2023 Early Hearing Detection & Intervention Conference

March 5-7, 2023 • Cincinnati, OH

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10/24/2016  |   7:15 PM - 10:00 PM   |  QUIET DOWN! Noise and Quality of Life   |  BGPOP Building 4A/B/C

QUIET DOWN! Noise and Quality of Life

We have all experienced the temporary tinnitus and probably temporary threshold shift that occurs after loud noise exposure. We have believed that there is no long-lasting harm from these temporary occurrences. These beliefs have proven to be incorrect. Recent histopathological data shows that cochlear hair cells are not the most vulnerable elements in the inner ear. It is actually the synapses between hair cells and cochlear nerve terminals that degenerate first in the aging or noise-exposed ear. This occurs immediately and is irreversible, after noise exposure. This primary neural degeneration (unlike hair cell loss) does not affect hearing thresholds, but likely contributes to problems understanding speech in difficult listening environments, and may be important in the generation of tinnitus and/or hyperacusis. This has been labeled ‘cochlear synaptopathy’. Diagnosis is difficult, with audiometric abnormalities only being seen between 10K and 16KHz, but SP/AP ratio on electrocochleography may help. Noise induced hearing loss (NIHL) is one of the major causes of preventable hearing loss. The WHO estimates that NIHL risk to 1.1 billion young people, due to unsafe listening practices. Nearly half of all teenagers and young adults (12 - 35 years old) in middle- and high-income countries are exposed to unsafe levels of sound from the use of personal audio devices and 40% of them are exposed to potentially damaging sound levels at clubs, discotheques and bars. In the US, between 1994 and 2006, the prevalence of HL among teenagers rose from 3.5% to 5.3%. Worldwide, 16% of the disabling HL in adults is attributed to occupational noise: 20-25% in men and 10-15% in women. Apart from hearing loss, noise-induced quality of life effects in all age groups include hypertension, sleep disturbance, cognitive impairment, and other deleterious non-auditory health effects. Direct local and national regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions.

  • Describe the current condition of ‘noise pollution’ in the developing world.
  • Identify the relationship between noise exposure, hidden hearing loss, and quality of life.
  • Formulate an action plan to educated people and politicians/regulators regarding the negative long-lasting effects of noise exposure.

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Presenters/Authors

Sujana S. Chandrasekhar (), AAO-HNS/F, Hofstra-Northwell Sch of Med, sujana1@gmail.com;
Dr. Chandrasekhar attended medical school at Mount Sinai School of Medicine in New York City, graduated at the age of 22, and completed her residency in Otolaryngology-Head and Neck Surgery at New York University Medical Center in New York and fellowship in Otology and Neurotology at the House Ear Clinic and Institute in Los Angeles, California. She served on the full-time academic faculty of both UMDNJ-New Jersey Medical School and Mount Sinai School of Medicine before entering private practice in New York City in October 2004. She is currently Director of New York Otology, Director of Neurotology at the James J. Peters Veterans Administration Medical Center, Otologist/Neurotologist at the New York Head and Neck Institute, and Clinical Professor at Hofstra-Northwell School of Medicine. Her clinical interests include management of disorders of hearing, balance, tinnitus, facial nerve, and lateral skull base, as well as cochlear and Baha implants. Dr. Chandrasekhar's research interests include hearing loss, tinnitus, vertigo, skull base tumors and temporal bone histopathology. She has published several papers, monographs, and book chapters in otology/ neurotology and otolaryngology including a landmark paper on sudden hearing loss and four Clinical Practice Guidelines. She has also written on, and is funded for, gender research in otolaryngology. Dr. Chandrasekhar was honored with the AAO-HNS's Distinguished Service Award in September 2006 and 2012, with the Helen Krause Trailblazer Award from the AAO-HNS Women in Otolaryngology Section in 2012, and with the Physician Mentor Recognition Award, American Medical Association Women Physicians Section in 2013. She has participated in several Humanitarian missions – medical, surgical, and teaching – in Central America, India, and South America. Dr. Chandrasekhar served as President of the American Academy of Otolaryngology-Head and Neck Surgery 2015-2106. She is the third woman and the first person of Indian descent to hold that office. She has a husband, Kris Ramanathan, and four children, ranging in age from 20 to 11.


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