Acoustic shock is a little-known condition. It includes a range of symptoms following a sudden, unexpected loud sound incident near the ear, causing a temporary or permanent impairment to the ear structures or associated nervous systems. The symptoms include (by Westcott):
- Tinnitus, Hyperacusis
- Dull ache in the ear, can radiate to cheek, neck, arm
- Sensation of fullness/blockage in the ear
- Sensations of burning, numbness
- Muffled, distorted hearing
- Loss of balance
- Hearing loss
Westcott proposed Acoustic shock involves abnormal contractions of the tensor tympani muscle (Tonic Tensor Tympanic Syndrome – TTTS). Other proposed mechanisms include changes in the central nervous system. Pre-existing psychological conditions, such as stress/anxiety problem, increase the vulnerability of those to developing Acoustic Shock.
A proposed Acoustic Shock diagnostic guide includes (Grindleford Criteria) :
- There must be a defined acoustic incident
- Ear symptoms should start straight away or shortly afterward
- Ear symptoms should be outside ‘physiological’ or ‘startle’ responses
- Ear symptoms should be experienced in or arise from the exposed ear(s)
- There may be significant psychological overlay/relationship to illness behaviour
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