Meng Zhao-Li, Chen Fei, Zhao Fei, Gu Hai-Ling, Zheng Yun
Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
Cardiff School of Health Science, Cardiff Metropolitan University, Cardiff CF3 0UJ, United Kingdom.
World J Clin Cases. 2022 Feb 26;10(6):1815-1825. doi: 10.12998/wjcc.v10.i6.1815.
BACKGROUND: Noise-induced hearing loss (NIHL) is the second most common acquired hearing loss following presbycusis. Exposure to recreational noise and minimal use of hearing protection increase the prevalence of NIHL in young females. NIHL is irreversible. Identifying minor hearing pathologies before they progress to hearing problems that affect daily life is crucial. AIM: To compare the advantages and disadvantages of extended high frequency (EHF) and otoacoustic emission and determine an indicator of hearing pathologies at the early sub-clinical stage. METHODS: This cross-sectional study was implemented in West China Hospital of Sichuan University from May to September 2019. A total of 86 participants, aged 18-22 years, were recruited to establish normative thresholds for EHF. Another 159 adults, aged 18-25 years with normal hearing (0.25-8 kHz ≤ 25 dBHL), were allocated to low noise and noise exposure groups. Distortion otoacoustic emission (DPOAE), transient evoked otoacoustic emissions (TEOAE), and EHF were assessed in the two groups to determine the superior technique for detecting early-stage noise-induced pathologies. The chi-square test was used to assess the noise and low noise exposure groups with respect to extended high-frequency audiometry (EHFA), DPOAE, and TEOAE. 0.05 was considered statistically significant. RESULTS: A total of 86 participants (66 females and 20 males) aged between 18 and 22 (average: 20.58 ± 1.13) years were recruited to establish normative thresholds for EHF. The normative thresholds for 9, 10, 11.2, 12.5, 14, 16, 18, and 20 kHz were 15, 10, 20, 15, 15, 20, 28, and 0 dBHL, respectively. A total of 201 participants were recruited and examined for eligibility. Among them, 159 adults aged between 18 and 25 years were eligible in this study. No statistical difference was detected between the noise exposure and the low noise exposure groups using EHFA, DPOAE, and TEOAE ( > 0.05) except in the right ear at 4 kHz using TEOAE (abnormal rate 20.4% 5.2%, respectively; = 0.05). CONCLUSION: These results showed TEOAE as the earliest indicator of minor pathology compared to DPOAE and EHFA. However, a multicenter controlled study or prospective study is essential to verify these results.
背景：噪声性听力损失（NIHL）是继老年性听力损失之后第二常见的后天性听力损失。接触娱乐噪声且极少使用听力保护措施会增加年轻女性中NIHL的患病率。NIHL是不可逆的。在轻微听力病变发展为影响日常生活的听力问题之前识别它们至关重要。 目的：比较扩展高频（EHF）和耳声发射的优缺点，并确定早期亚临床阶段听力病变的一个指标。 方法：这项横断面研究于2019年5月至9月在四川大学华西医院开展。共招募了86名年龄在18至22岁的参与者来建立EHF的正常阈值。另外159名年龄在18至25岁、听力正常（0.25 - 8 kHz≤25 dBHL）的成年人被分配到低噪声组和噪声暴露组。对两组进行畸变产物耳声发射（DPOAE）、瞬态诱发耳声发射（TEOAE）和EHF评估，以确定检测早期噪声性病变的更优技术。采用卡方检验对噪声暴露组和低噪声暴露组在扩展高频听力测定（EHFA）、DPOAE和TEOAE方面进行评估。P < 0.05被认为具有统计学意义。 结果：共招募了86名年龄在18至22岁（平均：20.58±1.13）的参与者来建立EHF的正常阈值。9、10、11.2、12.5、14、16、18和20 kHz的正常阈值分别为15、10、20、15、15、20、28和0 dBHL。总共招募了201名参与者并检查其是否符合条件。其中，159名年龄在18至25岁的成年人符合本研究条件。除了在右耳4 kHz处使用TEOAE时噪声暴露组和低噪声暴露组之间存在差异（异常率分别为20.4%和5.2%；P = 0.05）外，使用EHFA、DPOAE和TEOAE在两组之间未检测到统计学差异（P > 0.05）。 结论：这些结果表明，与DPOAE和EHFA相比，TEOAE是轻微病变的最早指标。然而，需要多中心对照研究或前瞻性研究来验证这些结果。
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