Acoustic trauma (pop trauma)

Comprehensive Guide to Acoustic Trauma (Pop Trauma)

An acoustic trauma or acoustic trauma is an injury to the hearing organ by the action of extreme noise and pressure on the ear. This can cause permanent injuries and permanently impair hearing.

What is acoustic trauma?

Acoustic trauma is damage to the hearing organ from exposure to extreme noise and pressure on the ear.

Acoustic trauma is damage to the hearing organ caused by brief exposure to noise and pressure. The ear can compensate for and withstand a certain amount of pressure and volume, but if the values ​​are too high, it will be damaged.

The human hearing organ consists of an outer part that is located in auricle, Ear canal and middle ear divided. The middle ear is separated from the ear canal by an elastic membrane (eardrum). The outer part is also called the sound conduction apparatus, because this is where the sound hits and is passed on to the inner ear. The inner ear is made up of the cochlea and the organ of equilibrium.

The extremely sensitive cochlea receives the sound and sends the signals to the brain; the organ of equilibrium is responsible for registering the position and movements of the head. If strong noise hits the ear as a sudden short bang or even permanently, it can no longer process these stimuli and acoustic trauma occurs. Depending on the source of noise, a distinction the explosion trauma , the acoustic trauma and the noise trauma .

Causes

The cause of acoustic trauma is excessive noise. There are three types. We speak of bang trauma when a volume of more than 150 db affects the ear for a period of less than 3 ms. This is the case with rifle shots or firecrackers.

An explosion trauma is caused by a volume of over 150 db that lasts longer than 3 ms. Causes of this type of acoustic trauma are, for example, detonations or the explosion of an airbag. A slap in the face can also trigger an explosion trauma.

The noise trauma is caused by permanently excessive noise, such as occurs in the disco, during construction work or at rock concerts. With all three types of causes, the hearing organ is injured and an acoustic trauma is triggered as a result.

Symptoms, ailments & signs

People who have been exposed to a loud bang usually experience acute hearing loss in one or both ears immediately afterwards. In addition, tinnitus can occur, which manifests itself as a persistent, high-frequency noise in the ears. After a bang, there is usually an over-sensitivity to noises .

You experience dizziness , imbalance, and other symptoms caused by temporary or permanent damage to the eardrum. A severe bang can also be associated with a tear in the eardrum . Then, in addition to the symptoms mentioned, there are usually pain in the ear, easy bleeding and nausea .

In addition, those affected feel vertigo and suffer from jerky eye movements, the so-called nystagmus . A very extensive eardrum injury can lead to further symptoms such as facial paralysis. An otitis media can also occur. This usually manifests itself as pain in the area of ​​the affected ear canal and a slight discharge.

In exceptional cases, the affected people suffer permanent hearing loss after an impact trauma. In the absence of treatment, severe acoustic trauma can lead to complete deafness . However, based on the symptoms and complaints mentioned and an anamnesis, the trauma can usually be diagnosed quickly and treated in a targeted manner.

Diagnosis & course

Acoustic trauma can cause various injuries to the ear. The eardrum can burst, the ossicles torn apart and the windows to the cochlea and organ of equilibrium can also tear.

Often there is earache and decreased hearing performance. Noises in the ears (tinnitus) or balance disorders and dizziness are also possible. After a pop trauma, the symptoms often improve a few days after the event, but in about half of the cases the damage is permanent. The ear usually does not recover from an explosion trauma and the disturbances persist.

A noise trauma, i.e. permanently excessive sound, usually results in permanent hearing loss for certain high frequencies. One speaks here of high-frequency hearing loss. The history of the patient and knowledge of the triggering event are important in diagnosing acoustic trauma.

With a hearing test , the doctor checks the hearing ability and draws a so-called audiogram, in which the hearing ability and the hearing loss are shown. Other special tests can be used to determine exactly which parts of the ear were damaged by the acoustic trauma.

Complications

A variety of complications can occur with a blast trauma. In the worst case, the ear canal is so badly injured after the impact trauma that hearing loss or complete hearing loss can occur. A hearing loss cannot be treated easily because there is no specific treatment for the eardrum.

In many cases, the patient has to live with the disease and is dependent on the use of a hearing aid. This can lead to severe restrictions in everyday life. Especially in young people, hearing loss can lead to depression and a reduced quality of life.

After an acoustic trauma, noises occur in most cases in the ear. This can be a hissing noise or a beeping sound. Whether these noises will disappear cannot be predicted. Often they only occur temporarily. If the noises occur continuously, this can lead to headaches and insomnia for the person concerned.

This leads to fatigue and a generally aggressive mood. In addition, there may be pain in the ear or imbalance. The patient complains of dizziness and nausea. A doctor should always be consulted after an impact trauma in order to avoid consequential damage.

When should you go to the doctor?

Specialist treatment is not necessary for every form of acoustic trauma. After an impact trauma, the hearing function is usually restored after a few days. If the symptoms persist, treatment by a specialist is advisable.

If pain in the inner ear persists even hours after a trauma, a specialist should check whether the sound conduction apparatus is damaged. In addition to sharp pain and hearing noises, bleeding in the ear is a clear indicator of the need for treatment. These severe forms of acoustic trauma require medication and the healing process to be supervised by a medical professional.

For many, complaints that affect hearing function occur over a longer period of time rather than through trauma. If hearing deteriorates permanently, a medical diagnosis will clarify the cause. By examining the outer ear, the specialist determines which parts are damaged. If chronic hearing loss is suspected, notification is mandatory, as the illness may limit the person’s ability to work. If necessary, a specialist can determine exactly how severely the hearing is damaged and which frequencies the patient can still perceive.

Treatment & Therapy

Treatment for acoustic trauma depends on how severely damaged the ear is. Usually a therapy similar to that used for a sudden hearing loss is used. Infusions and cortisone are administered to stimulate the blood flow , with the cortisone often also being introduced directly into the inner ear.

An explosion trauma is often treated with overpressure. In addition, the patient is placed in an overpressure chamber in which he is exposed to high ambient pressure and at the same time breathes pure oxygen. This increases the oxygen concentration in the blood, which counteracts infections and promotes the healing of injured structures. If injuries to the middle ear occurred during the acoustic trauma, these are treated surgically.

In a microsurgical procedure, the ossicles can be restored with a plastic and ruptures (tears) of the eardrum or the windows to the inner ear can be closed. The healing phase of the acoustic trauma lasts about six weeks. If there are still complaints, one must assume that they will persist.

Outlook & forecast

Healing takes place in the ear depending on the severity of the damage. No improvement in hearing function is to be expected in the case of chronic noise trauma. The damaged hair tissue cannot form again and the support of hearing aids is necessary.

Damage caused by short-term exposure to sound has a more positive healing balance. Destroyed parts of the sound system such as the eardrum are regenerated by the body or surgically covered and recover after a few weeks. Only in severe cases is there a risk of hearing loss. However, if a damaged ear is exposed to high volume levels again after healing, symptoms are more likely to recur than a healthy ear.

A frequent complaint from injured parties is the occurrence of chronic noises in the ears, which are perceived with different intensities. After trauma or phases of great psychological stress, tinnitus usually disappears after a few hours or days. Some noises in the ears keep recurring after trauma, especially in stressful situations. Treatment by a specialist hardly helps with ringing in the ears, and covering with cotton wool is also useless. In severe cases, tinnitus sufferers can plague them for a lifetime.

Prevention

You can prevent acoustic trauma by avoiding places with high noise pollution. At concerts, disco visits or other events with extreme noise, you should protect your ears with special earplugs.

You can do that yourself

For successful healing after an acoustic trauma, those affected should carefully restructure their everyday lives. Patients themselves contribute a lot to their own quality of life and can alleviate symptoms with simple means.

After a bang or explosion trauma, patients should under no circumstances be exposed to further noise levels above 85 decibels. The inner ear needs rest so that the destroyed sound apparatus does not suffer any further damage. Covering the auricle with cotton or cloth often helps . Cooling should be avoided, as the reduced blood flow to the skin can disrupt the healing process.

In the case of tinnitus or chronic noise trauma, the psyche of those affected is particularly stressed. Many patients drown out annoying noises in the ears with headphones and soft music – if only one ear is affected, this method is also suitable during the day. Wearing headphones in both ears would endanger everyday traffic and is prohibited by law on bicycles.

The sensitivity to noises resulting from the damage to the inner ear and the loss of hearing function in certain frequency ranges also make contact with other people more difficult. Openness is the best way here – if the personal environment knows about the injury, people can be more considerate.

Acoustic trauma (pop trauma)

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