Manchester Centre for Audiology and Deafness, University of Manchester, UK.
Manchester Centre for Audiology and Deafness, University of Manchester, UK.
Hear Res. 2020 Sep 15;395:108021. doi: 10.1016/j.heares.2020.108021. Epub 2020 Jul 2.
Musicians are at risk of hearing loss due to prolonged noise exposure, but they may also be at risk of early sub-clinical hearing damage, such as cochlear synaptopathy. In the current study, we investigated the effects of noise exposure on electrophysiological, behavioral and self-report correlates of hearing damage in young adult (age range = 18-27 years) musicians and non-musicians with normal audiometric thresholds. Early-career musicians (n = 76) and non-musicians (n = 47) completed a test battery including the Noise Exposure Structured Interview, pure-tone audiometry (PTA; 0.25-8 kHz), extended high-frequency (EHF; 12 and 16 kHz) thresholds, otoacoustic emissions (OAEs), auditory brainstem responses (ABRs), speech perception in noise (SPiN), and self-reported tinnitus, hyperacusis and hearing in noise difficulties. Total lifetime noise exposure was similar between musicians and non-musicians, the majority of which could be accounted for by recreational activities. Musicians showed significantly greater ABR wave I/V ratios than non-musicians and were also more likely to report experience of - and/or more severe - tinnitus, hyperacusis and hearing in noise difficulties, irrespective of noise exposure. A secondary analysis revealed that individuals with the highest levels of noise exposure had reduced outer hair cell function compared to individuals with the lowest levels of noise exposure, as measured by OAEs. OAE level was also related to PTA and EHF thresholds. High levels of noise exposure were also associated with a significant increase in ABR wave V latency, but only for males, and a higher prevalence and severity of hyperacusis. These findings suggest that there may be sub-clinical effects of noise exposure on various hearing metrics even at a relatively young age, but do not support a link between lifetime noise exposure and proxy measures of cochlear synaptopathy such as ABR wave amplitudes and SPiN. Closely monitoring OAEs, PTA and EHF thresholds when conventional PTA is within the clinically 'normal' range could provide a useful early metric of noise-induced hearing damage. This may be particularly relevant to early-career musicians as they progress through a period of intensive musical training, and thus interventions to protect hearing longevity may be vital.
由于长时间暴露在噪声中，音乐家有听力损失的风险，但他们也可能有亚临床听力损伤的风险，如耳蜗突触病。在目前的研究中，我们调查了噪声暴露对年轻成年（年龄范围为 18-27 岁）音乐家和非音乐家正常听阈的听力损伤的电生理、行为和自我报告相关性的影响。早期职业生涯的音乐家（n=76）和非音乐家（n=47）完成了一个测试组合，包括噪声暴露结构化访谈、纯音听力测试（PTA；0.25-8 kHz）、扩展高频（EHF；12 和 16 kHz）阈值、耳声发射（OAE）、听觉脑干反应（ABR）、噪声下言语感知（SPiN）和自我报告的耳鸣、听觉过敏和噪声下听力困难。音乐家和非音乐家的总终生噪声暴露相似，其中大部分可归因于娱乐活动。音乐家的 ABR 波 I/V 比值明显大于非音乐家，并且无论噪声暴露如何，他们更有可能报告耳鸣、听觉过敏和噪声下听力困难的经历和/或更严重的经历。二次分析显示，与噪声暴露水平最低的个体相比，噪声暴露水平最高的个体的外毛细胞功能降低，这可通过 OAE 测量。OAE 水平也与 PTA 和 EHF 阈值有关。高水平的噪声暴露也与 ABR 波 V 潜伏期的显著增加有关，但仅在男性中，以及听觉过敏的更高患病率和严重程度。这些发现表明，即使在相对年轻的年龄，噪声暴露也可能对各种听力指标产生亚临床影响，但不支持终生噪声暴露与 ABR 波幅度和 SPiN 等耳蜗突触病的替代指标之间的联系。当常规 PTA 在临床“正常”范围内时，密切监测 OAE、PTA 和 EHF 阈值可以为噪声性听力损伤提供有用的早期指标。这可能对早期职业生涯的音乐家特别重要，因为他们正在经历一段密集的音乐训练时期，因此保护听力寿命的干预措施可能至关重要。
