Temporary and Permanent Noise-induced Threshold Shifts: A Review of Basic and Clinical Observations.
Temporary and Permanent Noise-induced Threshold Shifts: A Review of Basic and Clinical Observations.
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DOI：
10.1097/mao.0000000000001071
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Kil J
中科院分区：
文献类型：
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作者：
Ryan AF;Kujawa SG;Hammill T;Le Prell C;Kil J
回顾与定义暂时性(TTS)和永久性(PTS)阈值漂移及其后遗症相关的基本和临床结果。对相关科学文献和政府定义进行了广泛审查。评估了TTS和PTS的定义和特点，并综述了扩展我们对噪声性听力损失的程度、性质和后果的认识的最新进展。暴露在强声中会产生TTS，即听力敏感度的急剧变化，随着时间的推移而恢复，或PTS，一种无法恢复到暴露前水平的损失。一般情况下，2、3和4千赫时的阈值漂移≥为10分贝，用于人体研究的报告目的。耳蜗区的高频区域对噪声损伤最为敏感。耳道的共振也会导致4-6 kHz的高噪声敏感度的频率区域。主要的噪声目标是耳蜗毛细胞。虽然这种毛细胞损伤的机制尚不清楚，但有证据表明，活性氧物种、应激信号通路和细胞凋亡在其中起到了作用。另一个靶点是毛细胞和初级传入神经元之间的突触。噪音过后，即使听力阈值可能恢复正常，大量这样的突触和它们的神经元也会丢失。这影响了对噪声中信号的听觉处理和检测。TTS和PTS的后果包括严重的通信缺陷，可能影响履行军事职责或获得/保留文职工作。耳鸣和创伤后应激障碍的恶化也是潜在的后遗症。
To review basic and clinical findings relevant to defining temporary (TTS) and permanent (PTS) threshold shifts and their sequelae. Relevant scientific literature and government definitions were broadly reviewed. The definitions and characteristics of TTS and PTS were assessed and recent advances that expand our knowledge of the extent, nature and consequences of noise-induced hearing loss were reviewed. Exposure to intense sound can produce TTS, acute changes in hearing sensitivity that recover over time, or PTS, a loss that does not recover to pre-exposure levels. In general, a threshold shift ≥10 dB at 2, 3 and 4 kHz is required for reporting purposes in human studies. The high-frequency regions of the cochlea are most sensitive to noise damage. Resonance of the ear canal also results in a frequency region of high noise sensitivity at 4–6 kHz. A primary noise target is the cochlear hair cell. While the mechanisms that underlie such hair cell damage remain unclear, there is evidence to support a role for reactive oxygen species, stress pathway signaling and apoptosis. Another target is the synapse between the hair cell and the primary afferent neurons. Large numbers of these synapses and their neurons can be lost after noise, even though hearing thresholds may return to normal. This affects auditory processing and detection of signals in noise. The consequences of TTS and PTS include significant deficits in communication that can impact performance of military duties or obtaining/retaining civilian employment. Tinnitus and exacerbation of post-traumatic stress disorder are also potential sequelae.