Beyond standard audiometry: Auditory dysfunction and steroid treatment outcomes in young adults following acoustic trauma

The impact of military noise exposure on auditory function is not well established and may not be fully captured by standard audiometry. This study aimed to evaluate: (1) the effects of military noise exposure on auditory function in young adults using (a) self-reported otological symptoms, (b) standard and ultra-high frequency (UHF; 9–14 kHz) audiometry, (c) distortion product otoacoustic emissions (DPOAE); (2) oral steroids effects on audiometric results, outer hair-cell function, and otological symptoms. A retrospective review of medical records was conducted for 189 young adults exposed to military noise. Participants with normal hearing underwent one assessment, while those with hearing loss or otological symptoms were reassessed after ~ 10 days and 3 months. Steroid-treated patients were compared to untreated controls. Over half the cohort showed hearing loss in the standard or UHF range. Otological symptoms, particularly tinnitus and aural fullness, were prevalent even among individuals with normal standard-range thresholds. UHF audiometry and DPOAEs detected abnormalities missed by standard audiometry. Partial spontaneous recovery occurred within 10 days post-injury. Steroid treatment was linked to greater hearing thresholds improvements, particularly in the high-frequency range. UHF recovery was significantly greater in the right ear, suggesting asymmetry in vulnerability and recovery patterns. Military noise exposure leads to a highly prevalent and multifaceted impact on auditory function. Although treated patients showed greater gains, post-exposure threshold differences between treated and untreated patients restrict direct inference regarding steroid efficacy. Comprehensive assessment, including symptoms, UHF audiometry, and DPOAEs, is essential for accurate diagnosis and monitoring.