With the exception of eardrum rupture from intense explosive noise, the outer and middle ear are rarely damaged by noise. More commonly, hearing loss is a result of neural damage involving injury to the hair cells (Figure 6.1.6). Two theories are offered to explain noise-induced injury. The first is that excessive shearing forces mechanically damage the hair cells. The second is that intense noise stimulation forces the hair cells into high metabolic activity, which overdrives them to the point of metabolic failure and consequent cell death. Once destroyed, hair cells cannot regenerate.
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