常频听阈正常的民航飞行学员扩展高频听阈分析

摘要

目的 探讨扩展高频(extended highfrequency,EHF)测听对于早期发现民航飞行学员听力损失的意义.方法 对中国民航某飞行学院尚处于理论学习阶段的175例飞行学员(均为男性,18~25岁,平均20.2±0.92岁)进行问卷调查和EHF测听,所有受试者常频(0.25~8 kHz)听阈≤25 dB HL,将结果与国外相应推荐标准比较;将其中173例听力资料完整的学员(除外中耳疾病和有听力损失家族史各1例)按照随身听使用情况分为低风险组(不使用,121例)和高风险组(使用时间>1年,每天>1小时,52例),比较两组间EHF听阈及检出率的差异.结果 173例飞行学员9~20 kHz各频率听阈值均略高于美国国家标准化协会规定的声压级参考阈值和国外文献推荐的同年龄段标准;高风险组9、12.5、16、18 kHz阈值显著高于低风险组(P<0.05或0.01),随着频率增高,高风险组听阈检出率逐渐下降,在18、20 kHz的检出率显著低于低风险组(P<0.01).结论 EHF测听有助于早期发现飞行学员噪声性听力损失,应当重视民航飞行学员听力保健,建议避免使用或减少随身听使用时间.%Objective To study extended high frequency (EHF) audiometry for early detection of hearing loss in student pilots in civil aviation.Methods A total of 175 student pilots (all male,18~25 years old, mean 20.2±0.92 years) from a university flight academy were surveyed and underwent EHFA.All subjects had hearing thresholds ≤25 dB HL at conventional frequencies (0.25~8 kHz).The results were compared with the corresponding recommended standards in other countries.According to the use of personal listening devices, all the subjects were divided into the low risk group (non-use, 121 cases) and the high risk group (using>1 year, day>1 hour, 52 cases).The differences of hearing thresholds and detection rates at EHF between the two groups were compared.Results The hearing thresholds of 173 subjects (1 case of middle ear disease and 1 case with family history of hearing loss were excluded) at 9~20 kHz were slightly higher than the reference equivalent threshold sound pressure level (RETSPL) prescribed by American National Standardization Association and the age-matched thresholds recommended by a foreign literature (P<0.05 or P<0.01).The hearing thresholds in the high risk group elevated dramatically than that in the low risk group at 9,12.5,16 and 18 kHz(P<0.05 or P<0.01).As frequencies increased, the detection rate of hearing thresholds in the high risk group decreased gradually, and at 18 and 20 kHz it was significantly lower than that in the low risk group (P<0.01).Conclusion EHF audiometry is a helpful tool for early detection of noise-induced hearing loss in student pilots.Hearing health care should be emphasized in civilian student pilots.It is recommended to avoid the use of personal listening devices or reduce the use time of them.