儿童听力障碍与成人耳鸣之间的关联。

Association Between Childhood Hearing Disorders and Tinnitus in Adulthood.

作者信息

Aarhus Lisa, Engdahl Bo, Tambs Kristian, Kvestad Ellen, Hoffman Howard J

机构信息

Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.

Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.

出版信息

JAMA Otolaryngol Head Neck Surg. 2015 Nov;141(11):983-9. doi: 10.1001/jamaoto.2015.2378.

Abstract

IMPORTANCE

The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies.

OBJECTIVES

To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss.

DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort study of 32 430 adults (aged 20-56 years) who underwent pure-tone audiometry and completed a tinnitus questionnaire in the Nord-Trøndelag Hearing Loss Study, which was a part of the Nord-Trøndelag Health Study 2 (HUNT2). The study was conducted from January 1, 2014, to April 1, 2015. Data analysis was performed from April 1, 2014, to April 1, 2015. As children, the same individuals had undergone screening audiometry in a longitudinal primary school hearing investigation, including ear, nose, and throat examinations when indicated.

INTERVENTIONS

Pure-tone audiometry, questionnaires, and ear, nose, and throat examinations.

MAIN OUTCOMES AND MEASURES

Self-reported tinnitus (yes or no) in adulthood measured by questionnaires.

RESULTS

Adults who had hearing loss at the time of the school investigation (n = 3026) reported more tinnitus, measured as odds ratio (95% CI), than did adults with normal childhood hearing (n = 29 404) (1.4 [1.3-1.6]). Childhood hearing disorders associated with tinnitus in adulthood included sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media (2.4 [1.9-3.0], 2.4 [1.5-3.9], and 1.6 [1.3-2.0], respectively). These estimates were adjusted for age, sex, and noise exposure in adulthood. After further analyses that included adjustment for adult hearing threshold, none of these childhood hearing disorders remained positively associated with tinnitus.

CONCLUSIONS AND RELEVANCE

Childhood hearing disorders associated with tinnitus in adulthood include sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media. After adjustment for the adult hearing threshold, none of the childhood hearing disorders was positively associated with tinnitus. Hence, it appears that these significant associations are mediated or transmitted through adult hearing loss.

摘要

重要性

儿童听力障碍与成人耳鸣之间的关联尚未在纵向队列研究中得到检验。

目的

确定不同类型的儿童听力损失与成人耳鸣之间的关联,并评估耳鸣风险是否由成人听力损失介导。

设计、地点和参与者:基于人群的队列研究,纳入了32430名年龄在20至56岁之间的成年人,他们在北特伦德拉格听力损失研究中接受了纯音听力测试并完成了耳鸣问卷,该研究是北特伦德拉格健康研究2(HUNT2)的一部分。研究于2014年1月1日至2015年4月1日进行。数据分析于2014年4月1日至2015年4月1日进行。这些个体在儿童时期曾在一项纵向小学听力调查中接受过听力筛查,必要时还包括耳鼻喉检查。

干预措施

纯音听力测试、问卷调查以及耳鼻喉检查。

主要结局和测量指标

通过问卷测量的成人自我报告耳鸣(是或否)。

结果

在学校调查时存在听力损失的成年人(n = 3026)报告耳鸣的比例更高,以比值比(95%置信区间)衡量,高于儿童时期听力正常的成年人(n = 29404)(1.4 [1.3 - 1.6])。与成人耳鸣相关的儿童听力障碍包括感音神经性听力损失、慢性化脓性中耳炎以及与复发性急性中耳炎病史相关的听力损失(分别为2.4 [1.9 - 3.0]、2.4 [1.5 - 3.9]和1.6 [1.3 - 2.0])。这些估计值针对成人的年龄、性别和噪声暴露进行了调整。在进一步分析中纳入成人听力阈值调整后,这些儿童听力障碍均不再与耳鸣呈正相关。

结论和相关性

与成人耳鸣相关的儿童听力障碍包括感音神经性听力损失、慢性化脓性中耳炎以及与复发性急性中耳炎病史相关的听力损失。在调整成人听力阈值后,没有一种儿童听力障碍与耳鸣呈正相关。因此,这些显著关联似乎是通过成人听力损失介导或传递的。

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