Acoustic trauma (bang trauma)
What is an acoustic trauma?An acoustic trauma or sonic trauma is a damage to the hearing organ caused by extreme noise and pressure on the ear.
Acoustic trauma is a damage of the hearing organ, which is caused by a short-term stress with noise and pressure. The ear can balance and endure a certain amount of pressure and volume, but if the values are too high, it will be damaged.
The human auditory organ consists of an outer part, which is divided into auricles, auditory canal and middle ear. The middle ear is separated from the ear canal by an elastic membrane (eardrum). The outer part is also called sound conduction apparatus, because here the sound hits and is forwarded to the inner ear. The inner ear is composed of the cochlea and the organ of balance.
The extremely sensitive cochlea receives the sound and sends the signals to the brain; the organ of balance is responsible for registering the position and movements of the head. If strong noise, as a sudden short bang or permanently, hits the ear, it can no longer process these stimuli and acoustic trauma occurs. Depending on the type of noise source one distinguishes the explosion trauma, the blast trauma and the noise trauma.
The cause of an acoustic trauma is excessive noise. There are three types. Blast trauma is when a volume of more than 150 db is applied to the ear for a period of less than 3 ms. This is the case with rifle bullets or bangers.
An explosion trauma is caused by a volume of over 150 db, which lasts longer than 3 ms. Causes of this type of acoustic trauma include blasting or the explosion of an airbag. Even a slap can trigger an explosion trauma.
The noise trauma is caused by permanently excessive noise, as it occurs in the disco, during construction or rock concerts. In all three types of causes, the hearing organ is injured, causing an acoustic trauma.
Symptoms, complaints & signs
Persons who have been exposed to a loud bang, usually suffer immediately after an acute hearing loss in one or both ears. In addition, a tinnitus can occur, which manifests itself by a continuous, high-frequency noise in the ears. After a bang trauma there is usually a hypersensitivity to noise.
It causes dizziness, balance disorders and other symptoms caused by temporary or permanent damage to the eardrum. A severe bang trauma may also be associated with a tympanic membrane tear. Then come to the symptoms mentioned usually pain in the ear, slight bleeding and nausea added.
In addition, the 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. Also a middle ear inflammation can occur. This usually manifests itself as pain in the area of the affected ear canal as well as slight discharge.
In exceptional cases, the affected persons suffer a permanent hearing loss after a bang trauma. In the absence of treatment, a severe acoustic trauma can lead to complete deafness. On the basis of the mentioned symptoms and complaints and a medical history, however, the trauma can usually be quickly diagnosed and treated in a targeted manner.
Diagnosis & History
An acoustic trauma can lead to various injuries in the ear. The eardrum may burst, the ossicles tear apart, and the windows of the cochlea and the organ of balance may rupture.
Often it comes to earache and reduced hearing. Even ear noises (tinnitus) or balance disorders and dizziness are possible. After a bang, the symptoms often improve a few days after the event, but in about half of the cases, the damage is permanent. From an explosion trauma, the ear usually does not recover and the disturbances persist.
Through a noise trauma, that is, in case of permanently excessive sound, usually a lasting deafness develops for certain high frequencies. One speaks here of a Hochtonschwerhörigkeit. For the diagnosis of an acoustic trauma the history of the patient and the knowledge about the triggering event are important.
With a hearing test, the doctor checks the hearing and records a so-called audiogram, in which the hearing and hearing loss are displayed. With further special tests it can be determined exactly which parts of the ear were damaged by the acoustic trauma.
In a bang trauma, different complications can occur. In the worst case, the auditory canal is so badly injured after the bang trauma that a hearing loss or a complete loss of hearing occur. A deafness can not be easily treated because there is no specific treatment for the eardrum.
In many cases, the patient has to live with the condition and is dependent on the use of a hearing aid. This can lead to severe restrictions in everyday life. Deafness can lead to depression and reduced quality of life, especially in young people.
After an acoustic trauma, in most cases, noises develop in the ear. This can be a noise or a beeping. Whether these sounds disappear can not be predicted. Often they only come in temporarily. If the noise is permanent, it may cause headache and insomnia in the affected person.
This leads to a tiredness and a general aggressive mood. In addition, pain in the ear or balance disorders may also occur. The patient complains of dizziness and nausea. After a bang trauma should always be consulted a doctor to avoid consequential damage.
When should you go to the doctor?
Specialist treatment is not necessary for every form of acoustic trauma. After a blast trauma, the hearing is usually restored after a few days. If the complaints persist, the treatment by a specialist is advisable.
If, after a trauma, you still experience pain in the inner ear after hours, a specialist should check whether the sound-conducting apparatus has been damaged. In addition to sharp pains and auditory sounds, bleeding in the ear is a clear indicator of the need for treatment. These severe forms of acoustic trauma must be treated with medication and the healing of a physician supervised.
Symptoms that affect the hearing function, in many cases over a longer period of time instead of a trauma. If hearing is permanently reduced, a medical diagnosis clarifies the cause. The specialist determines by examining the outer ear, which parts are damaged. If chronic hearing loss is suspected, it is mandatory to report, as the disease may limit the ability to work of the person concerned. If necessary, a specialist can determine exactly how severely the hearing is damaged and what frequencies the patient can still perceive.
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Treatment & Therapy
The treatment of acoustic trauma depends on how bad the ear is damaged. Usually a similar therapy as in a hearing loss is used. Circulation-enhancing infusions and cortisone are administered, with the cortisone often being introduced directly into the inner ear.
An explosion trauma is often treated with overpressure. In addition, the patient comes into a hyperbaric chamber in which he is exposed to a high ambient pressure while breathing 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 have occurred during the acoustic trauma, these are surgically treated.
In a microsurgical procedure, the ossicles can be restored by means of a plastic and ruptures (tears) of the eardrum or the window to the inner ear can be closed. The healing phase of the acoustic trauma lasts about six weeks. If you still have complaints, you have to assume that they will persist.
Outlook & Forecast
The healing proceeds depending on the severity of the damage in the ear. In a chronic noise trauma, no improvement in hearing is expected. The damaged hair tissue can not regenerate and hearing aid support is needed.
Damage caused by the brief exposure to sound, have a more positive healing balance. Destroyed parts of the sonic apparatus such as the eardrum are regenerated or surgically covered by the body and recover after a few weeks. Only in severe cases threatens the loss of hearing. However, if a damaged ear recovers from high levels of volume after healing, the likelihood of the symptoms returning is higher than that of a healthy ear.
A common complaint of victims is the appearance of chronic ear noises, which are perceived with varying degrees of intensity. After traumas or periods of great mental stress, tinnitus disappears after a few hours or days in most cases. Some ear noises occur after a trauma again and again, especially in stressful situations. The treatment by a specialist hardly helps with ear noises, also the covering with cotton wool has no purpose. In severe cases, a tinnitus sufferer can also plague a lifetime.
You can avoid acoustic trauma by avoiding places with high levels of noise pollution. During concerts, disco visits or other events with extreme noise, one should protect the ears with special ear plugs.
You can do that yourself
For the successful healing after an acoustic trauma sufferers should gently restructure their everyday lives. Patients themselves contribute a lot to their own quality of life and can relieve symptoms with simple means.
Under no circumstances should patients continue to be exposed to noise levels above 85 decibels following a blast or explosion trauma. The inner ear needs rest, so that the destroyed sound system does not take any further damage. Often, covering the ear with cotton wool or fabric helps. Cooling should be avoided as the reduced blood flow to the skin can interfere with the healing process.
In a tinnitus or a chronic noise trauma especially the psyche affected is burdened. Disturbing ear noises drown out many patients with headphones and soft music - if only one ear is affected, this method is also suitable during the day. Wearing headphones on both ears would endanger everyday life on the road and is prohibited by law on wheels.
Sensitivity to noise and loss of hearing in certain frequency ranges resulting from injury to the inner ear also complicates contact with other people. Openness is the best way here - if the personal environment knows about the injury, people can take better account of it.