Borderline Audiogram

[jezbowman]

I attended Gatwick yesterday for an initial class one medical (I've held a class two since 2002) which was mostly okay apart from getting awful results on the hearing test.

The doctor said that the level of hearing loss was what you might expect from someone who had been exposed to shelling on a battlefield! I'm awaiting further information by post from the CAA but from memory the results were in the 35-40dB loss for the 3kHz and 35dB for the 2kHz tests. I believe the limits are 50dB for 3kHz and 35dB for 2kHz. I was asked if there could be any particular reason for this level of hearing loss and at the time I couldn’t really think of any, since this was all quite a surprise to me.

Since yesterday there are a couple of things that I have thought of that I should have mentioned:

* I have played tuned percussion in a 30 piece brass band for 16 years. This consists of 2hr rehearsals, twice a week. I would imagine that of that 2hrs, <1hr is spent in a "loud" (100dB) environment.
* I've flown about 150 hours in a light single (C152) with standard David Clarke headsets (no ANR).
* I spend 12hrs / week in the car commuting to/from work at motorway speeds. The car has usually been a well insulated family type.
* While in their sound-proof box I could hear aircraft taking off and people walking down the corridor! :ooh:

I know we don’t do diagnosis on this forum but I'd be interested in the viewpoint of others as this is worrying me a lot. The CAA wants me to see an ENT specialist before they will issue a class one to ascertain why a 28yo guy has such terrible hearing. Any feedback would be greatly appreciated.

[poss]

I have played tuned percussion in a 30 piece brass band for 16 years. This consists of 2hr rehearsals, twice a week. I would imagine that of that 2hrs, <1hr is spent in a "loud" (100dB) environment.


Theres your answer. I'm very suprised that you're suprised with the results as this type of activity is very damaging to your hearing, I have moulded ear plugs for when I play in a band or do sound engineering.

Here is a site with more information on hearing loss and damaging sound levels: http://www.dangerousdecibels.org/hearingloss.cfm

[jezbowman]

poss, thanks for the link.

I am a little surprised that this has caused damage as the duration spent at these levels of sound pressure are relatively short, although frequent. Remember, I'm not talking about amplified instruments, this is a brass band and only a small percentage of the total music is “loud”. There is as much played at piano as forte.

I’ve been to a few live music events / nightclubs in my time and not used protection (ear protection that is!) but then who hasn’t? Awareness of such issues is very poor, especially 10 years ago when I was at university / going to gigs / etc.

Ultimately, if nothing is found by the ENT guy (or girl) other than noise induced hearing loss and I am issued a class one “on the limits”, then so be it. My musical days will be over as I conserve what’s left of my hearing to pass future audiograms or more probably "occupational assessments" when I can't pass the audiogram. :(

[A10Warthog]

Regarding the hearing...
You can fly with glasses and lenses, but can you fly with hearingaid'? If you also have spare one in your flight bag?
Just wondering...

[AMEandPPL]

:bored: << You can fly with glasses and lenses, but can you fly with hearing aid ? >>

Yes, you can, I see a couple of guys who do. Not unnaturally, audios and ENT specialist reports are required at fairly regular intervals. But the principle that " if a special sense (vision, hearing, etc) is inadequate naturally, why not boost it by technology " also applies here.

This is, I'm afraid, a topic we will hear about ( pun intended ! ) more and more in the future. Extremely loud noise, sometimes put forward as "music" or "entertainment" seems to be increasingly part of our world.

Think of the folk with Walkmans on the train playing into earphones. If I can hear the noise at the other end of the carriage, then just how great is the sound level at his eardrums ? Similarly, the rap noise coming from the car full of teenagers, whichy can be heard from half a mile away because the volume is so high, and the windows wide open. This is noise pollution in a big way, and I really don't think they have a clue of the problems they will face in future. And as for pop concerts, or wedding discos . . . . . where the speakers are usually violently vibrating . . . . . . . words fail me !


PS - can anyone explain to me how to get the "quotes" from previous posts in the blue boxes . . . . . I'm obviously missing something here !

[jezbowman]

Well, the ENT consultant doesnt think it's noise related hearing loss. This is due to the frequency that the loss is centred around. He'd normally expect to see loss of higher frequencies and therefore suggests that my loss may be more congenital as there is a pronounced dip at 2kHz.

Unfortunatly, the right hear has slightly more loss than the left ear at 3kHz (the same amount of loss as at 2kHz) and for this reason he has requested an MRI scan. I'm worried. :uhoh:

Anybody had one of these for hearing loss? The test doesn't worry me (apart for the threat of dye injection, which is a big phobia of mine) but the reasons why he has asked for this does worry me greatly.

The annoying thing is that I don't think I'm deaf! I think my hearing is as it always has been.

[WG774]

You have absolutely nothing to fear from being selected for an MRI scan - it's par-for-the course in a scenario such as this.

The scan will look for damage to the bones in your ear, blockages from debris (excess deposits from dead skin etc) and also - and most obviously - the general shape of your eustachian tubes / cochlea etc.

I'm no expert, but I believe there is a small chance your problem could be due to eustachian tube or TJMD-type problems. This can create a 'hole' in the hearing - it's not solely a shelf at high frequencies.

There's also the issue of acoustic neuromas (not malignant), although these are incredibly rare; but your GP will want to rule it out.

If you don't have other health issues such as balance problems, nausea and tinnitus, there's a good chance that the MRI scan could reveal something that's treatable and non-life threatening.

Don't worry about the MRI scan - bear in mind that the GP needs to be careful to prevent litigation at a later date! I wish I'd had an MRI years ago - it seems your Dr. isn't messing around here which can only be a good sign.

Best of luck!

edit - I notice you have loss in both ears... This means it's highly unlikely to be a growth / neuroma-type issue as this would probably just affect one ear. It could well be due to loud music... Bear in mind that different people have different thresholds for hearing damage - you may just have a lower threshold.

BTW - Do you spend much time on a mobile phone? Although proof is thin on the ground, there are research studies being conducted in this area by organisations that usually choose their subjects for research carefully...

[jezbowman]

WG774 - thanks for that, you've no idea how much better your post made me feel! The hearing loss in the right ear is worse at 3kHz. At 2kHz it is the same in both ears. So they are not exactly the same.

If I use a mobile then it's normally on the right ear but I dont use a mobile that often.

I would say there was some very slight tinnutus in the right ear. I hardly ever notice it since I'm either at work, with computer fans running all around me, in the car with engine/road noise or at home with my baby daughter screaming in my ears all the time. Only in bed for the nano-second it takes me to fall to sleep do I notice a slight ringing. The ENT consultant didnt ask me about ringing and I forgot to mention it.

[A10Warthog]

regarding the ringing in the ear, I got it from a gunshot 6months back, and is there a link between noise induceed tinnitis and vertigo? can you damage the balance organs with a gunshot?

[poss]

Having recently just been through my inital with good results for my hearing (probably due to the earplugs) I can see how you can easily fail and have your hearing misdiagnosed. I had to hold my breath at times because that, ontop of my heart beating and slight tinitus in my right ear was all I could hear - difficult to make out a sound in that, I heard the sound clicked the button then wondered if I'd actually heard anything. It's a very dodgy test and I do not feel the sound proof box along with enclosed headphones is the best way of doing it.
I too have slight tinitus, it's something that happens to any musician or music lover over time but rest assure it will eventually go away. Don't give up playing your music, I still do studio and live work with moulded ear plugs and that filters out a lot of the SPL's.

[WG774]

regarding the ringing in the ear, I got it from a gunshot 6months back, and is there a link between noise induceed tinnitis and vertigo? can you damage the balance organs with a gunshot?

There is a very strong link between tinnitus and balance issues with people who have TJMD issues. I can't say if this relates to your gun-shot though. It strikes me as pretty odd to get permanent damage from one shot... I would've thought that you'd get temporary tinnitus that'd go after a few days?

My advice to you is to go for an MRI. You can get one for £250 in London - small change when you consider how many potential issues it can illuminate / rule out.

BTW- Tinnitus can be triggered by blocked E-Tubes.

[highhope]

Hi

Just wondered if anyone could shed light on my particular situation:

I had a perforated eardrum when I was 5...this healed and unfortunatly, now I'm left with a slight hearing loss in the left ear at 2kHtz.

My results are as follows:

1000htz = 0dB
2000htz = 45dB
3000htz = -5dB

So you see, a real drop at 2kHtz, then right back up to just -5dB at 3000htz! The doctor actually had to check his machine wasn't malfunctioning!

From the above though, I'm outside the limits for an initial class 1. My doctor tells me I have excellent hearing and I know full well that this loss has never and will never pose a problem to either flying or life in general.

It's only in one ear, at one frequency but 10dB below the required level...can anyone suggest whether I'm flogging a dead horse by getting this medical done; or are they likely to consider that overall, my hearing's great?

Cheers

[A10Warthog]

The tinnitus does not bother me too much, the only thing is that my right ear hurts, just a little, and it's all the time.
I feel my balance is just fine, the ENT doc says my ear drum was a little red, but normal. The hearing test was fine... Maybe I should try to ignore it, instead of thinking about it 24/7..

what is TJMD by the way..

[WG774]

Oops! I should've written TMJD - it is referred to by different acronyms in different places: http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder

There are strong connections between ET problems / tinnitus etc and TMJD - as can be seen in this thread. I won't provide a link as most the sites I find have commercial content, but try a Google for more info.

[WG774]

Jez - I got the results from my MRI today and I thought I'd post back here - it could put your mind at rest.

I was sent for an MRI because of my recurrent ETD (Eustachian Tube Dysfunction), i.e a hearing-related issue.

If you go for a private scan, this is possibly how you'll get treated:

MRI scanning in the private sector is fiercely competitive in terms profit margins. It costs nearly twice as much to give my cat an ultrasound as it does for me to get an MRI - with a machine costing 20x as much and 3x the staff!

The impression I got at the clinic worried me somewhat; when I looked at the lens, I could see 3 radiologists all staring intently at screens... When the scan finished, I was given a CD and ushered away pronto - and I mean pronto. The radiologists had already moved onto other things, and appeared to be literally turning their backs on me... This worried me somewhat...I wondered if they'd discovered something unpleasant and didn't want to look at me in case it gave the game away...

Anyway, the GP revealed that my MRI was pretty normal, and they'd written a report. The bottom line is that these places don't have the kind of margins one would imagine them to have (I'm not defending fat-cat private health firms, just saying it's competitive). Think about it: a million quid machine, 3 qualified radiologists, a City base and £250 for a scan that takes 20-odd minutes...

What's the point of my post you might ask? Just to say that commercial pressures at these facilities can potentially give an unpleasant impression to the patient - when in reality - the staff are doing their best not to incur the wrath of managers.

[fireflybob]

My audiogram for a Class I has been marginal for a few years now - I am on an annual audio for my medical. When it first occured I was required to provide a report from a training captain and/or chief flying instructor that my hearing loss was not causing any problems during flight. This was duly provided without any problems.

As an aside though I can copy VOLMET and ATC Comms in conditions of considerable interference (mush) when my younger counterparts are unable to do so!