Scribd Logo
Hochladen

Willkommen bei Scribd!

  • 1983 Lateralização e Ruido

    Hochgeladen von

    Caio Leônidas
    9 Ansichten7 Seiten
    oi

    Copyright

    © © All Rights Reserved

    Verfügbare Formate

    PDF oder online auf Scribd lesen

    Stufen Sie dieses Dokument als nützlich ein?

    Sind diese Inhalte unangemessen?

    Dieses Dokument melden
    oi

    Copyright:

    © All Rights Reserved
    Als PDF herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    9 Ansichten7 Seiten

    1983 Lateralização e Ruido

    Hochgeladen von

    Caio Leônidas
    oi

    Copyright:

    © All Rights Reserved
    Als PDF herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 7
    Audiology 22: 199-205 (1983) Lateral Differences in Susceptibility to Noise Damage David Y. Chung, Glenn N. Willson, R. Patrick Gannon Hearing Branch, Workers’ Compensation Board of British Columbia, Richmond, B.C., Canada Key Words, Lateral dillerences- Susceptibility - Noise-induoed hearing los. Abstract. Usually equal noise exposure is considered do cause symmetrical hearing loss. Jn studying | 461 audiometric records of elaims for mse-inducod hearing los, it was found that 69 (4.75) had a well-defined pattem ofheariag loss in which only 2 kH2 is asymmetrical by 20 dB or more. Audiograms ofthis type suggest that the cochlea ofthe worse ear has been ‘damaged more extensively towards the apex. Othe 69 eases witha 2-KHz asymmetry, 82.6% Jad worse hearing thresholds in se eft ear at 2 KHz In $0% of the 69 eases, the asymmetry could not be accounted for even aller the examination oftheir medical, osupationaland non- ‘ecupatinal histories is believed thatthe asymmetry at? kH2 isa manifestation ofa lateral iffrence in susceptibility to noise damage and tha the lef ear isthe more susceptible one in the majority of eases, In the evaluation of noise-induced hearing loss, noise is usually considered to cause similar amounts of damage to both ears. When there is a discrepancy between the thresholds of the two ears, it is usually believed that the person has been subjected to asymmetrical noise expo- sure, or that other pathologies are involved. An example of the latter is shooting [Chungetal., 1981]. A difference in noise exposure of the two ears in industry is, however, not as obvious as in the case of shooting, In most situations, industrial noise exposures can be treated as equal in both ears ofa worker over a period of time, From our experience with industries in British Columbia there are relatively few occupations in which noise expo- sures to the two ears are consistently different. In the adjudication of compensation claims for occupational hearing loss, asymmetrical sensorineural hearing loss requires an explanation. In the absence of a ready explanation from the medical history (e., head ‘Chung/Witlson/Gannen 200 injury), or from the noise exposure history (&., shooting) —more definitive tests are carried out, namely neurological examination, vestibular testing and/or evoked response audiometry (brain stem or cortical). Even then, frequently, no adequate explanation for the asymmetry is found, ‘There is a particular class of asymmetry that occurs in our claimant population. We denote this class as *2-kHz asymmetry’. The definition of the 2-kHz asymmetry is that the lateral difference at 2 kHz must be 20 dB ‘or more, whereas itis 10 dB or less at other octave frequencies (0.25, 0.5, 1, 4 and 8 KHZ). A typical audiogram of this class is shown in figure 1 Actually, in most cases, the asymmetry at 2 kHz is more than 20 dB and the adjacent octave frequencies are 5 dB or less. The 2-kHz asymmetry is interesting because it constitutes a well- defined group in which asymmetry can be studied. The objective of this study was to gain insight into the causes of asymmetry in cases with confirmed noise-induced hearing loss. This was done by examining the phenomenon of the 2-kHz asymmetry. “Methods {69 audiograms witha 2-kHz asymmetry. as defined aber, were separated fom a total ‘f 1 461 clair files (4.7%). These claims were filed by workers petitioning the Workers’ Com: pensation Board of British Columbia (WCB) for noise-induced hearing los. All audiograms were recorded by audiologists atthe Hearing Branch ofthe WCB, All 69 audiograms-with the 2-KHIL asymmetry were ofthe type with high-frequency sensorineural hearing less with no ‘conductive component. The hearing loses in these cases were diagnosed 25 noise-induced aller consideration of(() detailed occupational and non-occupational history of noise expo- sure, @)amedical history, 3 the results ofaudiological tess which include middle-earimped- ance tes, pure-ione audiometry, speech test, and when necesary, evoked-response audi- fometry (cortical or brain stem), ‘The mean age of the 69 claimants was $8.4 years, ranging Rom 36 to 82 yeats, The ‘medical history revealed that none ever had a head injury ear sumsery of ear aches. The frequencies at which the hearing thresholds were obiained were 0.28,0.5, 1,2, 3,4, 6 and & [flz. When a precipitous hearing loss occurred between | and 2 KHz, threshold at 1 $00 Ha was ako obtained, “Although the 2-kHz asymmetry defines thatthe only asymmetry in hearing loss i at 2 kHz, the ast that all the 69 subjects had high-frequency sloping hearing loss sugges a prob- able reason forthe asymmetry in this population is a more extensive damage ffom noise towands the apex ofthe cachlea in the worse ea. This can be seen in figure 1. The lft ea, ‘being the worse one, stants the downvar slopeat | kHzand then levelsoffat 4 kHz. The right ‘ear, on the other hang, begins at? KH and also levels off at 4 kHz. The area enclosed by the audiogram ofthe two cars seems to represent extra damage extending towards the apex of the cochlea in the lft car, IF this isthe cas, then there are two possible explanations for the Lateral Dillerences in Susceptibility 201 8 20 so 1280 —“a000—“a066ao6o 1800" 3000" 000 Freaueney, He Fig. 1. A typical audiogram with a 2-kI2 asymmetry. O= Right ear: 8 =Fel ear

    Das könnte Ihnen auch gefallen