Diagnostic Differences of Hearing Loss and Central Auditory Processing Disorder Following Varying Frequency of Temporary Auditory Threshold Shift on a Global Scale: A Comparative, Retrospective Real-World Data Analysis

OBJECTIVES: Through loud volume in headphones, live music events, or traumatic events, noise-induced hearing loss is experienced globally, with approximately 26 million adults between ages 20-69 affected. Specifically with short term bursts of loud volume at or above 120 decibels, Temporary Auditory Threshold Shift (TATS) occurs when hairs within the ear are displaced due to large amounts of auditory input, but do not immediately return to their stationary position. This results in briefly obstructed hearing but may result in permanent hearing loss if frequently experienced. This study aims to ascertain the difference in diagnosis of hearing loss and Central Auditory Processing Disorder (CAPD) in patients with recurrent TATS (rTATS) and patients with only one instance of TATS.

METHODS: Patients were identified via the TriNetX Global federated network through querying of ICD-10 H93.24 for TATS, excluding patients with prior record of ICD-10 H91 for Other hearing loss. Patients queried had record of first TATS diagnosis since June 23, 2004 and were grouped based on recurrence (rTATS) or non-recurrence of TATS diagnosis in their EHR. Cohorts were propensity score matched for current age, age at index, sex, race, and ethnicity to control for possible demographic confounding.

RESULTS: Of the 13,180 patients in each cohort, 3,090 (23.4%) with rTATS and 1,750 (13.3%) TATS experienced unspecified hearing loss at some point after their TATS diagnosis (RR=1.766, p<0.0001). Additionally, rTATS patients had over two times the risk of developing CAPD compared to those with one instance of TATS (RR=2.2, p<0.0001).

CONCLUSIONS: Patients with rTATS have a significantly higher risk of developing hearing loss or CAPD compared to those experiencing TATS once, suggesting that frequent exposure to high volume levels likely contributes to subsequent diagnoses and may provide insight into the development and diagnosis of CAPD, as the source of the disorder is not currently well identified.