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The Association Between Extended High-Frequency Loss and Vestibular Function Among Young Earphone Users
Jeyasakthy Saniasiaya1, Jeyanthi Kulasegarah1, Kumar Seluakumaran2
1Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
The Annals of Otology, Rhinology, and Laryngology
|September 24, 2025
Summary
Young adults using earphones with extended high-frequency (EHF) hearing loss show early saccule damage. Cervical vestibular evoked myogenic potential (cVEMP) may detect this noise-induced cochlear damage.
Area of Science:
- Audiology
- Neuroscience
- Otolaryngology
Background:
- Unsafe earphone use can lead to hearing loss, with early shifts potentially occurring at extended high frequencies (EHFs) before conventional frequencies are affected.
- Preliminary evidence suggests regular earphone use may also cause vestibular impairment.
Purpose of the Study:
- To investigate vestibular function in young adults with normal conventional audiograms but varying EHF hearing status.
- To determine if EHF hearing loss from earphone use is associated with early vestibular deficits.
Main Methods:
- 131 young earphone users (12-25 years) were assessed for listening habits and audiogram thresholds at conventional and EHFs.
- Vestibular function was evaluated using cervical vestibular evoked myogenic potential (cVEMP), subjective visual vertical (SVV), and video Head Impulse Test (vHIT).
- Results were compared between participants with and without EHF hearing loss.
Main Results:
- 15.3% of participants exhibited EHF hearing loss despite normal conventional audiograms.
- Longer daily earphone usage duration was significantly associated with EHF loss (P=.008).
- A significant reduction in cVEMP amplitude was observed in those with EHF loss (P<.001), indicating potential saccule damage.
Conclusions:
- Earphone users with EHF loss may experience concurrent early saccule damage.
- Cervical vestibular evoked myogenic potential (cVEMP) shows promise as a tool for detecting early noise-induced cochlear damage.
- Further large-scale cohort studies are needed to validate cVEMP's utility.
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