Le Trung N, Straatman Louise V, Lea Jane, Westerberg Brian
Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.
J Otolaryngol Head Neck Surg. 2017 May 23;46(1):41. doi: 10.1186/s40463-017-0219-x.
Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure tone threshold testing. Noise-induced damage to the cochlea is traditionally considered to be associated with symmetrical mild to moderate hearing loss with associated tinnitus; however, there is a significant number of patients with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well.
Recent epidemiology and animal studies have provided further insight into the pathophysiology, clinical findings, social and economic impacts of noise-induced hearing loss. Furthermore, it is recently shown that acoustic trauma is associated with vestibular dysfunction, with associated dizziness that is not always measurable with current techniques. Deliberation of the prevalence, treatment and prevention of noise-induced hearing loss is important and timely. Currently, prevention and protection are the first lines of defence, although promising protective effects are emerging from multiple different pharmaceutical agents, such as steroids, antioxidants and neurotrophins.
This review provides a comprehensive update on the pathophysiology, investigations, prevalence of asymmetry, associated symptoms, and current strategies on the prevention and treatment of noise-induced hearing loss.
噪声性听力损失是感音神经性听力损失最常见的形式之一，是一个主要的健康问题，在很大程度上是可以预防的，而且其实际发生率可能比传统纯音阈值测试所显示的更为广泛。传统上认为，噪声对耳蜗的损害与对称性轻至中度听力损失及耳鸣有关；然而，有相当数量的患者阈值不对称，而且根据接触噪声的情况，还会出现重度至极重度听力损失。
近期的流行病学和动物研究进一步深入了解了噪声性听力损失的病理生理学、临床表现、社会和经济影响。此外，最近有研究表明，声创伤与前庭功能障碍有关，伴有眩晕，而目前的技术并不总能检测出这种眩晕。探讨噪声性听力损失的患病率、治疗和预防具有重要的现实意义。目前，预防和防护是第一道防线，不过多种不同的药物制剂，如类固醇、抗氧化剂和神经营养因子，已显示出有前景的保护作用。
本综述全面更新了噪声性听力损失的病理生理学、检查、不对称患病率、相关症状以及当前的预防和治疗策略。
