Deafness/Hearing Impairment/Question on Threshold Shift


Hello Dr. Linton I am reading up on Tinnitus and am confused about something. When someone is at a concert or nightclub for a few hours they go in the "threshold shift" which muffles the ear from the loud sound. I have read that this is to protect the ear from damage. What I don't understand is if one goes into that threshold shift and the ear is being protected then why does damage and tinnitus still occur?


The hair cells in the inner ear are somewhat protected by a muscle in our middle ear.  This muscle can only protect up to a certain point.  When this muscle is contracted and protecting, it causes the threshold shift in our hearing.  Much like anything in life, this muscle can be pushed to the limit and can reach a point of distress where it is not able to protect any longer.

This happens for two reasons: the sound is so loud (like a gunshot or explosion) that the muscle simply isn't strong enough to hold the sound out; the sound is loud but steady and simply lasts too long and the muscle can't hold the protection indefinitely.  

Both of these scenarios will cause the muscle to fatigue and not be able to protect the inner ear hair cells and ultimately will result in permanent hearing loss and/or tinnitus. If the hair cells are permanently damaged, the result is hearing loss.

Thank you for your question.
Kelley Linton, AuD
Doctor of Audiology

Deafness/Hearing Impairment

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Dr. Kelley Linton


I'm an audiologist in private practice in Arkansas. I graduated from the University of Florida medical school. I specialize in hearing loss; hearing rehabilitation; hearing aids; noise induced hearing loss; occupational noise exposure; OSHA guidelines and regulations; hearing protection; tinnitis; newborn hearing testing; children and hearing loss and diagnosis and etiology of hearing loss.


I've been a practicing audiologist for 20 years and have owned a private practice for 14 years. I am also an audiologist in the United States Army where I teach DOD hearing conservation regulations and manage 3000 DOD employees at an army industrial facility.

Arkansas Academy of Audiology American Academy of Audiology Academy of Doctors of Audiology American Speech and Hearing Association National Hearing Conservation Association

Journal of the Academy of Audiology Southwest Times Record, Fort Smith, Arkansas Press Argus Courier, Van Buren, Arkansas

Au.D. - Doctor of Audiology, University of Florida American Academy of Audiology fellow member Audiology Board Certification American Speech and Hearing Association certification Arkansas State Audiology license-current CPT United States Army Medical Corps

Awards and Honors
American Speech and Hearing Association "ACE" award x 7 years United States Army Accommodation Award Arkansas Academy of Audiology elected board of director x 3 years Better community award, Fort Smith, AR for volunteer audiology service to free community health clinic

Past/Present Clients
Serving newborn to geriatric ages.....unable to provide specific names.

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