Background: Personal listening devices (PLDs) are considered one of the most popular sources of recreational noise that may result later on in hearing loss. However, most PLD users are unaware that they are putting themselves at risk of sensorineural hearing loss. 
Objective: to assess and early discover subtle changes in hearing sensitivity caused by personal audio devices (PADs).
Methods: In this case control study, the participants were selected through simple random sampling with age range from 14 to 20 years. The study was conducted at the Audiology Unit, Sohag University Hospital, Sohag, Egypt between March 2018 and January 2019. The participants were divided into two groups: Group I (case group) with history of regular use of PADs and Group II (control group) who never use PADs. All participants underwent pure tone audiometry (PTA), extended high frequency (EHF) audiometry, immitencemetry and transient evoked otoacoustic emissions (TEAOE). Data were analyzed using IBM-SPSS version 23. Statistical methods used include descriptive analysis (mean, range and standard deviation), odds ratio and Pearson correlation test.
Results: The average duration of PAD use in the case group was 2 years with 68.29% of  PLD use  ≥4 days/ week, 63.41% of  PLD use ≥ one hour daily and 39.02% preferring high volume. Tinnitus was the most common problem that occurred immediately after PAD use, followed by hearing loss. The EHF results showed a highly statistically significant difference in the threshold between the two groups at all tested frequencies (the odds ratio was 165.00 with a high degree of significance p=0.0004). The whole case group showed hearing threshold shift at all frequencies from 10 to 16 KHz at both ears. The largest hearing threshold shift occurred in the case group that used PADs for two or more years. The odds ratio for Transient Evoked Otoacoustic Emissions (TEOAE) response was 1.0649 with no statistically significant differences between case and control groups (p=0.8264). However, the mean amplitude of the overall TEOAE spectrum was lower in the case group compared with the controls. In the right ear, it was 16.85±3.02 dB in the case versus 18.92±3.14 dB in the control with the degree of the significance less than 0.01. In the left ear, it was 16.92±4.28 dB in the case versus 19.01±3.76 in the controls with the degree of the significance less than 0.05. 
Conclusion: The current study suggests that the long-term use of PLDs can impair hearing function, so a screening protocol should be considered for early identification of NIHL in PLD users.
Keywords: Noise, hearing loss, personal audio devices


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