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Background: Hearing loss following head injury is a major medical problem in both adults and children, which may go
unnoticed when it does not affect speech frequencies.
Study: In the study done at the ENT Department of Christian Medical College, India, 60 patients with history suggestive of
mild head injury were evaluated over a period of six months.
Results: A vast majority (75%) of the RTAs (Road traffic accidents) was two wheeler accidents. Majority (83%) was males and
66% were between the ages of 20-50 years. The incidence of road traffic accidents was high in the age group of 20-50 years. Pure
tone audiometry assessment of hearing immediately post trauma with respect to frequencies affected revealed that hearing loss
was mainly in the high frequency region with greatest loss noticed at 4000 Hz and 8000 Hz. In case of mild hearing loss on PTA,
there was absence of emissions in 70% at 1000 Hz, 69% at 2000 Hz, 83% at 4000 Hz. This would suggest that damage to outer
hair cells becomes more pronounced when there is manifest hearing loss on PTA. In few cases with normal hearing, DPOAEs
were absent throughout the evaluation time period suggesting irreversible damage to outer hair cells.
Conclusion: Higher the frequencies affected and severe the hearing loss, poorer was the prognosis. Distortion product otoacoustic
emissions assessment at 3000 and 4000 Hz were found to be significant and has a higher predictive value in assessing
outer hair cell damage.