Analysis Of Audiological Characteristics And Establishment Of Diagnostic Model For Hidden Hearing Loss Caused By Noise Exposure

Objective:To explore the audiological characteristics of individuals with hidden hearing loss(HHL)caused by noise exposure and establish a diagnostic model for patients with HHL caused by noise exposure according to the characteristics,so as to provide references for early detection and intervention of hearing loss.Methods:A total of 101 young subjects were recruited and divided into high-risk group and low-risk group according to their daily noise exposure.All subjects completed hearing related questionnaires(including noise exposure,speech audiometry in quiet and headset use),pure tone audiometry(PTA),distortion product otoacoustic emissions(DPOAE),auditory brainstem response(ABR),electrocochleogram(ECoch G)and speech audiometry under noise.Results:1.Hearing related questionnaires: 101 subjects were male,including 51 in the high-risk group and 50 in the low-risk group.There were significant differences in working years between the high-risk group and the low-risk group(P<0.001).There were significant differences in the use of hearing protection equipment(P<0.001)and speech audiometry in quiet(P=0.005).The incidence of tinnitus in high-risk group and low-risk group was 49.0%and 38.0%,respectively,and there was no significant difference(P=0.264).2.PTA: The hearing thresholds of 12.5 k Hz(P=0.014),16 k Hz(P=0.019)and 18 k Hz(P=0.028)in the high-risk group were higher than those in the low-risk group.3.DPOAE: The DP values at 8 k Hz(P=0.039)and 10 k Hz(P=0.005)in the high-risk group were lower than those in the low-risk group.Signal-to-noise ratio(SNR)values were not significantly different among all groups(P> 0.05).4.ECoch G: The amplitudes of summating potential(SP)(P=0.017)and action potential(AP)(P=0.012)of high-risk group were lower than those in low-risk group.There was no significant difference in SP/AP amplitude ratio between the two groups(P=0.752).5.ABR: The amplitude of wave Ⅲ in the high-risk group was higher than that in the lowrisk group(P=0.030);The ratio of wave Ⅰ/ wave Ⅲ amplitude in the high-risk group was lower than those in the low-risk group(P=0.031).There was no significant difference in wave Ⅰ amplitude between the two groups(P=0.584).6.Speech audiometry under noise: when the SNR =-7.5 d B(P=0.030)and-5 d B(P<0.001),the speech discrimination score of the high-risk group was lower than that of the low-risk group.When SNR=0 d B,there was no significant difference in speech discrimination score between the two groups(P=0.285).There was no significant difference in speech discrimination threshold between the two groups(P=0.541).7.Combination of diagnostic indicators: We constructed the combination of diagnostic indicators and calculated the Odds ratio(OR).The DPOAE 10 k Hz DP value(OR=0.856),ECoch G SP amplitude(OR=0.171),ABR wave Ⅲ amplitude(OR=5.080)and SNR=-5 d B speech discrimination score(OR=0.911)were combined.The Area Under Curve(AUC)of Receiver operating characteristic curve(ROC)was 0.864(95%CI=0.793-0.934).The sensitivity was 76.47%.The specificity was 90.00%.Conclusions:DPOAE 10 k Hz DP value,ECoch G SP amplitude,ABR wave Ⅲ amplitude and SNR=-5d B noise speech recognition rate should be the focus of screening for noise exposed HHL patients.We hope that this diagnostic combination can help early detection of noise exposed HHL patients.In order to minimize the development of Sensorineural hearing loss(SNHL).