332:
other systems that produce loud noises over a long period of time. The toughening effect is put in place by increasing the system's resistance to noise over time. Currently, the specific mechanisms that cause the cochlear toughening are not known. However, the OHCs and related processes are known to play a role. The other toughening measure is to spread a given amount of energy to the system over a longer amount of time. This would allow recovery processes to take place during the quiet interludes that are gained by increasing the exposure duration. So far, studies have not shown a direct correlation between the amount of toughening and the amount of threshold shift experienced. This suggests that even a toughened cochlea may not be completely protected.
505:
with functional capabilities. This explains the synergistic interaction between noise and styrene because the cochlea will be increasingly damaged with the excessive vibrations of the noise plus the damage caused by the chemical itself. Specifically, noise damage typically damages the first layer of the outer hair cells. The combined effects of styrene and noise exposure shows damages to all three rows instead, reinforcing previous results. Also, the combined effects of these chemicals and the noise produce greater auditory fatigue than when an individual is exposed to one factor immediately followed by the next.
195:
80:
318:
required is related to the magnitude of the initial hearing loss. The most significant recovery was found to occur during the first 15 minutes following cessation of the noise exposure. When sufficient recovery time is not allotted, the effects become permanent, resulting in acquired noise-induced hearing loss. Up to 120 minutes of recovery time can be required of noises of only 95 dB. For comparison, common items that can produce noise at this level are motorcycles and subways.
466:. Although this is generally good for the body, combined noise exposure during highly physical activities was shown to produce a greater TTS than just the noise exposure alone. This could be related to the amount of ROS being produced by the excessive vibrations further increasing the metabolic activity required, which is already increased during physical exercise. However, a person can decrease their susceptibility to TTS by improving their cardiovascular fitness overall.
267:: the classical passive system and an active process. The passive system works to stimulate the inner hair cells directly and works at levels above 40 dB. At stimulation levels that prevent the excitation of the passive system, prolonged noise exposure results in a decrease in the loudness heard over time, even when the actual intensity of the noise has not changed. This is caused by the exhaustion of the active process.
202:
435:. Further uses of these substances would need to be personalized to the individual and only under close monitoring. Antioxidants do not have these negative effects and therefore are the most commonly researched substance for the purpose of protecting against auditory fatigue. However, at this time there has been no marketed application. In addition, no
209:
356:, a state described by reduced active cochlear displacements. Although limited research has been done with these two substances in terms of protective drug regimes because of their associated risks, both have shown positive results in reducing auditory fatigue by the decrease in ROS formation through individual mechanisms described below.
504:
heighten the risk of auditory damages. Those individuals in work environments are more likely to experience the noise and chemical combination that can increase the likelihood of auditory fatigue. Individually, styrene is known to cause structural damages of the cochlea without actually interfering
250:
Temporary threshold shifts related to auditory fatigue are related to the amplitude of a stimulus-driven traveling wave. This is believed to be true because the vibration propagated by the active process is not usually at the center of the maximum amplitude of this wave. Instead, it is located much
331:
Two protective measures have been investigated related to the amount of noise exposure and the duration of that exposure. Although these would be hard to regulate in spontaneous occurrences, they could have a positive effect on work conditions if guidelines could be set for machining times or for
461:
There are several factors that may not be harmful to the auditory system by themselves, but when paired with an extended noise exposure duration have been shown to increase the risk of auditory fatigue. This is important because humans will remove themselves from a noisy environment if it passes
293:
is required in order to maintain the electrochemical gradients used in mechano-electrical and electro-mechanical transduction during noise exposure and sound recognition. The metabolic activity is associated with active displacements which are components of the sound-induced vibration involving
472:
is another risk factor. As blood temperature rises, TTS increases when paired with high-frequency noise exposure. It is hypothesized that hair cells for high-frequency transduction require a greater oxygen supply than others, and the two simultaneous metabolic processes can deplete any oxygen
317:
and return threshold levels to their baseline values. There is currently no way to estimate the amount of time needed to recover from auditory fatigue because it is not usually detectable until after the injury has already occurred. Studies that measured recovery time have noted that the time
2120:
Kastelein, Ronald; Gransier, Robin; van Mierlo, Ron; Hoek, Lean; de Jong, Christ (2011). "Temporary hearing threshold shifts and recovery in a harbor porpoise (Phocoena phocoena) and harbor seals (Phoca vitulina) exposed to white noise in a 1/1-octave band around 4 kHz".
2438:
Popper, Arthur N.; Halvorsen, Michele B.; Miller, Diane; Smith, Michael E.; Song, Jiakun; Wysocki, Lidia E.; Hastings, Mardi C.; Kane, Andrew S.; Stein, Peter (2005). "Effects of surveillance towed array sensor system (SURTASS) low frequency active sonar on fish".
484:
of a person. Exposure to noise greater than 95 dB in individuals with heavy workloads was shown to cause severe TTS. In addition, the workload was a driving factor in the amount of recovery time required to return threshold levels to their baselines.
508:
It is important to understand that noise exposure itself is the main influential factor in threshold shifts and auditory fatigue, but that individuals may be at greater risk when synergistic effects take place during interactions with the above factors.
1606:
Bielefeld, Eric C.; Kopke, Richard D.; Jackson, Ronald L.; Coleman, John K.M.; Liu, Jianzhong; Henderson, Donald (2007). "Noise protection with N-acetyl-l-cysteine (NAC) using a variety of noise exposures, NAC doses, and routes of administration".
280:
displacement, caused by the traveling wave, becomes continually more basal in regards to the cochlea. A sustained low-level stimulus can cause an energetic exhaustion of the active system which in turn prevents the passive system from activating.
2325:
Chen, Yuh-Shyang; Tseng, Fen-Yu; Lin, Kai-Nan; Yang, Ting-Hua; Lin-Shiau, Shoei Yn; Hsu, Chuan-Jen (2008). "Chronologic
Changes of Nitric Oxide Concentration in the Cochlear Lateral Wall and Its Role in Noise-Induced Permanent Threshold Shift".
153:
of the inner ear is associated with temporary hearing loss and is involved in auditory fatigue. Complete loss of the stereocilia causes permanent hearing damage and is more associated with noise-induced hearing loss and other auditory diseases.
1963:
Lin, Cheng-Yu; Wu, Jiunn-Liang; Shih, Tung-Sheng; Tsai, Perng-Jy; Sun, Yih-Min; Guo, Yueliang Leon (2009). "Glutathione S-transferase M1, T1, and P1 polymorphisms as susceptibility factors for noise-induced temporary threshold shift".
380:
binding to OHC prestin which thereby reduces motility. This reduction in active displacement is again associated with depression of the cochlear amplifier which decreases the excessive vibrations experienced during noise-exposure.
275:
The active process is also known as the cochlear amplifier. This amplification increases vibrations of the basilar membrane through energy obtained from the Organ of Corti. As the stimulation increases, it is assumed that
368:. This decrease results in a reduction of active cochlear displacements and it is believed that the protection by furosemide stems from the limitation of excessive vibrations while the cochlear amplifier is depressed.
418:
Although auditory fatigue and NIHL protective measures would be helpful for those who are constantly exposed to long and loud noises, current research is limited due to the negative associations with the substances.
2273:
Gourévitch, Boris; Doisy, Thibaut; Avillac, Marie; Edeline, Jean-Marc (2009). "Follow-up of latency and threshold shifts of auditory brainstem responses after single and interrupted acoustic trauma in guinea pig".
2221:
Fetoni, A.R.; Mancuso, C.; Eramo, S.L.M.; Ralli, M.; Piacentini, R.; Barone, E.; Paludetti, G.; Troiani, D. (2010). "In vivo protective effect of ferulic acid against noise-induced hearing loss in the guinea-pig".
251:
further down and the differences associated between them explain the shift in threshold. The TTS that is experienced is the exhaustion of the active system located at the locus of the traveling wave driven by the
2164:
Gröschel, Moritz; Götze, Romy; Ernst, Arne; Basta, Dietmar (2010). "Differential Impact of
Temporary and Permanent Noise-Induced Hearing Loss on Neuronal Cell Density in the Mouse Central Auditory Pathway".
305:
or ROS. Elevated levels of ROS continue to increase the metabolic demands of the system. These increasing demands fatigue the system and eventually lead to structural damages to the Organ of Corti.
462:
their pain threshold. However, when paired with other factors that may not physically recognizable as damaging, TTS may be greater even with less noise exposure. One such factor is
764:
Adelman, Cahtia; Perez, Ronen; Nazarian, Yoram; Freeman, Sharon; Weinberger, Jeffrey; Sohmer, Haim (2010). "Furosemide
Administered before Noise Exposure can Protect the Ear".
477:
of the local vessels. Further research could be done to see if this is a reason for the increased TTS during physical exercise that is during continued noise-exposure as well.
1347:
Zheng, Xiang-Yang; Henderson, Donald; McFadden, Sandra L.; Hu, Bo-Hua (1997). "The role of the cochlear efferent system in acquired resistance to noise-induced hearing loss".
2066:
Finneran, James J.; Schlundt, Carolyn E. (2010). "Frequency-dependent and longitudinal changes in noise-induced hearing loss in a bottlenose dolphin (Tursiops truncatus)".
1506:
Ikeda, K.; Morizono, T. (1989-04-01). "Effect of
Albumin-Bound Furosemide on the Endocochlear Potential of the Chinchilla: Alleviation of Furosemide-Induced Ototoxicity".
1658:
Kopke, Richard D.; Jackson, Ronald L.; Coleman, John K.M.; Liu, Jianzhong; Bielefeld, Eric C.; Balough, Ben J. (2007). "NAC for noise: From the bench top to the clinic".
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reserves of the cochlea. In this case, the auditory system undergoes temporary changes caused by a decrease in the oxygen tension of the cochlear endolymph that leads to
30:, PTS) if sufficient recovery time is not allowed before continued sound exposure. When the hearing loss is rooted from a traumatic occurrence, it may be classified as
37:
There are two main types of auditory fatigue, short-term and long-term. These are distinguished from each other by several characteristics listed individually below.
517:
Studies have been carried out in humans, marine mammals (dolphins, harbour porpoises and harbour seals) rodents (mice, rats, guinea pigs and chinchillas) and fish.
1853:
Miller J, Ren T, Dengerink H, Nuttall A. Cochlear blood flow changes with short sound stimulation. Scientific Basis of Noise-Induced
Hearing Loss. 1996:95-109.
1398:
Adelman, Cahtia; Freeman, Sharon; Paz, Ziv; Sohmer, Haim (2008). "Salicylic Acid
Injection before Noise Exposure Reduces Permanent Threshold Shift".
289:
Currently it is believed that auditory fatigue and NIHL are related to excessive vibrations of the inner ear which may cause structural damages.
2377:
Yamashita, Daisuke; Minami, Shujiro B.; Kanzaki, Sho; Ogawa, Kaoru; Miller, Josef M. (2008). "Bcl-2 genes regulate noise-induced hearing loss".
932:
Ohlemiller, Kevin K.; Wright, James S.; Dugan, Laura L. (1999). "Early
Elevation of Cochlear Reactive Oxygen Species following Noise Exposure".
1050:
Henderson, Donald; Bielefeld, Eric C.; Harris, Kelly Carney; Hu, Bo Hua (2006). "The Role of
Oxidative Stress in Noise-Induced Hearing Loss".
741:
McFadden D, Plattsmier H. Exposure-induced loudness shifts and threshold shifts. New
Perspectives in Noise-induced Hearing Loss. 1982:363-374.
255:
described below. Auditory fatigue can be explained by the relative activity of the active process at low-level stimulation (<30 dB).
22:
is defined as a temporary loss of hearing after exposure to sound. This results in a temporary shift of the auditory threshold known as a
149:
In general, structural damages to any anatomical part of the human ear can cause hearing-related problems. Usually, minor bending of the
1811:
Miani, C; Bertino, G; Francescato, Mp; di
Prampero, Pe; Staffieri, A (1996). "Temporary Threshold Shift Induced by Physical Exercise".
1768:
Lindgren, F.; Axelsson, A. (1988). "The Influence of Physical Exercise on Susceptibility to Noise-Induced Temporary Threshold Shift".
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at certain doses. Research has been done to determine their ability to protect against auditory fatigue and permanent damage through
1263:
1296:
Hamernik, Roger P.; Ahroon, William A. (1998). "Interrupted noise exposures: Threshold shift dynamics and permanent effects".
165:. The OHCs are the most fragile of the hair cells, hence their involvement in auditory fatigue and other hearing impairments.
162:
535:
158:
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relationships between the drugs on the degree of reduction of auditory fatigue have been discovered at this time.
581:
Charron, Sylvie; Botte, Marie-Claire (1988). "Frequency selectivity in loudness adaptation and auditory fatigue".
410:), has been shown to reduce ROS formation associated with the excessive vibrations induced by the noise exposure.
1863:
Axelsson, A.; Vertes, D; Miller, J. (1981). "Immediate Noise Effects on Cochlear Vasculature in the Guinea Pig".
1451:"Furosemide alters organ of corti mechanics: evidence for feedback of outer hair cells upon the basilar membrane"
1169:
Ward, W. Dixon (1970). "Temporary Threshold Shift and Damage-Risk Criteria for Intermittent Noise Exposures".
2530:
406:' by studies looking for protective tendencies of antioxidants. In addition, NAC, or N-acetyl-L-cysteine (
1908:"Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers"
996:
Chen GD, Henderson D (2009). "Cochlear injuries induced by the combined exposure to noise and styrene".
2490:
31:
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Ou, Henry C; Bohne, Barbara A; Harding, Gary W (2000). "Noise damage in the C57BL/CBA mouse cochlea".
2500:
542:. Dept. of Otolaryngology, Washington University School of Medicine, St. Louis, MO. Archived from
298:, a motor protein that causes OHC motility. Excess vibrations require increased metabolic energy.
302:
150:
365:
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In all cases of auditory fatigue, sufficient recovery time should allow full correction of the
1711:"Uniform comparison of several drugs which provide protection from noise induced hearing loss"
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There are some factors that are known to directly affect the auditory system. Contact with
8:
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Housley GD et al., "ATP-gated ion channels mediate adaptation to elevated sound levels"
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In addition, these extra vibrations can cause the formation of free radicals known as
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2001:
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CHEN, Chiou-Jong; DAI, Yu-Tung; SUN, Yih-Min; LIN, Yi-Chang; JUANG, Yow-Jer (2007).
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161:, or OHCs, can be thought of as microamplifiers that provide stimulation to the
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1876:
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Furosemide injections prior to noise exposure have been shown to decrease the
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recovery requires a minimum of several minutes but can take up to several days
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Another factor that may not show signs of being harmful is the current
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is a compound most frequently used in anti-acne washes, but is also an
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There are two different systems associated with the mechanics of the
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full recovery from TTS can be achieved in approximately two minutes
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Temporary or permanent loss of hearing due to exposure to sound
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24:temporary threshold shift
1906:Mizoue, T (2003-01-01).
1139:10.2486/indhealth.45.527
259:Classical passive system
176:. Some fish also have a
443:Risk increasing factors
303:reactive oxygen species
231:Organ of Corti showing
2282:. Elsevier BV: 66–79.
2167:Journal of Neurotrauma
1865:Acta Oto-Laryngologica
1813:Scandinavian Audiology
1770:Scandinavian Audiology
1728:10.1186/1745-6673-5-26
1609:Acta Oto-Laryngologica
366:endocochlear potential
114:
2385:(4). Wiley: 920–928.
2334:(5). Wiley: 832–836.
2179:10.1089/neu.2009.1246
890:10.1007/s101620020028
246:Traveling wave theory
82:
2531:Occupational hazards
513:Experimental studies
354:toughening phenomena
285:Excessive vibrations
2453:2005ASAJ..117Q2440P
2135:2011ASAJ..129.2432K
2080:2010ASAJ..128..567F
2029:1991ASAJ...90..147M
1924:10.1136/oem.60.1.56
1310:1998ASAJ..103.3478H
1234:1960ASAJ...32..497W
1183:1970ASAJ...48..561W
653:1955ASAJ...27Q1013H
595:1988ASAJ...83..178C
322:Protective measures
241:Affected mechanisms
189:
490:ototoxic chemicals
457:Ototoxic chemicals
315:hearing impairment
291:Metabolic activity
253:cochlear amplifier
183:
115:
83:Human ear anatomy.
41:Short-term fatigue
2461:10.1121/1.4809471
2391:10.1002/jnr.21533
2143:10.1121/1.3587953
2088:10.1121/1.3458814
1918:(1). BMJ: 56–59.
1412:10.1159/000115436
1242:10.1121/1.1908111
1191:10.1121/1.1912172
1126:Industrial Health
1052:Ear & Hearing
946:10.1159/000013846
662:10.1121/1.1918032
464:physical exercise
448:Physical exercise
238:
237:
57:Long-term fatigue
2543:
2473:
2472:
2435:
2429:
2428:
2402:
2374:
2368:
2367:
2328:The Laryngoscope
2322:
2316:
2315:
2270:
2264:
2263:
2218:
2212:
2205:
2199:
2198:
2161:
2155:
2154:
2117:
2108:
2107:
2063:
2057:
2056:
2037:10.1121/1.401308
2012:
2006:
2005:
1966:Hearing Research
1960:
1954:
1953:
1943:
1903:
1897:
1896:
1860:
1854:
1851:
1845:
1844:
1808:
1802:
1801:
1765:
1759:
1758:
1748:
1730:
1706:
1700:
1699:
1660:Hearing Research
1655:
1649:
1648:
1603:
1597:
1596:
1586:
1546:
1540:
1539:
1503:
1497:
1496:
1486:
1446:
1440:
1439:
1395:
1389:
1388:
1349:Hearing Research
1344:
1338:
1337:
1318:10.1121/1.423056
1293:
1280:
1278:
1276:
1275:
1266:. Archived from
1260:
1254:
1253:
1217:
1211:
1210:
1166:
1160:
1159:
1141:
1117:
1092:
1091:
1047:
1038:
1037:
998:Hearing Research
993:
974:
973:
929:
920:
919:
909:
869:
860:
859:
820:Hearing Research
815:
806:
805:
761:
742:
739:
733:
732:
693:Hearing Research
688:
675:
674:
664:
632:
623:
622:
603:10.1121/1.396443
578:
559:
558:
553:
551:
531:
502:carbon disulfide
475:vasoconstriction
278:basilar membrane
225:Cochlea showing
211:
204:
197:
190:
163:inner hair cells
159:outer hair cells
108: Purple is
107:
97:
87:
75:Affected anatomy
20:Auditory fatigue
2551:
2550:
2546:
2545:
2544:
2542:
2541:
2540:
2511:
2510:
2482:
2477:
2476:
2436:
2432:
2375:
2371:
2323:
2319:
2271:
2267:
2219:
2215:
2206:
2202:
2162:
2158:
2118:
2111:
2064:
2060:
2013:
2009:
1961:
1957:
1904:
1900:
1861:
1857:
1852:
1848:
1809:
1805:
1766:
1762:
1707:
1703:
1656:
1652:
1604:
1600:
1547:
1543:
1504:
1500:
1447:
1443:
1396:
1392:
1345:
1341:
1294:
1283:
1273:
1271:
1262:
1261:
1257:
1218:
1214:
1167:
1163:
1118:
1095:
1048:
1041:
994:
977:
930:
923:
870:
863:
816:
809:
762:
745:
740:
736:
689:
678:
633:
626:
579:
562:
549:
547:
532:
528:
523:
515:
445:
416:
389:
374:
362:
348:are considered
338:
329:
324:
311:
287:
273:
261:
248:
243:
188:
113:
105:
103:
95:
93:
88: Brown is
85:
77:
72:
17:
12:
11:
5:
2549:
2539:
2538:
2533:
2528:
2523:
2509:
2508:
2506:Safe listening
2503:
2498:
2493:
2488:
2481:
2478:
2475:
2474:
2430:
2369:
2317:
2276:Brain Research
2265:
2213:
2200:
2156:
2109:
2058:
2007:
1955:
1898:
1855:
1846:
1803:
1760:
1701:
1650:
1598:
1541:
1498:
1441:
1390:
1339:
1281:
1255:
1212:
1161:
1093:
1039:
1004:(1–2): 25–33.
975:
921:
861:
807:
743:
734:
676:
624:
560:
525:
524:
522:
519:
514:
511:
459:
458:
455:
452:
449:
444:
441:
429:Salicylic acid
415:
412:
408:acetylcysteine
388:
383:
373:
372:Salicylic acid
370:
361:
358:
346:salicylic acid
337:
334:
328:
325:
323:
320:
310:
307:
286:
283:
272:
271:Active process
269:
260:
257:
247:
244:
242:
239:
236:
235:
229:
227:organ of Corti
223:
213:
212:
205:
198:
184:
174:sound pressure
143:organ of Corti
104:
94:
84:
76:
73:
71:
68:
67:
66:
63:
54:
53:
50:
47:
15:
9:
6:
4:
3:
2:
2548:
2537:
2534:
2532:
2529:
2527:
2524:
2522:
2519:
2518:
2516:
2507:
2504:
2502:
2499:
2497:
2494:
2492:
2489:
2487:
2484:
2483:
2470:
2466:
2462:
2458:
2454:
2450:
2446:
2442:
2434:
2426:
2422:
2418:
2414:
2410:
2406:
2401:
2400:2027.42/58028
2396:
2392:
2388:
2384:
2380:
2373:
2365:
2361:
2357:
2353:
2349:
2345:
2341:
2337:
2333:
2329:
2321:
2313:
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2305:
2301:
2297:
2293:
2289:
2285:
2281:
2277:
2269:
2261:
2257:
2253:
2249:
2245:
2241:
2237:
2233:
2229:
2225:
2217:
2210:
2204:
2196:
2192:
2188:
2184:
2180:
2176:
2172:
2168:
2160:
2152:
2148:
2144:
2140:
2136:
2132:
2128:
2124:
2116:
2114:
2105:
2101:
2097:
2093:
2089:
2085:
2081:
2077:
2073:
2069:
2062:
2054:
2050:
2046:
2042:
2038:
2034:
2030:
2026:
2022:
2018:
2011:
2003:
1999:
1995:
1991:
1987:
1983:
1979:
1975:
1971:
1967:
1959:
1951:
1947:
1942:
1937:
1933:
1929:
1925:
1921:
1917:
1913:
1909:
1902:
1894:
1890:
1886:
1882:
1878:
1874:
1870:
1866:
1859:
1850:
1842:
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1826:
1822:
1818:
1814:
1807:
1799:
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1779:
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1764:
1756:
1752:
1747:
1742:
1738:
1734:
1729:
1724:
1720:
1716:
1712:
1705:
1697:
1693:
1689:
1685:
1681:
1677:
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1669:
1665:
1661:
1654:
1646:
1642:
1638:
1634:
1630:
1626:
1622:
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1614:
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1602:
1594:
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1585:
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1576:
1572:
1568:
1564:
1560:
1556:
1552:
1545:
1537:
1533:
1529:
1525:
1521:
1517:
1513:
1509:
1502:
1494:
1490:
1485:
1480:
1476:
1472:
1468:
1464:
1460:
1456:
1452:
1445:
1437:
1433:
1429:
1425:
1421:
1417:
1413:
1409:
1405:
1401:
1394:
1386:
1382:
1378:
1374:
1370:
1366:
1362:
1358:
1354:
1350:
1343:
1335:
1331:
1327:
1323:
1319:
1315:
1311:
1307:
1303:
1299:
1292:
1290:
1288:
1286:
1270:on 2010-12-14
1269:
1265:
1259:
1251:
1247:
1243:
1239:
1235:
1231:
1227:
1223:
1216:
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1204:
1200:
1196:
1192:
1188:
1184:
1180:
1176:
1172:
1165:
1157:
1153:
1149:
1145:
1140:
1135:
1131:
1127:
1123:
1116:
1114:
1112:
1110:
1108:
1106:
1104:
1102:
1100:
1098:
1089:
1085:
1081:
1077:
1073:
1069:
1065:
1061:
1057:
1053:
1046:
1044:
1035:
1031:
1027:
1023:
1019:
1015:
1011:
1007:
1003:
999:
992:
990:
988:
986:
984:
982:
980:
971:
967:
963:
959:
955:
951:
947:
943:
939:
935:
928:
926:
917:
913:
908:
903:
899:
895:
891:
887:
883:
879:
875:
868:
866:
857:
853:
849:
845:
841:
837:
833:
829:
825:
821:
814:
812:
803:
799:
795:
791:
787:
783:
779:
775:
771:
767:
760:
758:
756:
754:
752:
750:
748:
738:
730:
726:
722:
718:
714:
710:
706:
702:
698:
694:
687:
685:
683:
681:
672:
668:
663:
658:
654:
650:
646:
642:
638:
631:
629:
620:
616:
612:
608:
604:
600:
596:
592:
588:
584:
577:
575:
573:
571:
569:
567:
565:
557:
546:on 2016-07-01
545:
541:
537:
530:
526:
518:
510:
506:
503:
499:
495:
491:
486:
483:
478:
476:
471:
470:Heat exposure
467:
465:
456:
453:
451:Heat exposure
450:
447:
446:
440:
438:
434:
433:anticoagulant
430:
426:
422:
411:
409:
405:
401:
397:
393:
387:
382:
379:
369:
367:
357:
355:
351:
347:
343:
333:
319:
316:
306:
304:
299:
297:
292:
282:
279:
268:
266:
256:
254:
234:
230:
228:
224:
222:
218:
215:
210:
206:
203:
199:
196:
192:
191:
187:
181:
179:
175:
171:
166:
164:
160:
155:
152:
147:
146:
144:
140:
136:
132:
128:
124:
119:
111:
101:
98: Red is
91:
81:
64:
61:
60:
59:
58:
51:
48:
45:
44:
43:
42:
38:
35:
33:
29:
25:
21:
2486:Hearing loss
2444:
2440:
2433:
2382:
2378:
2372:
2331:
2327:
2320:
2279:
2275:
2268:
2227:
2224:Neuroscience
2223:
2216:
2203:
2170:
2166:
2159:
2126:
2122:
2071:
2067:
2061:
2020:
2016:
2010:
1969:
1965:
1958:
1915:
1911:
1901:
1868:
1864:
1858:
1849:
1816:
1812:
1806:
1773:
1769:
1763:
1718:
1714:
1704:
1663:
1659:
1653:
1612:
1608:
1601:
1558:
1554:
1544:
1511:
1507:
1501:
1458:
1454:
1444:
1403:
1399:
1393:
1352:
1348:
1342:
1301:
1297:
1272:. Retrieved
1268:the original
1258:
1225:
1221:
1215:
1174:
1170:
1164:
1129:
1125:
1055:
1051:
1001:
997:
937:
933:
881:
877:
823:
819:
769:
765:
737:
696:
692:
644:
640:
586:
582:
555:
548:. Retrieved
544:the original
539:
529:
516:
507:
489:
487:
481:
479:
469:
468:
463:
460:
427:properties.
417:
390:
386:Antioxidants
375:
363:
353:
339:
330:
312:
300:
288:
274:
262:
249:
185:
178:lateral line
167:
156:
148:
120:
117:
116:
56:
55:
40:
39:
36:
27:
23:
19:
18:
437:synergistic
414:Limitations
151:stereocilia
34:, or NIHL.
2515:Categories
1274:2010-12-05
521:References
421:Furosemide
404:scavengers
392:Vitamins A
360:Furosemide
342:furosemide
336:Substances
233:hair cells
139:hair cells
100:middle ear
70:Physiology
2526:Audiology
2469:0001-4966
2409:0360-4012
2348:0023-852X
2296:0006-8993
2244:0306-4522
2187:0897-7151
2151:0001-4966
2096:0001-4966
2045:0001-4966
1986:0378-5955
1932:1351-0711
1885:0001-6489
1833:0105-0397
1790:0105-0397
1737:1745-6673
1680:0378-5955
1629:0001-6489
1575:0891-5849
1528:0886-4470
1475:0270-6474
1420:1421-9700
1369:0378-5955
1326:0001-4966
1250:0001-4966
1199:0001-4966
1148:0019-8366
1072:0196-0202
1018:0378-5955
954:1421-9700
898:1525-3961
840:0378-5955
786:0003-4894
713:0378-5955
671:0001-4966
611:0001-4966
217:Inner ear
131:outer ear
127:inner ear
110:inner ear
90:outer ear
2496:Tinnitus
2480:See also
2425:15931404
2417:17943992
2364:20410803
2356:18300700
2312:39059380
2304:19766602
2260:19479770
2252:20600667
2195:20504154
2104:20707425
2002:22102792
1994:19643173
1950:12499458
1755:20809938
1696:23196128
1688:17184943
1645:40224765
1637:17712668
1593:17395018
1436:19741330
1428:18259079
1156:17878624
1088:14805371
1080:16446561
1034:40198769
1026:19371775
962:10436315
916:12382101
856:14553141
848:10867283
802:37410959
794:20524581
729:39014408
492:such as
482:workload
454:Workload
425:diuretic
350:ototoxic
309:Recovery
219:showing
137:, outer
2536:Otology
2521:Hearing
2449:Bibcode
2131:Bibcode
2076:Bibcode
2053:1880282
2025:Bibcode
1941:1740373
1893:7257757
1841:8881006
1798:3406655
1746:2936911
1584:1950331
1536:2923694
1493:2010805
1484:3580957
1385:4782719
1377:9119763
1334:9637033
1306:Bibcode
1230:Bibcode
1207:5470502
1179:Bibcode
970:1345772
907:3202415
721:6826470
649:Bibcode
619:3343438
591:Bibcode
550:July 5,
498:toluene
494:styrene
296:prestin
265:cochlea
221:cochlea
170:otolith
135:cochlea
2467:
2423:
2415:
2407:
2362:
2354:
2346:
2310:
2302:
2294:
2258:
2250:
2242:
2193:
2185:
2149:
2102:
2094:
2051:
2043:
2000:
1992:
1984:
1948:
1938:
1930:
1891:
1883:
1839:
1831:
1796:
1788:
1753:
1743:
1735:
1694:
1686:
1678:
1643:
1635:
1627:
1591:
1581:
1573:
1534:
1526:
1491:
1481:
1473:
1434:
1426:
1418:
1383:
1375:
1367:
1332:
1324:
1248:
1205:
1197:
1154:
1146:
1086:
1078:
1070:
1032:
1024:
1016:
968:
960:
952:
914:
904:
896:
854:
846:
838:
800:
792:
784:
727:
719:
711:
669:
617:
609:
141:, and
106:
96:
86:
2421:S2CID
2360:S2CID
2308:S2CID
2256:S2CID
1998:S2CID
1692:S2CID
1641:S2CID
1432:S2CID
1381:S2CID
1084:S2CID
1030:S2CID
966:S2CID
852:S2CID
798:S2CID
725:S2CID
378:anion
340:Both
118:Note:
2465:ISSN
2413:PMID
2405:ISSN
2352:PMID
2344:ISSN
2300:PMID
2292:ISSN
2280:1304
2248:PMID
2240:ISSN
2191:PMID
2183:ISSN
2147:ISSN
2100:PMID
2092:ISSN
2049:PMID
2041:ISSN
1990:PMID
1982:ISSN
1946:PMID
1928:ISSN
1889:PMID
1881:ISSN
1837:PMID
1829:ISSN
1794:PMID
1786:ISSN
1751:PMID
1733:ISSN
1684:PMID
1676:ISSN
1633:PMID
1625:ISSN
1589:PMID
1571:ISSN
1532:PMID
1524:ISSN
1489:PMID
1471:ISSN
1424:PMID
1416:ISSN
1373:PMID
1365:ISSN
1330:PMID
1322:ISSN
1279:>
1246:ISSN
1203:PMID
1195:ISSN
1152:PMID
1144:ISSN
1076:PMID
1068:ISSN
1022:PMID
1014:ISSN
958:PMID
950:ISSN
912:PMID
894:ISSN
844:PMID
836:ISSN
790:PMID
782:ISSN
717:PMID
709:ISSN
667:ISSN
615:PMID
607:ISSN
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