Dr. Konstantina Stankovic

And then it goes away, that that is temporary threshold shift.

But now we know that some forms of temporary threshold shift are in fact permanent.

Although your hearing may come back, and in fact we can see it on audiometric testing, we now know that

The wheel has been set in motion where synapses that connect these sensory cells to neurons that contact them have been damaged or destroyed by loud sound.

It takes them a long time to degenerate.

And in fact, it's led to the concept of the so-called hidden hearing loss.

So there is obvious hearing loss that you can measure on audiograms, but now we have a new appreciation for the type of hearing loss that you are describing, and it's more common among young people.

And if they go through standard audiometric testing, it'll be perfect.

All of their audiometric thresholds are fine.

However, they report that

they cannot hear clearly in a noisy background, or they have this tinnitus that they didn't have before.

So what's now emerging from both animal and clinical data is that indeed there are anatomical correlates of this damage, and it typically involves synapses between sensory cells and neurons, or it may even involve hair cells and neurons themselves.

So what is the loud noise level?

That was one of your questions.

For example,

Right now, we are speaking at about 60 decibel in terms of sound pressure level.

And what does that mean?

Decibel, it's a logarithmic scale because we had to compress an enormous scale that's really million fold from the softest sound to the loudest sound that we can hear.

We compressed it to a linear scale.

That looks linear, it's not, but it's a logarithmic scale.