Departments of Physiology and Pharmacology, University of Calgary, 2500 University Drive NW, Calgary, Alberta, Canada.
Ear Hear. 2012 May-Jun;33(3):305-14. doi: 10.1097/AUD.0b013e318241e880.
It has become increasingly clear that even occasional exposure to loud sounds in occupational or recreational settings can cause irreversible damage to the hair cells of the cochlea and the auditory nerve fibers, even if the resulting partial loss of hearing sensitivity, usually accompanied by tinnitus, disappears within hours or days of the exposure. Such exposure may explain at least some cases of poor speech intelligibility in noise in the face of a normal or near-normal audiogram. Recent findings from our laboratory suggest that long-term changes to auditory brain function-potentially leading to problems with speech intelligibility-can be effected by persistent, passive exposure to more moderate levels of noise (in the 70 dB SPL range) in the apparent absence of damage to the auditory periphery (as reflected in normal distortion product otoacoustic emissions and auditory brainstem responses). Specifically, passive exposure of adult cats to moderate levels of band-pass-filtered noise, or to band-limited ensembles of dense, random tone pips, can lead to a profound decrease of neural activity in the auditory cortex roughly in the exposure frequency range, and to an increase of activity outside that range. This can progress to an apparent reorganization of the cortical tonotopic map, which is reminiscent of the reorganization resulting from hearing loss restricted to a part of the hearing frequency range, although again, no hearing loss was apparent after our moderate-level sound exposure. Here, we review this work focusing specifically on the potential hearing problems that may arise despite a normally functioning auditory periphery.
越来越明显的是,即使偶尔在职业或娱乐环境中接触到响亮的声音,也可能导致耳蜗毛细胞和听神经纤维的不可逆转的损伤,即使由此导致的部分听力敏感度丧失通常在接触后的数小时或数天内消失。这种接触至少可以解释一些在面对正常或接近正常听力图时在噪声中言语理解能力差的情况。我们实验室的最新发现表明,长期的听觉大脑功能变化——可能导致言语理解能力出现问题——可能是由持续的、被动的暴露于更中等水平的噪声(在 70 dB SPL 范围内)引起的,而听觉外围(如正常的失真产物耳声发射和听觉脑干反应所反映的)没有损伤。具体来说,成年猫被动暴露于中等水平的带通滤波噪声或有限带宽的密集随机音调脉冲对,会导致听觉皮层中与暴露频率大致相当的神经活动明显减少,并导致该范围以外的活动增加。这可能会导致皮质调谐图的明显重组,这让人联想到仅限于听力频率范围一部分的听力损失引起的重组,尽管在我们的中等水平声音暴露后,听觉并没有明显的损失。在这里,我们特别关注尽管听觉外围功能正常,但仍可能出现的潜在听力问题,回顾这项工作。