Acoustic Shock by Nail Gun
By Dennis A. Colucci, AuD, MA
Acoustic shock (AS) is a rare condition caused by an unexpected loud sound and resulting in a number of otologic symptoms, including otalgia without physical findings, tinnitus, hyperacusis, mild dizziness, and, in some cases, tonic tenor tympani syndrome and trigeminal nerve irritability (Wescott. Noise Health 2013; 15:117-128). Acoustic shock is a life-changing disorder with a significant psychogenic component (Hooper. J Laryngol Otol 2014;128[Suppl 2]:S2-9). People suffering from AS often stop working, retreat into isolation, and use hearing protection insidiously, as they fear everyday sound. What appears initially to be a complaint of peripheral hearing loss and tinnitus is actually much more extensive, as the central auditory structures and the limbic system become engaged and the patient’s behavior changes.