Recent advances in understanding and preventing noise-induced hearing loss

Noise-induced hearing loss (NIHL) is a major health problem in the United States and other industrialized countries. The purpose of this paper is to review the recent literature on NIHL. The review is organized around three major areas of research: 1) sources of damaging levels of noise, especially personal stereos and automotive air bags; 2) factors that influence individual susceptibility to NIHL, particularly sex and presbycusis; and 3) strategies for preventing NIHL with sound conditioning and pharmacologic interventions. The most promising approaches to protection of the ear seem to be pharmacologic strategies that eliminate reactive oxygen species, enhance cochlear microcirculation, and promote cell survival or repair. However, for pharmacologic strategies to be clinically useful, we need effective drug delivery systems that target the inner ear and strategies for “rescuing” cells from damage after exposure to noise.