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Work-related, noise-induced hearing loss: evaluation including evoked potential audiometry
D M Barrs1, L K Althoff, W W Krueger
1Department of Audiology, Santa Rosa Medical Center, San Antonio.
Summary
This study evaluated workers with noise-induced hearing loss. Evoked response audiometry, particularly middle latency response, effectively confirmed behavioral thresholds in diagnosing work-related hearing impairment.
Area of Science:
- Occupational medicine
- Audiology
- Otolaryngology
Background:
- Evaluating work-related, noise-induced hearing loss (NIHL) is crucial for worker's compensation claims.
- Standard audiometry and otologic examinations are primary diagnostic tools.
- Tinnitus and other otologic symptoms are often assessed.
Observation:
- 246 workers (492 ears) with suspected NIHL were evaluated.
- High-frequency sensorineural hearing loss was prevalent (85%).
- Asymmetric hearing loss was noted in 20% of patients.
Findings:
- Tinnitus was common (58%) but not a major symptom.
- A characteristic "noise notch" was infrequent (37%).
- Magnetic resonance imaging ruled out central lesions in asymmetric cases.
- Malingering was uncommon (9%).
Implications:
- Evoked response audiometry (ERA) is valuable for confirming NIHL diagnosis.
- Middle latency response (MLR) showed higher efficacy than auditory brainstem response (ABR) for high-frequency hearing loss.
- ERA aids in objective threshold confirmation for compensation claims.