The Tinnitus Clinic

When people first started to engage in warfare, being concerned about any health impact that the noise of battle might have had on soldiers was probably not high on anyone’s mind.

There are anecdotal stories going back centuries of soldiers being deafened by guns in the artillery, and as time has passed we have become more knowledgeable about the danger of hearing loss, and the impact on quality of life for people who lose hearing, and who may subsequently suffer with tinnitus.

The armed services have worked hard to provide the best possible ear protection under very hostile and challenging conditions. However, perhaps it is inevitable that men and women who serve in the military will, at some point in their career, be exposed to potentially damaging high intensity sound signals.

Impulse noise levels from military grade firearms and support weapons can regularly exceed 150 dB which is loud enough to cause immediate, irreversible damage to the auditory system. Once the hearing is damaged under these circumstances, there is no getting it back.

Even engine noise levels from land vehicles and aircraft can also predictably exceed 100 dB, particularly when engine revolutions are high. Considering that permanent auditory damage can start to occur if humans are exposed to sound pressure levels at, or above, 85dB it is clear that the risk of personnel suffering auditory damage is high if appropriate precautions are not taken.

It is well documented that exposure to high sound pressure levels can induce both temporary and permanent hearing loss. This form of auditory trauma most often causes a reduction in high pitched hearing acuity; sometimes with a particular loss emphasis around the resonant frequency of the human ear canal (usually between 3 and 4 KHz). This high frequency hearing loss, typically, leads to a reduction in what is called “speech discrimination ability”.

People with high pitched hearing loss are less able to hear consonants like ‘sh’, ‘th’ etc.. In addition, they also start to become less able to separate speech sounds from background noise leading to a reduced ability to communicate effectively in everyday social environments like restaurants etc.

This acquired hearing loss will also become greater over time as the individuals gets older.

There is also a host of evidence to demonstrate that hearing loss, induced by noise trauma, can also lead to tinnitus. Tinnitus is defined as the involuntary perception of sound in the absence of external noise, which is perceived as originating within a person’s ears or head. People with tinnitus often develop a negative emotional reaction to the tinnitus sound that can bring on anxiety. This emotional state can, in turn, lead to disrupted sleep and an inability to relax in quiet environments and a reduction the quality of life.

Sleep deprivation is a well documented phenomena which has been used as a method of torture in the past because it can cause both mental and physical breakdown over a long period of time,

Some people who have been exposed to excessive sound, also experience a change in the way they perceive loudness. They become far more sensitive to noise, and can become bothered by even small everyday low level sounds.

The clinical name for this is hyperacusis (over sensitive hearing) and is often diagnosed after acute noise trauma events that are linked to either temporary or permanent hearing losses. Hyperacusis can be challenging to treat and is known to have the potential to dramatically reduce quality of life.

So once the damage is done what can help?

As soon as you are aware of a problem with hearing you should go to your GP and seek a referral to the local audiology department. The sooner the hearing is aided by using a device the sooner the drop off in hearing will be slowed down.

There is a great deal of stigma around regarding hearing aids. If you are concerned about how people might perceive you for hearing an aid, it is worth remembering that people whose sight is poor will wear glasses or contacts. They don’t wait until they have very poor sight to seek help.

Many aids are now very discreet and are barely visible, so make sure you ask for the most discreet aid that is available.

If you are aware of having tinnitus, then look for some good self help advice. The American Tinnitus Association and British Tinnitus Association all have self help guides available on their websites.

The aim of self management is to reduce your focus on the tinnitus symptoms. The more you can stay physically and socially active and think about your interests rather than your tinnitus, the less your tinnitus will impact on you. Over time your brain can adjust to the tinnitus sound.

Self help may work for you, but if not seek a referral to your local tinnitus clinic or audiology centre where they will be able to provide you with information and treatment options.

Above all, wherever possible protect your hearing and that of your family. Once it’s gone – it’s gone.
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