Is Noise Exposure Associated With Impaired Extended High Frequency Hearing Despite a Normal Audiogram? A Systematic Review and Meta-Analysis.

IF 3 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Trends in Hearing Pub Date : 2025-01-01 Epub Date: 2025-05-16 DOI:10.1177/23312165251343757
Sajana Aryal, Monica Trevino, Hansapani Rodrigo, Srikanta Mishra
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Abstract

Understanding the initial signature of noise-induced auditory damage remains a significant priority. Animal models suggest the cochlear base is particularly vulnerable to noise, raising the possibility that early-stage noise exposure could be linked to basal cochlear dysfunction, even when thresholds at 0.25-8 kHz are normal. To investigate this in humans, we conducted a meta-analysis following a systematic review, examining the association between noise exposure and hearing in frequencies from 9 to 20 kHz as a marker for basal cochlear dysfunction. Systematic review and meta-analysis followed PRISMA guidelines and the PICOS framework. Studies on noise exposure and hearing in the 9 to 20 kHz region in adults with clinically normal audiograms were included by searching five electronic databases (e.g., PubMed). Cohorts from 30 studies, comprising approximately 2,500 participants, were systematically reviewed. Meta-analysis was conducted on 23 studies using a random-effects model for occupational and recreational noise exposure. Analysis showed a significant positive association between occupational noise and hearing thresholds, with medium effect sizes at 9 and 11.2 kHz and large effect sizes at 10, 12, 14, and 16 kHz. However, the association with recreational noise was less consistent, with significant effects only at 12, 12.5, and 16 kHz. Egger's test indicated some publication bias, specifically at 10 kHz. Findings suggest thresholds above 8 kHz may indicate early noise exposure effects, even when lower-frequency (≤8 kHz) thresholds remain normal. Longitudinal studies incorporating noise dosimetry are crucial to establish causality and further support the clinical utility of extended high-frequency testing.

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尽管听力图正常,噪声暴露是否与延伸高频听力受损有关?系统回顾和荟萃分析。
了解噪音引起的听觉损伤的初始特征仍然是一个重要的优先事项。动物模型表明,耳蜗基底特别容易受到噪音的影响,这增加了早期接触噪音可能与基底耳蜗功能障碍有关的可能性,即使阈值在0.25-8 kHz是正常的。为了在人类中研究这一点,我们在系统回顾之后进行了一项荟萃分析,研究了噪音暴露与听力之间的关系,频率从9到20 kHz,作为基础耳蜗功能障碍的标志。系统评价和荟萃分析遵循PRISMA指南和PICOS框架。通过检索5个电子数据库(例如PubMed),纳入了临床听力学正常的成人在9至20 kHz区域的噪声暴露和听力的研究。系统地回顾了来自30项研究的队列,包括大约2,500名参与者。采用随机效应模型对23项研究进行了meta分析。分析显示,职业噪声与听力阈值之间存在显著的正相关,在9和11.2 kHz时具有中等效应,在10、12、14和16 kHz时具有较大效应。然而,与娱乐性噪音的关联不太一致,只有在12、12.5和16 kHz时才有显著影响。埃格的测试显示出一些发表偏倚,特别是在10khz时。研究结果表明,高于8 kHz的阈值可能表明早期噪声暴露效应,即使低频(≤8 kHz)阈值保持正常。结合噪声剂量学的纵向研究对于建立因果关系和进一步支持扩展高频测试的临床应用至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trends in Hearing
Trends in Hearing AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGYOTORH-OTORHINOLARYNGOLOGY
CiteScore
4.50
自引率
11.10%
发文量
44
审稿时长
12 weeks
期刊介绍: Trends in Hearing is an open access journal completely dedicated to publishing original research and reviews focusing on human hearing, hearing loss, hearing aids, auditory implants, and aural rehabilitation. Under its former name, Trends in Amplification, the journal established itself as a forum for concise explorations of all areas of translational hearing research by leaders in the field. Trends in Hearing has now expanded its focus to include original research articles, with the goal of becoming the premier venue for research related to human hearing and hearing loss.
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