Auditory Threshold

听觉阈值
  • 文章类型: Review
    OBJECTIVE: To identify the pathophysiological definitions adopted by studies investigating \"cochlear synaptopathy\" (CS) and \"hidden hearing loss\" (HHL).
    METHODS: The combination of keywords \"Auditory Synaptopathy\" or \"Neuronal Synaptopathy\" or \"Hidden Hearing Loss\" with \"etiology\" or \"causality\" or \"diagnosis\" was used in the databases EMBASE, Pubmed (MEDLINE), CINAHL (EBSCO), and Web of Science.
    METHODS: Studies that investigated CS or HHL in humans using behavioral and/or electrophysiological procedures were included.
    METHODS: Data analysis and extraction were performed with regard to terminology, definitions, and population.
    RESULTS: 49 articles were included. Of these, 61.2% used the CS terminology, 34.7% used both terms, and 4.1% used HHL. The most-studied conditions were exposure to noise and tinnitus.
    CONCLUSIONS: CS terminology was used in most studies, referring to the pathophysiological process of deafferentiation between the cochlear nerve fibers and inner hair cells.
    OBJECTIVE: Identificar as definições fisiopatológicas adotadas pelos estudos que investigaram a “sinaptopatia coclear” (SC) e “perda auditiva oculta” (PAO).
    UNASSIGNED: Utilizou-se a combinação de unitermos “Auditory Synaptopathy” or “Neuronal Synaptopathy” or “Hidden Hearing Loss” com “etiology” or “causality” or “diagnosis” nas bases de dados EMBASE, Pubmed (MEDLINE), CINAHL (EBSCO) e Web of Science.
    UNASSIGNED: Incluiu-se estudos que investigaram a SC ou PAO em humanos com procedimentos comportamentais e/ou eletrofisiológicos.
    UNASSIGNED: Realizou-se a análise e extração de dados quanto a terminologia, definição e população estudada.
    RESULTS: Foram incluídos 49 artigos. Destes, 61,2% utilizaram a terminologia SC, 34,7% ambos os termos e 4,1% utilizaram PAO. As condições mais estudadas foram exposição ao ruído e zumbido.
    UNASSIGNED: A terminologia SC foi empregada na maioria dos estudos, com referência ao processo fisiopatológico de desaferenciação entre as fibras do nervo coclear e as células ciliadas internas.
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  • 文章类型: Meta-Analysis
    目的:移动测听(MA)的技术进步使使用平板电脑和智能手机进行听力评估成为可能。本系统综述(PROSPEROID:CRD42021274761)旨在确定医疗服务提供者可用的MA选项,评估他们测量听力阈值的准确性,并探索可能影响其准确性的因素。
    方法:对包括PubMed,Embase,科克伦,证据搜索和Dynamed于2021年12月13日进行,并于2022年10月30日重复,使用适当的医学主题词(MeSH)术语。合格的研究报告了使用MA来确定听力阈值,并将结果与传统的纯音测听(CA)进行了比较。调查MA进行听力筛查的研究(即报告只是通过/失败)不符合纳入条件。两位作者独立回顾了研究,提取的数据,并使用诊断准确性研究质量评估2(QUADAS-2)工具评估方法学质量和偏倚风险。
    方法:成人和儿童,有和没有听力障碍的诊断。
    方法:进行了荟萃分析,以获得在dBHL中使用MA和CA测量的阈值之间的平均差。
    结果:搜索返回了858篇文章。经过系统的审查,分析了17篇文章,包括1032名参与者。最常用的软件应用程序是ShoeboxTM(6/17),其次是HearingTestTM(3/17),然后HeartTestTM(2/17)。十项研究中使用了平板电脑,六部智能手机,和一台电脑。MA和CA阈值之间的平均差异为1.36dB(95%CI,0.07-2.66,p=0.04)。在500Hz测量的阈值中观察到移动测听(MA)和常规测听(CA)阈值之间的显着差异,在儿童中,当MA在一个音响亭进行时,当MA是自我管理的时候。然而,这些差异未超过临床显著阈值10分贝(dB).纳入的研究表现出高度的异质性,偏差风险高,对适用性的担忧低。
    结论:MA在测量听力阈值方面优于CA,并且在CA不可用或不可行的情况下提供听力评估的机会。未来的研究应优先考虑将纯音阈值评估与其他测试相结合,如语音识别和噪声数字,为了更全面地评估听力,评估可接受性和可行性,以及MA在非专业环境中的成本效益。
    OBJECTIVE: Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy.
    METHODS: A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
    METHODS: Adults and children, with and without diagnosis of hearing impairment.
    METHODS: A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL.
    RESULTS: Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability.
    CONCLUSIONS: MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.
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  • 文章类型: Meta-Analysis
    当前的证据支持在听力研究中越来越多地应用扩展高频(EHF:9至20kHz)测听法,这可能是由于该频率区域对已知听觉危险因素引起的损害的高度脆弱性。进行了本系统评价和荟萃分析,以调查听力图和耳鸣正常的成年人相对于对照组的EHF听力阈值是否增加。
    对由PubMed组成的电子数据库进行了全面搜索,ScienceDirect,威利,和谷歌学者使用组合关键词:“耳鸣,\"\"扩展高频,正常听力图,“和”隐藏的听力损失。\"
    从搜索数据库找到的261篇文章中,9项研究符合荟萃分析的纳入标准.在10、12.5、14、16和18kHz的听力阈值的效应大小分析中,耳鸣组和对照组之间观察到显着差异(p≤0.001),在所有研究中,I平方异质性分析均低于50%(p≥0.131).通过漏斗图和Egger回归检验(p≥0.211)的目视检查在荟萃分析中也没有发表偏倚。
    我们的发现支持了在大多数情况下,耳鸣与一定程度的耳蜗机械功能障碍有关,这可能无法通过常规测听法单独检测到。这一发现强调了EHF测听在临床实践中的重要性,这可能有助于早期识别容易发生耳鸣的个体,并通过预防性咨询计划减少新病例的数量。
    Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers.
    A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: \"tinnitus,\" \"extended high frequency,\" \"normal audiogram,\" and \"hidden hearing loss.\"
    From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger\'s regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses.
    Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.
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  • 文章类型: Journal Article
    由于耳朵作为高度敏感的压力传感器的作用,听觉系统特别容易受到爆炸伤害。在过去的几十年里,研究已经使用了各种动物模型和实验程序来重建爆炸引起的声创伤。鉴于该领域的发展性质以及我们对爆炸相关听觉障碍的分子机制的不完全理解,有必要对这些研究进行最新的讨论.这里,我们全面回顾了成熟的与爆炸相关的听觉病理学,包括鼓膜穿孔和毛细胞丢失。此外,我们讨论了重要的机械研究,旨在弥合我们目前对爆炸诱发耳蜗的分子和微观结构事件的理解中的差距,听觉神经,脑干,和中枢听觉系统的损伤。近期文献的主要发现包括内淋巴积水和耳蜗突触丢失之间的关联。在外周和中枢听觉系统中,以及针对爆炸伤生化标志物的治疗方法。我们得出的结论是,爆炸是一种极端形式的噪声暴露。冲击波产生的耳蜗损伤看起来类似于,但更极端的是,听觉研究中使用的标准噪声暴露协议。然而,爆炸引起的声学创伤研究中的实验差异使得比较和解释研究中的数据具有挑战性。
    The auditory system is particularly vulnerable to blast injury due to the ear\'s role as a highly sensitive pressure transducer. Over the past several decades, studies have used a variety of animal models and experimental procedures to recreate blast-induced acoustic trauma. Given the developing nature of this field and our incomplete understanding of molecular mechanisms underlying blast-related auditory disturbances, an updated discussion about these studies is warranted. Here, we comprehensively review well-established blast-related auditory pathology including tympanic membrane perforation and hair cell loss. In addition, we discuss important mechanistic studies that aim to bridge gaps in our current understanding of the molecular and microstructural events underlying blast-induced cochlear, auditory nerve, brainstem, and central auditory system damage. Key findings from the recent literature include the association between endolymphatic hydrops and cochlear synaptic loss, blast-induced neuroinflammatory markers in the peripheral and central auditory system, and therapeutic approaches targeting biochemical markers of blast injury. We conclude that blast is an extreme form of noise exposure. Blast waves produce cochlear damage that appears similar to, but more extreme than, the standard noise exposure protocols used in auditory research. However, experimental variations in studies of blast-induced acoustic trauma make it challenging to compare and interpret data across studies.
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  • 文章类型: Journal Article
    本研究探讨了有关音乐暴露是否暂时或永久影响年轻人听力敏感性的科学证据。利用四类个人听音装置的相关关键词,检索六个电子数据库,倾听的习惯,听力结果,和年龄。估计了对冲及其95%置信区间(CI)。HigginsI2也用于检查异质性。为了测试出版偏见,漏斗图是使用Egger回归绘制的。根据纳入标准,16项研究分为两组,以确定短期听力变化(n=7)和长期听力变化(n=9)。在短期内,在音乐曝光后,阈值或振幅没有显著的立即变化,尽管纯音阈值(PTAs)和失真产物耳声发射(DPOAEs)在4kHz时确实显示出最高的效应大小(-0.344,CI-0.727~0.038)和(0.124,CI-0.047~0.296).另一方面,对于长期的听力变化,PTA在6kHz(-0.525,CI-0.897至-0.154)和8kHz(-0.486,CI-0.819至-0.152)时提供了最高的效果大小,同时也暗示习惯和重复使用个人收听设备(PLD)可以对听力学测试中的一些重大听力变化起作用。我们得出的结论是,PLD的使用在使用后会在4kHz时产生一些暂时的听力变化,但这些变化随后会逆转。然而,重要的是要注意大量PLD用户关于他们的听力阈值在高频下的永久变化的经验,公众应该在这个问题上接受教育。
    The present study explores the scientific evidence on whether music exposure temporarily or permanently affects hearing sensitivity in young adults. Six electronic databases were searched using related keywords for the four categories of personal listening devices, listening habits, hearing outcomes, and age. The Hedges\' g and its 95% confidence intervals (CIs) were estimated. A Higgins I2 was also used to check for heterogeneity. To test for publication bias, funnel plots were drawn using Egger\'s regression. Based on the inclusion criteria, 16 studies were divided into two groups to identify short-term hearing changes (n = 7) and long-term hearing changes (n = 9). In the short term, there was no significant immediate change in the thresholds or amplitudes after the music exposure, although pure-tone thresholds (PTAs) and distortion product otoacoustic emissions (DPOAEs) did show the highest effect size (-0.344, CI -0.727 to 0.038) and (0.124, CI -0.047 to 0.296) at 4 kHz. On the other hand, for long-term hearing changes, the PTA provided the highest effect size at 6 kHz (-0.525, CI -0.897 to -0.154) and 8 kHz (-0.486, CI -0.819 to -0.152), while also implying that habitual and repeated personal listening device (PLD) usage can act on some significant hearing changes in audiological tests. We conclude that the use of a PLD produces a few temporary hearing changes at 4 kHz after its use but that the changes are then reversed. However, it is important to note heavy PLD users\' experience regarding permanent changes in their hearing thresholds at high frequencies, and the public should be educated on this issue.
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  • 文章类型: Journal Article
    It is well-established that excessive noise exposure can systematically shift audiometric thresholds (i.e., noise-induced hearing loss, NIHL) making sounds at the lower end of the dynamic range difficult to detect. An often overlooked symptom of NIHL is the degraded ability to resolve temporal fluctuations in supra-threshold signals. Given that the temporal properties of speech are highly dynamic, it is not surprising that NIHL greatly reduces one\'s ability to clearly decipher spoken language. However, systematic characterization of noise-induced impairments on supra-threshold signals in humans is difficult given the variability in noise exposure among individuals. Fortunately, the chinchilla is audiometrically similar to humans, making it an ideal animal model to investigate noise-induced supra-threshold deficits. Through a series of studies using the chinchilla, the authors have elucidated several noise-induced deficits in temporal processing that occur at supra-threshold levels. These experiments highlight the importance of the chinchilla model in developing an understanding of noise-induced deficits in temporal processing.
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  • 文章类型: Journal Article
    To conduct systematic review and meta-analyses of preclinical studies describing the efficacy of glucocorticoids administered via different routes for hearing preservation after cochlear implantation.
    A literature search was performed in PubMed to identify peer-reviewed articles published before December 31, 2017, with no language restrictions. Search components were \"Cochlear implant,\" \"Glucocorticoids,\" and \"Hearing preservation.\" The results were specified for animal studies.
    Original studies in which glucocorticoids were administered before or during cochlear implantation in animal models and hearing threshold shifts were measured using auditory brainstem response.
    Quality of included studies was assessed using the SYstematic Review Centre for Laboratory animal Experimentation protocol. Threshold Shift reduction between the \"study\" and \"control\" groups at 1-month postimplantation was the parameter used to evaluate hearing preservation.
    The random-effects models were used to combine the results of selected studies. Separate meta-analyses were performed for drug-eluting electrodes, systemic, and local administration.
    Administering either systemic or topical glucocorticosteroids had a significant effect on preserving low and high-frequency hearing. Topical administration was equally effective across a range of concentration levels and provided maximal hearing preservation when applied 120 minutes before implantation. The effect of systemic treatment was achieved with high doses, equivalent to 26 mg of dexamethasone per day in humans. No significant effect was found with the use of drug-eluting electrodes and more studies are needed to characterise the utility and efficacy of this administration method.
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  • 文章类型: Journal Article
    It is estimated that over 60% of adults with dementia will also have a hearing impairment, resulting in a dual sensory-cognitive communication disability. Hearing interventions may lessen the impact of hearing impairment on a communication disability; yet, for audiologists to recommend appropriate hearing interventions, the individual\'s hearing thresholds must first be accurately established. The gold standard test for establishing hearing thresholds is pure-tone audiometry (PTA). However, the ability of adults with dementia to successfully complete PTA is uncertain. This systematic review examined studies of adults with dementia to better determine the proportion who could complete PTA.
    Systematic review.
    Studies were included that assessed hearing in older adults who were reported as having mild and greater dementia. From a total of 1,237 eligible studies, only three were found to meet all inclusion criteria.
    Across these three studies, the proportion of adults with dementia who could successfully complete PTA ranged from 56% to 59%.
    Further research is needed in this area, particularly for adults with moderate and severe stages of dementia. Future research should also consider the feasibility of complementary, non-behavioural hearing tests. This systematic review was registered with the PROSPERO database, registration number CRD42017073041.
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  • 文章类型: Journal Article
    OBJECTIVE: COPD is an irreversible or persistent airflow obstruction, which affects up to 600 million people globally. The primary purpose of this systematic review was to explore the COPD-based alteration in the auditory system function by conducting a quantitative analysis of presently published data.
    METHODS: We systematically searched seven diverse electronic databases and manual searching of references to identify relevant studies. Data from the selected studies were rated by two investigators independently in a blinded fashion. Meta-analysis was done on pooled data using Cochrane\'s Review Manager 5.3.
    RESULTS: Sixteen articles received suitable scores and were thus included for further processes. Hearing loss (HL) was defined as a change in pure tone audiometry (PTA) thresholds, auditory brainstem response (ABR), and auditory P300 parameters. ABR wave was significantly elongated in patients with COPD than in controls (standardized mean difference [SMD]=0.27, 95% CI: 0.05-0.48, P=0.02). PTA was significantly higher in patients with COPD when compared with controls (SMD=1.76, 95% CI: 0.43-3.08, P=0.0004). We found that patients with COPD had a significantly higher latency than controls (SMD=1.30, 95% CI: 0.79-1.80, P=0.0001).
    CONCLUSIONS: COPD patients had considerably greater incidence of HL when compared with controls. Interestingly, although the mean PTA thresholds at every frequency for COPD patients were higher than those for controls, these values were still in the slight to mild HL ranges. Prolonged ABR wave latencies in the COPD patients suggest retro-cochlear involvement. Thus, COPD most frequently clusters with HL, but it is worth noting that alteration in hearing is not always recognized by medical experts as a frequent comorbidity associated with COPD.
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  • 文章类型: Journal Article
    这篇评论考虑了风力涡轮机产生的声音的性质,重点是低频声音(LF)和次声(IS),以了解人们工作和睡眠的声音措施的有用性。第二个焦点涉及LF/IS的生理转导机制的证据或LF/IS的体细胞效应的证据。虽然目前的证据并没有最终证明转导,它确实提供了一个强烈的外表。存在与LF和IS的测量和传播以及与可能的感知和生理效应相关的中枢神经系统的编码有关的大量悬而未决的问题。确定了一系列可能的研究领域。
    This review considers the nature of the sound generated by wind turbines focusing on the low-frequency sound (LF) and infrasound (IS) to understand the usefulness of the sound measures where people work and sleep. A second focus concerns the evidence for mechanisms of physiological transduction of LF/IS or the evidence for somatic effects of LF/IS. While the current evidence does not conclusively demonstrate transduction, it does present a strong prima facia case. There are substantial outstanding questions relating to the measurement and propagation of LF and IS and its encoding by the central nervous system relevant to possible perceptual and physiological effects. A range of possible research areas are identified.
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