Asymmetry in noise-induced hearing loss: Evaluation of two competing theories
Asymmetry in noise-induced hearing loss: Evaluation of two competing theories
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DOI：
10.4103/1463-1741.132092
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发表时间：
2014-03-01
期刊：
影响因子：
0.7
通讯作者：
Marlenga, Barbara
中科院分区：
文献类型：
--
作者：
Berg, Richard L.;Pickett, William;Marlenga, Barbara
关于为什么在噪声性听力损失（NIHL）中观察到不对称性存在相互竞争的理论。我们对一组年轻工人进行了16年的研究，对这些理论进行了评估。该研究的目的是描述和评估听力损失和不对称的模式，包括性别、农业暴露和枪击暴露。这是对一项随机对照试验随访期间收集的年轻人数据的二次分析。本随访研究评估了农村学生听力保护干预的长期效果。该样本由最初试验的690名参与者中的392人组成。共有355名年轻人（29-33岁）完成了基线和随访噪音暴露调查以及临床听力检查。数据以图形显示为阈值，按频率和耳朵以及耳朵之间的不对称程度（左减右）。在初级组比较中，使用混合线性模型分析低、高频平均值和平均高频不对称性。在2000赫兹的频率下，男性比女性表现出更多的听力损失，具有更大的不对称性和不同的不对称性模式。对于有听力损失记录的男性来说，随着听力损失水平的增加，不对称性也有增加的趋势。高频率的不对称性随拍摄曝光水平的不同而变化。虽然“头部阴影”在听力学和相关公共卫生文献中被认为是不对称听力损失的主要解释，但我们的研究结果更符合生理差异作为不对称听力损失的主要原因，男性左耳对NIHL的易感性更高。
Competing theories exist about why asymmetry is observed in noise-induced hearing loss (NIHL). We evaluated these theories using a cohort of young workers studied over 16 years. The study aim was to describe and evaluate patterns of hearing loss and asymmetry by gender, agricultural exposure and gunfire exposure. This was a secondary analysis of data collected from young adults during follow-up of a randomized controlled trial. This follow-up study evaluated long-term effects of a hearing conservation intervention for rural students. The sample consisted of 392 of 690 participants from the original trial. In total, 355 young adults (aged 29-33 years) completed baseline and follow-up noise exposure surveys and clinical audiometric examinations. Data are displayed graphically as thresholds by frequency and ear and degree of asymmetry between ears (left minus right). In the primary group comparisons, low and high frequency averages and mean high frequency asymmetry were analyzed using mixed linear models. At frequencies >2000 Hz, men showed more hearing loss, with greater asymmetry and a different asymmetry pattern, than women. For men with documented hearing loss, there was a trend toward increasing asymmetry with increasing levels of hearing loss. Asymmetry at high frequencies varied substantially by level of shooting exposure. While "head shadowing" is accepted as the primary explanation for asymmetric hearing loss in the audiologic and related public health literature, our findings are more consistent with physiological differences as the primary cause of asymmetric hearing loss, with greater susceptibility to NIHL in the left ear of men.