Szibor Annett, Hyvärinen Petteri, Lehtimäki Jarmo, Pirvola Ulla, Ylikoski Matti, Mäkitie Antti, Aarnisalo Antti, Ylikoski Jukka
a Department of Otolaryngology - Head and Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
b Helsinki Ear Institute , Helsinki , Finland.
Acta Otolaryngol. 2018 Jan;138(1):21-24. doi: 10.1080/00016489.2017.1367100. Epub 2017 Aug 31.
Music-induced acute acoustic trauma is not inevitably linked to hearing dysfunction as validated by conventional pure tone audiometry. Tinnitus is often in combination with hyperacusis. Our results point at 'silent hearing loss' as the underlying pathology, having afferent nerve terminal damage rather than hair cell loss as the structural correlate.
Exposure to loud music is one of the most common causes of acute acoustic trauma, which adolescents and teenagers experience by voluntary exposure to loud music of sound levels up to 110 dB(A).
The clinical and psychophysical data of 104 consecutive patients with music-induced hearing disorder (MIHD) were analyzed to construct individual hearing and tinnitus profiles. In all cases, tinnitus was the presenting symptom.
Hearing abilities were normal in about two-thirds of the tinnitus patients. Tinnitus was experienced most often as a high-frequency tone (83%). The Tinnitus Handicap Inventory (THI) scores ranged from 0 to 94 with an average score of 43.1. Visual analog scales (VAS) were used to assess tinnitus loudness (average 42.4) and annoyance (average 54.2), and tinnitus awareness was estimated (average 60.3). All VAS values correlated strongly with the THI. Hyperacusis was present in 65% and 71% of the patients reported sleeping disorders.
音乐诱发的急性听觉创伤并不必然与传统纯音听力测定所证实的听力功能障碍相关。耳鸣常与听觉过敏同时出现。我们的研究结果指出“隐性听力损失”是潜在的病理状况,其结构关联是传入神经末梢损伤而非毛细胞损失。
接触嘈杂音乐是急性听觉创伤最常见的原因之一,青少年会因自愿接触高达110 dB(A)声级的嘈杂音乐而受到影响。
分析了104例连续的音乐诱发听力障碍(MIHD)患者的临床和心理物理学数据,以构建个体听力和耳鸣图谱。所有病例中,耳鸣均为首发症状。
约三分之二的耳鸣患者听力正常。耳鸣最常表现为高频音(83%)。耳鸣障碍量表(THI)得分范围为0至94,平均分为43.1。使用视觉模拟量表(VAS)评估耳鸣响度(平均42.4)和烦恼程度(平均54.2),并估计耳鸣知晓度(平均60.3)。所有VAS值与THI均高度相关。65%的患者存在听觉过敏,71%的患者报告有睡眠障碍。