Effect of Personal Listening Device Usage on Auditory Brainstem Responses, SNR-50 and Extended High-Frequency Audiometry in Individuals with Normal Hearing Sensitivity

Abstract

Background: Exposure to recreational noise, particularly from personal listening devices (PLD), poses a significant risk to auditory health. Despite normal pure tone audiometry and otoacoustic emissions results, moderate noise exposure from PLDs can cause hidden hearing loss affecting auditory nerve fibers. Aim: This study aimed to investigate the effects of PLD usage on extended high-frequency audiometric thresholds (EHFA), SNR-50, and auditory brainstem responses (ABR) with and without ipsilateral masking in individuals with normal hearing sensitivity. Method: The study included 36 females aged 18-35 years, grouped into two (habitual and non-habitual PLD users) based on the duration and levels of their PLD usage. EHFA, SNR-50, and ABR with and without ipsilateral masking were recorded and analyzed using appropriate statistical tests. Results: Findings were analyzed using the Mann-Whitney U test for SNR-50 and EHFA, MANOVA for ABR, and Spearman's correlation between ABR wave amplitudes and SNR-50 values. Habitual PLD users had elevated thresholds at higher frequencies (9 kHz to 16 kHz) and higher SNR-50 values. The mean amplitude of ABR waves I and III was lower in the habitual PLD users, with wave I amplitude differences reaching statistical significance and increasing with higher masker levels. Similarly, habitual PLD users showed a larger wave V amplitude, likely due to central gain compensation and longer latencies for all peaks, with wave I latency significantly different at 70 dB SPL. Conclusion: Despite conventional audiological evaluation reflecting auditory health, the normal results of these tests do not necessarily indicate a healthy auditory system. Therefore, the test battery should incorporate more sensitive assessments EHFA, SNR-50, and ABR with and without ipsilateral masking. These tests can detect early signs of auditory damage, especially from recreational noise exposure, which can often be prevented.