Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus.
Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus.
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DOI：
10.3389/fnins.2016.00288
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发表时间：
2016
影响因子：
4.3
通讯作者：
Van de Heyning P
中科院分区：
文献类型：
--
作者：
Gilles A;Schlee W;Rabau S;Wouters K;Fransen E;Van de Heyning P
目的：年轻人经常接触高水平的音乐，这使他们更容易出现噪音引起的症状，如听力损失、听觉过敏症和耳鸣，后者是年轻人最常察觉的症状。尽管亚临床神经损伤在动物实验中得到了证实，但人类的相关性仍然存在争议。对于听力阈值正常的年轻人和由于休闲噪音引起的噪声性耳鸣(NIT)的潜在状况存在争议。本研究旨在评估噪声暴露的青少年与非噪声暴露的青少年听力特征的差异。方法：对87例有娱乐性噪声暴露史的青年进行耳镜检查、阻抗测量、包括高频、瞬变和失真产物耳声发射的纯音测听、连续噪声和调制噪声(经15 Hz调幅)的言语噪声测试、听性脑干反应(ABR)和问卷调查。19名学生报告娱乐性噪声暴露引起的NIT，并与非耳鸣受试者进行比较。结果：耳鸣患者和非耳鸣患者的听力阈值、耳声发射和脑干听觉诱发电位测试结果无显著差异。耳鸣患者在噪声环境下的言语接收能力显著低于非耳鸣患者(平均语音接收阈值得分分别为−5.77和−6.90dBSNR；p=0.025)和15 Hz AM噪声中的句子(平均言语接收阈值得分分别为−13.04和−15.17dBSNR；p=0.013)。在两组人中，在AM-15赫兹噪声条件下的语音接收与稳态噪声条件相比都有显著改善(p<；0.001)。然而，调制掩蔽释放不受NIT的存在的影响。结论：患有和不患有NIT的年轻人在测听、耳声发射和ABR方面没有差异，但耳鸣患者表现出噪声中语音接收能力的降低。根据先前的研究结果对结果进行了讨论，认为NIT可能发生在没有可测量的外周损害的情况下，如耳鸣受试者的噪声中语音缺陷所反映的那样。
Objectives: Young people are often exposed to high music levels which make them more at risk to develop noise-induced symptoms such as hearing loss, hyperacusis, and tinnitus of which the latter is the symptom perceived the most by young adults. Although, subclinical neural damage was demonstrated in animal experiments, the human correlate remains under debate. Controversy exists on the underlying condition of young adults with normal hearing thresholds and noise-induced tinnitus (NIT) due to leisure noise. The present study aimed to assess differences in audiological characteristics between noise-exposed adolescents with and without NIT. Methods: A group of 87 young adults with a history of recreational noise exposure was investigated by use of the following tests: otoscopy, impedance measurements, pure-tone audiometry including high-frequencies, transient and distortion product otoacoustic emissions, speech-in-noise testing with continuous and modulated noise (amplitude-modulated by 15 Hz), auditory brainstem responses (ABR) and questionnaires.Nineteen students reported NIT due to recreational noise exposure, and their measures were compared to the non-tinnitus subjects. Results: No significant differences between tinnitus and non-tinnitus subjects could be found for hearing thresholds, otoacoustic emissions, and ABR results.Tinnitus subjects had significantly worse speech reception in noise compared to non-tinnitus subjects for sentences embedded in steady-state noise (mean speech reception threshold (SRT) scores, respectively −5.77 and −6.90 dB SNR; p = 0.025) as well as for sentences embedded in 15 Hz AM-noise (mean SRT scores, respectively −13.04 and −15.17 dB SNR; p = 0.013). In both groups speech reception was significantly improved during AM-15 Hz noise compared to the steady-state noise condition (p < 0.001). However, the modulation masking release was not affected by the presence of NIT. Conclusions: Young adults with and without NIT did not differ regarding audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous findings suggestion NIT may occur in the absence of measurable peripheral damage as reflected in speech-in-noise deficits in tinnitus subjects.