Effects of Earbuds and Headphones on Hearing and Vestibular Outcomes in Adolescents and Young Adults: A Systematic Review and Evidence Synthesis

Background: Personal listening devices (PLDs)—earbuds, earphones, and headphones—are nearly ubiquitous among adolescents. We evaluated whether PLD exposure was associated with hearing loss, tinnitus, subjective auditory difficulty, or vestibular dysfunction in adolescents and young adults. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, we searched PubMed/MEDLINE (June 2021–June 2026) and verified citations through publisher pages, open-access sources, and citation tracking. Eligible studies reported PLD exposure and auditory or vestibular outcomes in adolescents, school students, or young adults. Results: Twenty-five studies were synthesized; 13 provided extractable quantitative signals. The strongest adolescent-specific evidence showed that earphone use in noisy environments was associated with hearing loss (pOR 4.54) and subjective hearing problems (pOR 8.39). The self-reported hearing decline increased from 14.2% (middle) to 32.2% (high school). Objective dosimetry showed that longer exposure was negatively correlated with self-rated hearing ( r  = −0.21 to −0.32). Vestibular evidence was extremely limited and was derived primarily from a single study, which reported a moderate association between PLD exposure and saccular function in an adolescent subgroup ( r  = 0.406). Aggregate data did not support a valid new pooled correlation or prediction model. Conclusion: Unsafe listening—high volume, prolonged daily use, listening in noisy environments, and cumulative exposure—is associated with auditory risk in young people. Adolescent-specific evidence remains limited, while vestibular findings are hypothesis-generating and insufficient to establish a consistent association. Future prospective studies require objective sound-dose tracking and standardized auditory and vestibular testing.