ABSTRACT
La exposición a ruido no ocupacional y a la música a alto nivel sonoro, constituye un creciente factor de riesgo de pérdida auditiva en adolescentes. Estudios internacionales postulan que una función importante del Sistema Eferente Medial (SEM) es proteger el oído interno frente al ruido mediante un mecanismo reflejo y que puede ser evaluado a través de la Supresión Contralateral (SC) de las otoemisiones acústicas transitorias (TEOAEs). El mecanismo subyacente de este fenómeno no se conoce en su totalidad y los antecedentes sobre el tema son escasos. En esta investigación se analizó la relación entre la Exposición General a Música (EGM), el estado de la función auditiva y el mecanismo de protección coclear. Participaron 91 adolescentes con edades entre 14 y 15 años. Se evaluaron dos dimensiones (a) Psicosocial: se examinó la EGM con un cuestionario de actividades extraescolares y (b) auditiva o sea el funcionamiento del SEM mediante SC de las TEOAEs y los perfiles audiométricos con audiometrías. Los resultados mostraron que la SC no influyó estadísticamente en los perfiles audiométricos y categorías de exposición. Sin embargo, los resultados de la SC se orientan hacia la menor magnitud de efecto supresor, disminución en la respuesta total en relación al descenso de los umbrales auditivos y en relación con las categorías alta y baja de EGM. Es necesario promover trabajos destinados al comportamiento de riesgo auditivo conjuntamente con el mecanismo protector del SEM. De esta manera se podrá contribuir en la identificación temprana de la sensibilidad auditiva en adolescentes expuestos a ruido no ocupacional.
Non-occupational exposure to noise, such as loud music sound level is an increasing risk factor for hearing loss in adolescents. International studies propose that an important function of the medial efferent system (MES) is protect the inner ear against noise by a reflex mechanism and can be evaluated through Contralateral Suppression (CS) of transient otoacoustic emissions (TEOAEs) to analyzing the presence or absence of suppressive effect. The absence of suppressive effect is considered a possible alteration of the MES and the role it exerts on the regulation of the outer hair cells. The underlying mechanism of this phenomenon is not known totality and the background about this topic are limited. However, researches suggests that MES would have an important role in protection against acoustic overstimulation under the hypothesis that a hearing with the presence of suppressive effect would tend to be more protected against exposure to high noise levels while ears with no effect suppressor may be more vulnerable to noise exposure. In this research the relationship between the General Exposure to Music (MGE), the state of hearing function and cochlear protection mechanism were analyzed in 91 adolescents with 14/15 years old, with male predominance, of two technical schools of the city of Córdoba (Argentina). Were evaluated the following dimensions: (a) Psychosocial: MGE through an Out of School Activities Questionnaire to know in detail the participation in five recreational activities to finally analyze the MGE and (b) Audiological: assessment of audiometric profiles, as a subjective method, by audiometry in the conventional frequency ranges (250-8000) Hz and an extended high frequency audiometry (8000-16000) Hz; function of MES assessment, objective method, through CS of TEOAEs to determine the presence or absence of suppressive effect. The study CS of TEOAEs consisted of two steps: Step 1, application of TEOAEs of an ear in form ipsilateral without acoustic stimulation in the contralateral ear (CAS) and Step 2, application of TEOAEs in the ear ipsilateral while applying CAS. Was considered presence of suppressive effect when there was a reduction in the response after the CAS that is to say when the difference of values obtained in the total response with and without CAS was positive. At the same time, was considered absence of suppressive effect in cases of maintained or increased the response after the CAS, obtaining a value of zero or negative. The results of the research showed that in the group with presence of suppressive effect the most of ears is among moderate and high categories of MGE with a lower average magnitude of suppressive effect and a decreased amplitude of the total response in the high category of MGE than the media category. Regarding audiometry the ears with presence of suppressive effect showed higher magnitude in the group of normal hearing thresholds compared with the group of descended hearing thresholds. The results related to CS of the TEOAEs statistically did not influence in the audiometric profiles and the exposure categories. However the results of the CS were oriented towards the smaller magnitude of suppressive effect, decreased total response related with the descended hearing thresholds and high and low categories of MGE. It is necessary to promote and intensify researches in relation to the auditory risk behaviors together with the protection mechanism of MES. In this way, more researches can contribute to the early identification of hearing sensitivity in adolescents exposed to non-occupational noise. It is important to implement a Psycho-Auditory Screening to collaborate in the prevention and promotion of hearing health.
ABSTRACT
La ecolocación es una habilidad que usaría inconscientemente la mayoría de las personas. Resulta crucial para la movilidad independiente de la persona ciega e implica utilizar sonidos autoproducidos y sus reflexiones para localizar y reconocer objetos que no se ven. Dos nuevos paradigmas han enriquecido el estudio de esta sorprendente habilidad: el del acoplamiento sensoriomotor y el de la sustitución sensorial. El primero sostiene que los sistemas perceptivo y motor constituyen procesos acoplados que requieren un insoslayable tratamiento unificado. El segundo considera que es posible ver con los oídos o con la piel en virtud de la plasticidad cerebral. En esta segunda parte se presenta la temática en el contexto teórico de la cognición corporizada y de recientes avances en neurociencias; se desarrollan además los estudios realizados en el tercer período. En esta revisión se reflejan cambios paradigmáticos en las ciencias del comportamiento y el valor científico acrecentado de la ecolocación humana.
Echolocation is an ability that can be used daily by human beings, even without being conscious of it. It turns out to be crucial to the efficient independent mobility of the blind person, an aspect that is severely affected by blindness. It implies using the information that emerges from self-produced sounds and their reflexions in order to locate and recognize unseen objects. According to the new cognitive and ecological paradigms in perception, it is believed that the primary function of the auditory system is to determinate, i.e., to localize and recognize, the characteristics of the sound source through the sounds emitted by it. Within this context, it has been very recently argued that echolocation (i.e., the ability to locate and recognize biologically relevant secondary sound sources through the information contained in the direct-reflected couple) is a variant of that general process of primary sound sources determination. Two recently established scientific paradigms have specially enriched the study of this amazing ability: the sensorimotor contingency theory and the sensory substitution perspective. The first approach claims that the perceptual and motor systems are coupling processes that demand a thoroughly unified treatment. The second approach considers that, for example, vision loss does not mean loss of the ability to see since it is possible to see with the ears or the skin. The central idea is that the information usually captured by vision may instead be captured by touch or audition, on account of brain plasticity. In this way, in echolocation (which represents a kind of 'seeing with the ears' natural sensory substitution system that is part of the human endowment) action consists of the exploratory activity that the subject carries out through self-generation of sounds and head and/or cane movements while sensation refers to certain tonal or spatial percepts related to the presence and characteristics of the objects that the subject (implicitly) learns to perceive probably as auditory Gestalts. In the first part of this article the main theoretical aspects and a revision of the studies throughout two of the three delimited periods were developed: FIRST APPROACHES (1700 - 1935) and SIENTIFIC STUDY OF HUMAN ECHOLOCATION (1940 -1980). The questions that researchers formulated during these periods were firstly concerned with discovering if blind persons actually possessed this ability, which of the sense organs was involved and which sensory stimulation was its necessary and sufficient condition. Secondly, they inquired into the scopes of echolocation and its possible underlying psychoacoustic mechanisms. The thorough investigations carried out allowed to unequivocally establishing that audition is the sensory basis of this ability and that changes in pitch are its necessary and sufficient condition. It was also demonstrated that not only blind subjects but also appropriately trained sighted subjects were able to precisely localize and recognize the characteristics of the experimental objects. In this second part, we present the object of study within the context of theories of embodied cognition and recent developments in the field of the neurosciences; we also elaborate upon studies carried out during the third period, named RECENT STUDIES, that extends from 1990 to present days. We show how the blind person with good echolocation ability becomes an excellent experimental model to study behavioral and neurophysiological aspects involved in implicit learning. The article illustrates the paradigm shifts that occurred in recent scientific history through the study of this particular human ability that, within the mentioned recent theoretical context, has acquired a renewed interest.