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  Table of Contents 
CASE REPORT
Year : 2022  |  Volume : 26  |  Issue : 3  |  Page : 201-203
 

Occupational noise-induced hearing loss in a video editor: A case report


1 Department of Occupational Safety and Health, Open University Malaysia, Malaysia
2 Department of Medicine, Manipal University College, Malaysia

Date of Submission27-Oct-2021
Date of Decision25-Jan-2022
Date of Acceptance24-Mar-2022
Date of Web Publication26-Sep-2022

Correspondence Address:
Dr. Balachandar S Sayapathi
Open University Malaysia, 9 1/2 Mile, Princess Garden Commercial Centre, Jalan Kuching - Serian, 93250 Kuching, Sarawak
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoem.ijoem_314_21

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  Abstract 


The diagnosis of occupational noise-induced hearing loss is rarely made in a video editor, although there is a high prevalence of hearing loss. A 37-year-old woman experienced gradual hearing loss associated with tinnitus for the past 3 years. Audiometry showed mild-to-severe sensorineural hearing loss in the right ear and mild-to-moderate sensorineural hearing loss in the left ear. There is a dip at 2 kHz, which is more pronounced in the right ear with recovery at 8 kHz. The portable listening devices risk causing hearing loss from high-output noise damaging the cochlear structures. The amplitudes on otoacoustic emission levels are decreased by using these devices, especially among long-time users. Incessant tinnitus may cause adverse effects on the quality of life. Sound therapy devices such as digital signal processing devices through hearing aids may assist this group of patients by distracting their attention from tinnitus.


Keywords: Noise-induced hearing loss, personal listening devices, threshold shift, tinnitus, video editor


How to cite this article:
Sayapathi BS, Rowther S. Occupational noise-induced hearing loss in a video editor: A case report. Indian J Occup Environ Med 2022;26:201-3

How to cite this URL:
Sayapathi BS, Rowther S. Occupational noise-induced hearing loss in a video editor: A case report. Indian J Occup Environ Med [serial online] 2022 [cited 2022 Dec 7];26:201-3. Available from: https://www.ijoem.com/text.asp?2022/26/3/201/357023





  Introduction Top


Occupational noise-induced hearing loss is one of the main occupational diseases in the US.[1] Noise-induced hearing loss may occur despite wearing a hearing protection device as noise may be transferred through air leaks or transmitted through bone conduction. The threshold shifts do occur while using digital music players. The increment of the shifts would depend on the level of noise produced and the duration of exposure. The high stimulus of noise for a long duration would damage the cochlear structures and decrease the amplitudes of otoacoustic emission.[2]


  Case Report Top


A 37-year-old woman experienced gradual hearing loss associated with tinnitus for the past 3 years. She was referred on February 2019 as the hearing loss had worsened especially on the right side without any symptoms of discharge. She used to smoke for 3 years (0.05 pack-year) and occasionally consumes alcohol. She denies any significant past medical illness nor family history and had not undergone any surgical procedures before. The patient had been working as a video editor since 2004 in a broadcasting center in Malaysia. She has been using earphones especially on the right side while editing the videos. The otoscopy examination and the external auditory canals of both sides revealed normal findings. The Rinne tests were positive on both sides of the ear, and there was no lateralization on the Weber test. Tympanometry showed type A of middle ear functioning for both ears. Pure tone audiometry showed right mild-to-severe sensorineural hearing loss and left mild-to-moderate sensorineural hearing loss as shown in [Figure 1] and [Figure 2], respectively. Dips are noted at 2 kHz and 4 kHz, which are more pronounced in the right ear with recovery at 8 kHz. The findings of repeat pure tone audiometry on May 2019 after 2 months showed similar findings. Magnetic resonance imaging revealed no significant abnormality.
Figure 1: Right audiometry

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Figure 2: Left audiometry

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  Discussion Top


Spankovich et al.[3] conducted an experimental study on 66 participants in the University of Florida to recognize temporary threshold shifts using digital music players. The shifts were observed, and the frequency involved varied, at which the maximum shift was detected. The shifts would rise when the stimulus level and duration of exposure are increased, but no obvious changes were noted on the amplitudes of otoacoustic emissions.

Portable listening devices produce high-output noise causing decreased amplitudes on otoacoustic emissions between 1.5 kHz and 6 kHz.[2] There was 14.1% of hearing loss noticed despite a volume setting of 79.8 dBA as these devices emphasize a low frequency unlike in an industrial setting. Amplified music is a non-steady noise causing deteriorating effects on hearing, and the intensity may vary with different types of music played. The sound pressure level ranges between 91 and 121 dBA at the maximum volume control settings,[4] whereas the peak level may surpass 130 dBA. The use of a personal music player at 100 dB for 15 minutes is equivalent to the use of the music player at 85 dB for 8 hours. The usage of a personal music player for more than 5 years would elevate the hearing threshold at 4 kHz, and the vulnerability to inner ear injury is higher in the right ear. Earphone users have hearing thresholds elevated by 7–9 dB compared to headphone operators.

Noise-induced hearing loss may recover after 2–3 weeks depending on severity of the noise exposure[5] but may be permanent if there is damage to cochlear hair cells. The terminals of the cochlear nerve are swollen on exposure to noise after 24 hours because of glutamate excitotoxicity. The threshold sensitivity may be recovered, but there will be continuous loss of cochlear neurons at high-frequency regions despite showing a normal amplitude in otoacoustic emissions and auditory brainstem responses. Hence, degeneration of the cochlear nerve because of noise may occur in the absence of hair cell damage. The normal hearing threshold may mask the continuing neural degeneration because of exposure to noise. The extended high-frequency audiometry (8–20 kHz) may detect early noise-induced hearing loss because of personal listening devices.

The prevalence of tinnitus is about 10% to 15% in the US and increases with age.[6] The history of exposure to loud noise also increases the occurrence of tinnitus. Around 43% of individuals with normal hearing may have tinnitus. The vestibular schwannoma needs to be ruled out in unilateral and pulsatile tinnitus where imaging is indicated.

Sensorineural hearing loss is typically the result of chronic use of portable listening devices while performing video editing. The hearing thresholds on this patient are permanent because of damage of cochlear hair cells as she has been working as a video editor for past 14 years. She was given hearing aids to divert attention from tinnitus, and they function as hearing amplification in hearing loss.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sayapathi BS, Su AT, Koh D. Comparing the effect of different permissible exposure limits on hearing threshold levels above 25 dBA over six months. Int Adv Otol 2014;10:5-13.  Back to cited text no. 1
    
2.
Montoya FS, Ibargüen AM, Vences AR, del Rey AS, Fernandez JM. Evaluation of cochlear function in normal-hearing young adults exposed to MP3 player noise by analyzing transient evoked otoacoustic emissions and distortion products. J Otolaryngol Head Neck Surg 2008;37:718-24.  Back to cited text no. 2
    
3.
Spankovich C, Griffiths SK, Lobariñas E, Morgenstein KE, de la Calle S, Ledon V, et al. Temporary threshold shift after impulse-noise during video game play: Laboratory data. Int J Audiol 2014;53(Suppl 2):S53-65.  Back to cited text no. 3
    
4.
Vinay SN, Moore BC. Effects of the use of personal music players on amplitude modulation detection and frequency discrimination. J Acoust Soc Am 2010;128:3634-41.  Back to cited text no. 4
    
5.
Kujawa SG, Liberman, MC. Adding insult to injury: Cochlear nerve degeneration after “temporary” noise-induced hearing loss. J Neurosci 2009;29:14077-85.  Back to cited text no. 5
    
6.
Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, et al. Clinical practice guideline: Tinnitus. Otolaryngol Head Neck Surg 2014;151:S1-40.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2]



 

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