With regret, we read the remarks by Zardouz and colleagues saying that the abstract conclusions in our article are not supported by the results of our study, especially those within the noise exposure group. A post hoc least significant difference test was executed only when the overall 3-way repeated-measures analysis of variance was significant. The Bonferroni correction was applied for significant overall results and between the comparisons of interest (ie, preexposure and postexposure measurements). So, the P value was divided by 2, 3, or 6 for significant effects of measurement × headphone, measurement × volume, and measurement × headphone × volume, respectively. Because multiple P values are often given, a range of P values is reflected instead of the actual values. However, we do recognize that increasing the sample size would lead to more statistical power. Nevertheless, besides group measures, the percentage of significant shifts that was based on the standard error of measurement from the control group was also evaluated. The odds for hearing deterioration based on pure-tone audiometry, transient-evoked otoacoustic emissions, and distortion product otoacoustic emissions were greater in the noise-exposed group than in the control group. Therefore, these temporary effects indicate the potential harmful effects of listening to an MP3 player for 1 hour. However, further research is needed to evaluate the long-term auditory effects of listening to MP3 players as well as in combination with other recreational noise exposures.
Keppler H, Dhooge I, Maes L, et al. Noise-Induced Hearing Loss From MP3 Players—Reply. Arch Otolaryngol Head Neck Surg. 2010;136(12):1280. doi:10.1001/archoto.2010.209
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