Long-Term Impairment of Sound Processing in the Auditory Midbrain by Daily Short-Term Exposure to Moderate Noise

Hearing loss among otolaryngologist and healthcare workers: Case control study

BACKGROUND

Noise-induced hearing loss is a prevalent occupational hazard characterized by gradual, sensorineural hearing impairment, primarily affecting higher frequencies (3-6 kHz) due to prolonged exposure to excessive noise. The severity of hearing impairment is directly linked to sound pressure intensity, frequency, exposure duration, and pattern. Otolaryngologists, among other healthcare specialists, frequently use instruments that surpass safety limits, rendering them more susceptible to noise-induced hearing loss. This condition detrimentally impacts communication, performance, healthcare personnel well-being, and patient safety.

OBJECTIVES

This study aims to assess whether otolaryngologists and other operating room staff face a higher risk of hearing loss compared to their peers in non-surgical fields, particularly considering advances in surgical instrumentation.

METHODS

A case-control study conducted at King Saud University Medical City in Riyadh, Saudi Arabia, in collaboration with the Otolaryngology and Audiology departments from June 2021 to December 2023. Comprehensive medical histories, physical measurements, and various audiological tests, including tympanometry, standard pure-tone audiometry, extended high-frequency pure-tone audiometry, and distortion-product otoacoustic emission (DPOM), were administered to ensure precise results. The study included 20 otolaryngologists of varying ages and experience levels (n = 20) and a comparison group of 20 apparently healthy non-otolaryngologist medical professionals. Both groups were drawn from the same population and matched for age, socioeconomic factors, and environments. All subjects underwent extensive audiological testing for result accuracy.

RESULTS

The mean age of otolaryngologists was 31 ± 11 years with a balanced gender distribution. In contrast, the mean age of the non-otolaryngologist group was 32 ± 10 years, with a male predominance. Otolaryngologists exhibited higher odds of low-frequency hearing loss. Additionally, most otolaryngologists displayed the absence of DPOM at 8 kHz, 9 kHz, and 10 kHz, whereas in non-otolaryngologists, DPOM was predominantly present.

CONCLUSIONS

This study provides objective evidence of varying hearing levels among otolaryngologists and their peers in different specialties. Preventive measures should be implemented to mitigate communication challenges and enhance patient safety.

Long-Term Moderate-Level Noise Exposure Caused Hyperexcitability in the Central Auditory System

Noise exposure is one of the most common causes of hearing loss and hyperacusis. Studies have shown that noise exposure can induce a cortical gain to compensate for reduced input of the cochlea, which may contribute to the increased sound sensitivity. However, many people with hyperacusis have no measurable cochlear lesion after being exposed to loud sound. In this experiment, we studied the neurological alterations in the cortical and subcortical areas following a prolonged moderate level of noise exposure (84 dB SPL, 8 h/day for 4 weeks) in the laboratory mice. The cochlear function was monitored by auditory brainstem responses (ABRs). The behavioral auditory sensitivity and temporal processing were evaluated using the acoustic startle response (ASR) and gap-induced prepulse inhibition (gap-PPI). The central auditory functions were determined by electrophysiological recordings of the inferior colliculus (IC) and the auditory cortex (AC). Our results showed that although there was no significant difference in the ABR thresholds, the noise group showed enhanced ASR and gap-PPI compared to the control group. Increased neural activity in both the IC and the AC was recorded in the noise-exposed mice compared to the control group, suggesting a central gain in both the subcortical and cortical regions. The current source density (CSD) analysis of the AC response revealed an increased columnar excitation and reduced corticocortical projection in the noise group, different from the central gain model of noise-induced hearing loss. Our results suggest that chronic "nondestructive" noise can increase the gain of the central auditory system by altering the balance of auditory thalamocortical and intracortical inputs, which may contribute to the increased sound sensitivity in people with normal hearing.

Effects of Age on Responses of Principal Cells of the Mouse Anteroventral Cochlear Nucleus in Quiet and Noise

Older listeners often report difficulties understanding speech in noisy environments. It is important to identify where in the auditory pathway hearing-in-noise deficits arise to develop appropriate therapies. We tested how encoding of sounds is affected by masking noise at early stages of the auditory pathway by recording responses of principal cells in the anteroventral cochlear nucleus (AVCN) of aging CBA/CaJ and C57BL/6J mice in vivo. Previous work indicated that masking noise shifts the dynamic range of single auditory nerve fibers (ANFs), leading to elevated tone thresholds. We hypothesized that such threshold shifts could contribute to increased hearing-in-noise deficits with age if susceptibility to masking increased in AVCN units. We tested this by recording the responses of AVCN principal neurons to tones in the presence and absence of masking noise. Surprisingly, we found that masker-induced threshold shifts decreased with age in primary-like units and did not change in choppers. In addition, spontaneous activity decreased in primary-like and chopper units of old mice, with no change in dynamic range or tuning precision. In C57 mice, which undergo early-onset hearing loss, units showed similar changes in threshold and spontaneous rate at younger ages, suggesting they were related to hearing loss and not simply aging. These findings suggest that sound information carried by AVCN principal cells remains largely unchanged with age. Therefore, hearing-in-noise deficits may result from other changes during aging, such as distorted across-channel input from the cochlea and changes in sound coding at later stages of the auditory pathway.

Low Intensity Noise Exposure Enhanced Auditory Loudness and Temporal Processing by Increasing Excitability of DCN

Sound stimulation is generally used for tinnitus and hyperacusis treatment. Recent studies found that long-term noise exposure can change synaptic and firing properties in the central auditory system, which will be detected by the acoustic startle reflex. However, the perceptual consequences of long-term low-intensity sound exposure are indistinct. This study will detect the effects of moderate-level noise exposure (83 dB SPL) on auditory loudness, and temporal processing was evaluated using CBA/CaJ mice. C-Fos staining was used to detect neural activity changes in the central auditory pathway. With two weeks of 83 dB SPL noise exposure (8 hours per day), no persistent threshold shift of the auditory brainstem response (ABR) was identified. On the other hand, noise exposure enhanced the acoustic startle response (ASR) and gap-induced prepulse inhibition significantly (gap-PPI). Low-level noise exposure, according to the findings, can alter temporal acuity. Noise exposure increased the number of c-Fos labeled neurons in the dorsal cochlear nucleus (DCN) and caudal pontine reticular nucleus (PnC) but not at a higher level in the central auditory nuclei. Our results suggested that noise stimulation can change acoustical temporal processing presumably by increasing the excitability of auditory brainstem neurons.

Silence, Solitude, and Serotonin: Neural Mechanisms Linking Hearing Loss and Social Isolation

For social animals that communicate acoustically, hearing loss and social isolation are factors that independently influence social behavior. In human subjects, hearing loss may also contribute to objective and subjective measures of social isolation. Although the behavioral relationship between hearing loss and social isolation is evident, there is little understanding of their interdependence at the level of neural systems. Separate lines of research have shown that social isolation and hearing loss independently target the serotonergic system in the rodent brain. These two factors affect both presynaptic and postsynaptic measures of serotonergic anatomy and function, highlighting the sensitivity of serotonergic pathways to both types of insult. The effects of deficits in both acoustic and social inputs are seen not only within the auditory system, but also in other brain regions, suggesting relatively extensive effects of these deficits on serotonergic regulatory systems. Serotonin plays a much-studied role in depression and anxiety, and may also influence several aspects of auditory cognition, including auditory attention and understanding speech in challenging listening conditions. These commonalities suggest that serotonergic pathways are worthy of further exploration as potential intervening mechanisms between the related conditions of hearing loss and social isolation, and the affective and cognitive dysfunctions that follow.

Visual input shapes the auditory frequency responses in the inferior colliculus of mouse

The integration of visual and auditory information is important for humans or animals to build an accurate and coherent perception of the external world. Although some evidence has shown some principles of the audiovisual integration, little insight has been gained into its functional purpose. In this study, we investigated the functional influence of dynamic visual input on auditory frequency processing by recording single unit activity in the central nucleus of the inferior colliculus (ICc). Results showed that the auditory responses of ICc neurons to sound frequencies could be enhanced or suppressed by visual stimuli even though the same visual stimuli induced no neural responses when presented alone. For each ICc neuron, the most effective visual stimuli were located in the same azimuth as for auditory stimuli and preceded for ∼20 ms. Additionally, visual stimuli could steepen or flatten the frequency tuning curves (FTCs) of ICc neurons by various visual effects at each responsive frequency. The modulation degree of auditory FTCs was dependent on the minimal thresholds (MTs) of ICc neurons, i.e., with MTs increasing, the modulation degree decreased. Due to the non-homogeneous distribution of MTs which was lowest at 10 kHz, visual modulation of auditory FTCs exhibited a frequency-specific manner, the closer it reached the characteristic frequency (CF) of 10 kHz, the greater modulation. Thus, visual modulation of auditory frequency responses in ICc is dependent not only on the visual stimulus but also on the auditory characteristics of ICc neurons. These results suggest a moment-to-moment visual modulation of auditory frequency responses that in real time increase auditory frequency sensitivity to audiovisual stimuli. Furthermore, in the long term such modulation could serve to instruct auditory adaptive plasticity to maintain necessary and accurate auditory detection and perceptual behavior.