耳鸣严重程度与交响乐团音乐家的声音暴露有关，与听力损伤无关。
Tinnitus Severity Is Related to the Sound Exposure of Symphony Orchestra Musicians Independently of Hearing Impairment.
机构信息
Department of ORL Head and Neck Surgery and Audiology, Odense University Hospital, Odense C, Denmark.
Institute of Clinical Research, University of Southern Denmark, Odense M, Denmark.
出版信息
Ear Hear. 2019 Jan/Feb;40(1):88-97. doi: 10.1097/AUD.0000000000000594.
OBJECTIVES
Tinnitus can be debilitating and with great impact of musicians professional and private life. The objectives of the study were therefore to: (1) describe the epidemiology of tinnitus including its severity in classical orchestra musicians, (2) investigate the association between tinnitus severity in classical musicians and their cumulative lifetime sound exposure, and (3) the association between tinnitus and hearing thresholds.
DESIGN
The study population included all musicians from five Danish symphony orchestras. Answers regarding their perception of tinnitus were received from 325 musicians, and 212 musicians were also tested with audiometry. Any tinnitus and severe tinnitus were two definitions of tinnitus used as outcomes and analyzed in relation to an estimation of the cumulative lifetime sound exposure from sound measurements and previously validated questionnaires and the average hearing threshold of 3, 4, and 6 kHz.
RESULTS
Thirty-five percentage of all musicians (31% female and 38% of male musicians) reported having experienced at least one episode of tinnitus lasting for more than 5 minutes during their life. Severe tinnitus with a severe impact on daily life was reported by 19% of the musicians (18% of female and 21% of male musicians). The severity of tinnitus was associated with increased lifetime sound exposure but not to poorer high frequency hearing thresholds when the lifetime sound exposure was considered. The odds ratio for an increase in one unit of tinnitus severity was 1.25 (95% CI, 1.12-1.40) for every 1 dB increase in lifetime sound exposure.
CONCLUSION
Musicians frequently report tinnitus. Any tinnitus and severe tinnitus are significantly associated with the cumulative lifetime sound exposure, which was shown to be the most important factor not only for the prevalence but also for the severity of tinnitus-even in musicians without hearing loss. High-frequency hearing thresholds and tinnitus severity were correlated only if the cumulative lifetime sound exposure was excluded from the analyses.
目的
耳鸣可能使人虚弱，并对音乐家的职业和私人生活产生重大影响。因此，这项研究的目的是：（1）描述耳鸣的流行病学，包括其在古典管弦乐队音乐家中的严重程度；（2）调查古典音乐家耳鸣严重程度与他们一生中累积的噪声暴露量之间的关系；（3）耳鸣与听力阈值之间的关系。
设计
研究对象包括来自丹麦五个交响乐团的所有音乐家。收到了 325 名音乐家对耳鸣感知的回答，其中 212 名音乐家还接受了听力测试。使用两种耳鸣定义（任何耳鸣和严重耳鸣）作为结果进行分析，这些定义与通过声音测量和先前验证的问卷对累积终生噪声暴露量的估计以及 3、4 和 6 kHz 的平均听力阈值有关。
结果
所有音乐家中有 35%（31%为女性，38%为男性）报告在其一生中至少经历过一次持续超过 5 分钟的耳鸣发作。19%的音乐家（18%为女性，21%为男性）报告有严重的耳鸣，对日常生活有严重影响。当考虑终生噪声暴露时，耳鸣的严重程度与噪声暴露的增加有关，但与高频听力阈值较差无关。终生噪声暴露每增加 1 dB，耳鸣严重程度增加一个单位的优势比为 1.25（95%CI，1.12-1.40）。
结论
音乐家经常报告耳鸣。任何耳鸣和严重耳鸣与累积终生噪声暴露显著相关，这不仅是耳鸣患病率的最重要因素，也是严重程度的最重要因素，即使在没有听力损失的音乐家也是如此。只有在排除累积终生噪声暴露量后，高频听力阈值和耳鸣严重程度才相关。
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