Work-related, noise-induced hearing loss: evaluation including evoked potential audiometry.
This article reviews the evaluation of 246 workers (492 ears) who underwent otologic and audiologic testing as part of a worker's compensation claim for work-related, noise-induced hearing loss. Tinnitus was present in 58% of the patients, but was rarely a major symptom. Other otologic symptoms or a history of ear disease were virtually nonexistent. Standard audiometry showed a downsloping, high-frequency sensorineural hearing loss in 85% of the ears tested, with only 37% having a characteristic "noise notch" at 4000 or 6000 hertz. Asymmetric hearing loss was not uncommon, with 48 patients (20%) undergoing magnetic resonance scanning, all of whom showed no central lesion responsible for the loss. Proven malingering was surprisingly uncommon (9%). In this study, evoked response audiometry was a valuable adjunct to confirm behavioral thresholds in the evaluation of possible work-related, noise-induced hearing loss. The middle latency response was more effective than the auditory brainstem response as a result of the high-frequency steepness of the audiometric curve.
Barrs
D M
DM
Department of Audiology, Santa Rosa Medical Center, San Antonio.
Althoff
L K
LK
Krueger
W W
WW
Olsson
J E
JE
D000161:Acoustic Stimulation; D000328:Adult; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001309:Auditory Threshold; D016057:Evoked Potentials, Auditory, Brain Stem; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D013067:Speech Perception