Manchester Centre for Audiology and Deafness, University of Manchester, UK.
Manchester Centre for Audiology and Deafness, University of Manchester, UK.
Hear Res. 2024 Sep 15;451:109077. doi: 10.1016/j.heares.2024.109077. Epub 2024 Jul 30.
Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicians has involved cross-sectional study designs that may capture only a snapshot of hearing health in relation to noise exposure. The aim of this study was to investigate the effects of cumulative noise exposure on behavioural, electrophysiological, and self-report indices of hearing damage in early-career musicians and non-musicians with normal hearing over a 2-year period. Participants completed an annual test battery consisting of pure tone audiometry, extended high-frequency hearing thresholds, distortion product otoacoustic emissions (DPOAEs), speech perception in noise, auditory brainstem responses, and self-report measures of tinnitus, hyperacusis, and hearing in background noise. Participants also completed the Noise Exposure Structured Interview to estimate cumulative noise exposure across the study period. Linear mixed models assessed changes over time. The longitudinal analysis comprised 64 early-career musicians (female n = 34; age range at T0 = 18-26 years) and 30 non-musicians (female n = 20; age range at T0 = 18-27 years). There were few longitudinal changes as a result of musicianship. Small improvements over time in some measures may be attributable to a practice/test-retest effect. Some measures (e.g., DPOAE indices of outer hair cell function) were associated with noise exposure at each time point, but did not show a significant change over time. A small proportion of participants reported a worsening of their tinnitus symptoms, which participants attributed to noise exposure, or not using hearing protection. Future longitudinal studies should attempt to capture the effects of noise exposure over a longer period, taken at several time points, for a precise measure of how hearing changes over time. Hearing conservation programmes for "at risk" individuals should closely monitor DPOAEs to detect early signs of noise-induced hearing loss when audiometric thresholds are clinically normal.
音乐家由于经常接触高强度的噪音，因此有听力损失和耳鸣的风险。由于听觉系统（如耳蜗突触病）的损伤可能不容易通过标准的临床测量来检测，因此之前对音乐家听力损失的风险可能被低估了。之前大多数研究音乐家听力损失的研究都涉及到横断面研究设计，这些设计可能只能捕捉到与噪声暴露相关的听力健康的一个快照。本研究的目的是在 2 年内调查累积噪声暴露对早期职业音乐家和正常听力非音乐家的行为、电生理和自我报告的听力损伤指标的影响。参与者每年完成一次测试，包括纯音听力测试、扩展高频听力阈值、畸变产物耳声发射（DPOAE）、噪声下言语感知、听觉脑干反应和耳鸣、听觉过敏和背景噪声下听力的自我报告测量。参与者还完成了噪声暴露结构化访谈，以估计研究期间的累积噪声暴露。线性混合模型评估随时间的变化。纵向分析包括 64 名早期职业音乐家（女性 n = 34；T0 时的年龄范围为 18-26 岁）和 30 名非音乐家（女性 n = 20；T0 时的年龄范围为 18-27 岁）。由于音乐家身份，变化很小。随着时间的推移，一些措施的微小改善可能归因于练习/测试-再测试效应。一些措施（例如，外毛细胞功能的 DPOAE 指数）与每个时间点的噪声暴露相关，但随时间没有显著变化。一小部分参与者报告他们的耳鸣症状恶化，这归因于噪声暴露或没有使用听力保护。未来的纵向研究应尝试在更长的时间内捕捉噪声暴露的影响，并在几个时间点进行测量，以精确测量随时间的听力变化。对于“高危”个体的听力保护计划，应密切监测 DPOAE，以在临床听力阈值正常时发现噪声性听力损失的早期迹象。
