Does listening behavior shape middle-ear function? A wideband tympanometry study in headphone users

To investigate the impact of long-term in-ear headphone use on middle-ear transmission properties in young adults using wideband tympanometry (WBT), and to assess cochlear and reflex-level function through transient evoked otoacoustic emissions (TEOAEs) and acoustic reflex thresholds (ARTs).

Sixty-four ears from 32 female participants (aged 18-30 mean: 23 ± 2.83) were classified into a high exposure group (HEG; ≥3 h/day, ≥ 5 days/week, for ≥ 2 years) and a low exposure group (LEG; ≤1 h/day or no use). Wideband acoustic absorbance was recorded at both ambient and peak pressure conditions across 226-8000 Hz. Additional assessments included resonance frequency, equivalent ear canal volume, TEOAE amplitudes, and ipsilateral ARTs. Non-parametric comparisons were performed using Mann-Whitney U tests.

Under ambient pressure, the HEG group demonstrated significantly lower absorbance than the LEG group between 500 and 1259 Hz and at 2 kHz (p < .05), while showing significantly higher absorbance at 5039 Hz (p < .05). Under peak pressure, significantly lower absorbance in HEG was observed at 793 Hz and 1 kHz, with higher absorbance again found at 5039 Hz (p < .05). No significant group differences were found in resonance frequency, ear canal volume, TEOAEs, or ARTs.

Prolonged in-ear headphone use appears to induce subtle, subclinical alterations in middle-ear sound transmission mechanics, without measurable cochlear dysfunction. Wideband tympanometry may serve as a sensitive tool for detecting early auditory changes associated with prolonged recreational sound exposure, underscoring the importance of considering middle-ear biomechanics in the broader context of auditory health monitoring suggesting that subclinical changes in middle-ear mechanics warrant longitudinal monitoring in young users of personal listening devices.