Sermin KUMDAKCI, Fulya ÖZER, Seyra ERBEK, Levent ÖZLÜOĞLU

ORKESTRA SANATÇILARINDA AFFERENT ve EFFERENT İŞİTME SİSTEMİNİN DEĞERLENDİRİLMESİ

Amaç: Orkestra sanatçılarında afferent işitme sistemini saf ses odyometri, yüksek frekans odyometri, geçici uyarılmış otoakustik emisyon ile; efferent işitme sistemini ise medial olivokoklear kompleks supresyon testi ile incelemektir. Gereç ve Yöntem: Aynı orkestrada çalan en az 5 yıl deneyimi olan 30 sanatçı ve kontrol grubu olarak müzik icra etmeyen 30 gönüllü alınmıştır. Saf Ses Odyometri (SSO) ve yüksek frekans odyometri ile işitme eşikleri değerlendirilmiştir. Transient uyarılmış otoakustik emisyon (TEOAE) testiyle ilk olarak kontralateral akustik stimülasyon (KAS) verilmeden önce ölçümler alınmış, daha sonra 70 dB dar band gürültü ile KAS verilerek aynı anda TEOAE testiyle medial olivokoklear kompleks refleksi (MOCR) ölçülmüştür. Ortalama prova süreleri günlük 4 saat; ortam gürültüsüne maruz kalma süreleri haftada 20-35 saat arasında değişmektedir. Bulgular: SSO eşiklerine göre; orkestra çalışanlarında 16 kHz’de özellikle sol kulakta anlamlı bir eşik yükselmesi tespit edilmiştir (orkestra grubu 42,17 dB; kontrol grubu 31,83 dB). TEOAE amplitüdleri, orkestra sanatçılarında tüm frekanslarda anlamlı derecede azdır (p<0.001). Orkestra sanatçılarında kontralateral akustik stimulasyon verildiğinde; 1, 2,4 ve 8 kHz frekanslarında anlamlı olarak TEOAE emisyon değerlerinde belirgin bir azalma tespit edilmiştir (p<0,05). Orkestra sanatçılarında prova süresi arttıkça TEOAE değerlerinde azalma gözlenirken; kontralateral supresyon değerlerinde anlamlı bir farklılık olmamıştır. Sonuç: Orkestrada çalan sanatçıların işitme sistemi değerlendirilmesinde, saf ses odyometri tek başına yeterli değildir. İşitme takibinde yüksek frekans odyometri ve otoakustik emisyonun beraber kullanımının gerekli olduğu bu çalışmada vurgulanmaktadır. Orkestra sanatçılarında medial olivary kompleks refleks aktivitesinin değerlendirilmesi önemli olmakla beraber müzisyenlerin işitme takibinde medial olivary kompleks refleks aktivitesinin tek başına kullanımı ile ilgili prospektif uzun dönem çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Orkestra, müzisyen, geçici uyarılmış otoakustik emisyon, Medial Superior Olivary Kompleks, kontralateral supresyon, yüksek frekans odyometri

EVALUATION OF AFFERENT and EFFERENT AUDITORY SYSTEM IN ORCHESTRA MUSICIANS

Objectives: To evaluate afferent hearing system of musicians with pure sound audiometry, high frequency audiometry, transient-evoked otoacoustic emission and to examine the efferent hearing system with medial olivocochlear complex suppression. Materials and Methods: A total of 60 people, including 30 orchestra artists and 30 control groups, were included in this study. Hearing thresholds were evaluated with Pure Tone Audiometry. TEOAE test was first measured, then contralateral acoustic stimulation (CAS) with 70 dB narrow band noise was given and measured simultaneously with TEOAE test. The average rehearsal time is 4 hours per day and varies between 20-35 hours per week. Results: A significant threshold increase in the left ear was detected at orchestral staff at 16 kHz (orchestra group 42.17 dB; control group 31.83 dB). TEOAE amplitudes were significantly lower at all frequencies in orchestra (p <0.001). When CAS was given in the group of orchestral artists; A significant decrease in TEOAE emission values was detected at frequencies of 1, 2,4 and 8 kHz (p <0.05). While the rehearsal time has been increased, TEOAE values have been decreased. There was no significant correlation between rehearsal duration and contralateral suppression values. Conclusion: In the evaluation of the hearing system of the musicians playing in the orchestra, pure tone audiometry alone is not enough and high-frequency audiometry and TEOAE is mandatory. Although it is important to evaluate medial olivary complex reflex activity in musicians, prospective long-term studies are required for the use of medial olivary complex reflex activity alone in the follow-up of hearing in musicians.

Keywords:

Orchestra, musician, transient evoked otoacoustic emission, contralateral supression, medial superior olivary complex, high frequency audiometry,

PDF

___

Bulut E, Öztürk G, Taş M, Türkmen MT, Gülmez ZD, Öztürk L. (2019). Medial olivocochlear suppression in musicians versus non-musicians. Physiol Int.; 106(2):151-157.
Christopher Kirk E, Smith DW. (2003). Protection from acoustic trauma is not a primary function of the medial olivocochlear efferent system. JARO, 445-465.
Ciuman RRJIjobsI. (2010). The efferent system or olivocochlear function bundle–fine regulator and protector of hearing perception. 6(4):276.
Cooper NP, Guinan JJ. (2003). Separate mechanical processes underlie fast and slow effects of medial olivocochlear efferent activity. J Physiol, 548(1): 307-312.
Dowling WJ, Harwood DL. (1986).Music cognition. Academic Press, St Louis,
Guinan JJ. (2006). Olivocochlear efferents: Anatomy, physiology, function and the measurement of efferent effects in humans. Ear Hearing, 27: 589-607.
Guinan Jr JJJHr. (2018). Olivocochlear efferents: Their action, effects, measurement and uses, and the impact of the new conception of cochlear mechanical responses. 362:38-47.
He DZ, Jia S, Dallos PJJoN. (2003). Prestin and the dynamic stiffness of cochlear outer hair cells.23(27):9089-96.
Høydal EH, Lein Størmer CC, Laukli E, Stenklev NC. (2017). Transient evoked otoacoustic emissions in rock musicians. Int J Audiol. Sep;56(9):685-691.
Jansen EJ, Helleman HW, Dreschler WA. (2009). Noise-induced hearing loss and other hearing complaints among musicians of symphony orchestras. Int Arch Occup Environ Health ; 82: 153–64.
Karlsson K, Lundquist PG, Olaussen T. (1983). The hearing of symphony orchestra musicians. Scand Audiol. 12(4):257–264.
Kumar P, Grover V, Publius A S, Sanju HK, Sinha S. (2016). Assessment of rock musician's efferent system functioning using contralateral suppression of otoacoustic emissions. World J Otorhinolaryngol Head Neck Surg. 2(4):214-218.
Murray, N.M., LePage, E.L.,Mikl, N. (1998). Innerear damagein an opera theatre orchestra as detected by otoacoustic emissions, pure tone audiometry and sound levels. Aust J Audiol, 20: 67-78.
Otsuka S, Tsuzaki M, Sonoda J, Tanaka S, Furukawa S. (2016). A Role of Medial Olivocochlear Reflex as a Protection Mechanism from Noise-Induced Hearing Loss Revealed in Short-Practicing Violinists. Plos One; 11(1): 46-9.
Perrot X, Micheyl C, Khalfa S, Collet L (1999). Stronger bilateral efferent influences on cochlear biomechanical activity in musicians than in non-musicians. Neurosci. Lett.; 262(3):167–170.
Rasmussen GLJJoCN. (1946). The olivary peduncle and other fiber projections of the superior olivary complex.;84(2):141-219.
Sisto R, Cerini L, Sanjust F, Carbonari D, Gherardi M, Gordiani A. (2020). Distortion product otoacoustic emission sensitivity to different solvents in a population of industrial painters. Int J Audiol. Jan 8:1-12.
Somma G, Pietroiusti A, Magrini A, Coppeta L, Ancona C, Gardi S. (2008). Extended high‐frequency audiometry and noise-induced hearing loss in cement workers. Am. j of Industrial Medicine. 51(6):452-62.
You S, Kong TH, Han W. (2020). The Effects of Short-Term and Long-term Hearing Changes on Music Exposure: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 17(6): 25-8. Zadeh M, Silbert NH, Sternasty K, Swanepoel W, Hunter LL, Moore DR. (2019). Extended high-frequency hearing enhances speech perception in noise. Proc Natl Acad Sci U S A. 116(47):23753-9.