining the eardrum or conducting a hearing test, impedance tests such as tympanogram are performed. The most important thing is the tinnitus evaluation for accurate diagnosis of tinnitus. This test, called a tympanogram, is conducted to see at what frequency and to what extent the patient has hearing loss and tinnitus along with the hearing test. Usually, we can confirm that tinnitus is heard in the location where hearing loss occurs. After the test, evaluation is done based on more accurate diagnostic criteria. Could you please explain how the diagnostic criteria are set? Sensorineural hearing loss has various conditions and criteria, but it is difficult to explain all of them. Basically, it involves gradual hearing loss after prolonged exposure to noise. Particularly, if there is hearing loss around 4K, it is considered sensorineural hearing loss.

Now, in terms of sensorineural hearing loss due to aging, it seems to decline quickly compared to that appearance. In the case of noise-induced hearing loss, it shows a sharp shape at 4 kHz, which can be clearly observed in our hearing tests. Even in industries, if it is damaged over 50 dB at 4 kHz, there are related laws and regulations to refer to. Let's conclude the diagnosis at this point and briefly touch upon the treatment. Professor, it is commonly said that once hearing is damaged, it cannot be fundamentally restored. Viewers may be curious if this is true. Yes, as you mentioned, unfortunately, the damaged hair cells cannot be recovered, so for patients with noise-induced hearing loss, there is no way to fundamentally restore the hearing loss.

No, but there are cases where suddenly you can't hear within a few days. These cases are now sudden deafness, especially for those who suddenly can't hear after listening to loud sounds in nightclubs or karaoke. If you come quickly, you can receive treatment within a short period of time. Treatment can be done with steroid hormones, steroid injections into the eardrum, antiviral drugs, blood circulation improvers, etc., and with enough rest, some improvement can be expected. However, fundamentally, for noise-induced hearing loss that we think of, there are currently no such recovery methods. Yes, since there is still no clear treatment for noise-induced hearing loss, prevention is the most important. To prevent, how should you manage it? First of all, I would recommend changing the habit of listening to loud sounds or music.

When listening to music, it is more advantageous to use headphones rather than earphones. Even when listening to music of the same volume, with earphones that fit tightly into the ears, all sound is directly transmitted to the eardrums. However, with headphones, the sound spreads in a wider direction, resulting in less physical pressure on the eardrums. Therefore, it is recommended to use headphones. In the case of in-ear canal type earphones, such as earbuds, they tend to deliver sound louder than headphones, which may increase the risk of noise-induced hearing loss. Please remember this and be mindful when using headphones. It is good to avoid listening at high volumes, especially in places with strong background noise like buses, subways, or internet cafes.

It would be good to avoid enjoying it for a long time. In places where public transportation or such noise is heard, it's better not to listen to it. There are many shooting ranges in our country, so when such noise is expected, I think it's a good idea to wear ear protection equipment. Especially, it would be nice to use earplugs. If you think you are unavoidably exposed to a lot of noise, you should give time for your ears to rest in a quiet place from time to time. Also, some antibiotics can cause hearing loss. So, when taking long-term antibiotics, it is recommended to consult with a doctor before taking the medication. It is also helpful to regularly receive hearing tests and examinations. Using headphones or

You gave good advice, such as listening a bit quieter. I would like to show you some materials that could be helpful for prevention. It is called the Ten Commandments of Hearing Loss Diagnosis for the Hearing Impaired, distributed by the Korean Society of Otorhinolaryngology. If you look through it, you will see ten different situations like phone calls, conversations, TV sounds, and more. If three or more of these situations match your own, it is recommended to visit the hospital promptly. Please read it and see if you have any of these symptoms. We hope you will check if you have any of these symptoms. An otolaryngologist talked about ear, nose, throat, and TV noise-induced hearing loss. Thank you, Professor Lim Ki-jung, for your help for a long time. Then, I will see you again in the next episode of Ear, Nose, Throat TV.

한 번 걸리면 회복하기 어려운 소음성 난청

안녕하세요.
대한이비인후과학회의 '귀코목TV' 유튜브 채널입니다.
'귀코목TV'는 귀,  코, 목 그리고 얼굴과 관련된 질환 및 치료에 대해 올바르고 다양한 정보를 알려드리고 있습니다.
본 영상은 격주로 금요일마다 업로드됩니다. 많은 관심과 구독을 부탁드립니다!
