耳塞式耳机与头戴式耳机对青少年及年轻成人听力和前庭结局的影响：系统综述与证据整合

文献信息

中文摘要

背景： 个人收听设备（PLDs）——耳塞式耳机、入耳式耳机和头戴式耳机——在青少年中几乎无处不在。我们评估了PLD暴露是否与青少年及年轻成人的听力损失、耳鸣、主观听觉困难或前庭功能障碍相关。
方法： 遵循系统综述和荟萃分析优先报告条目2020（PRISMA 2020），我们检索了PubMed/MEDLINE（2021年6月至2026年6月），并通过出版商页面、开放获取来源和引文追踪核实了引文。符合条件的研究报告了青少年、在校学生或年轻成人的PLD暴露与听觉或前庭结局。
结果： 共整合了25项研究；其中13项提供了可提取的定量信号。最强的青少年特异性证据显示，在嘈杂环境中使用耳机与听力损失（pOR 4.54）和主观听力问题（pOR 8.39）相关。自报听力下降从14.2%（初中）增加到32.2%（高中）。客观剂量测定显示，较长的暴露时间与自评听力呈负相关（r = -0.21至-0.32）。前庭证据极为有限，主要来自一项单一研究，该研究报告了PLD暴露与青少年亚组球囊功能之间的中度关联（r = 0.406）。汇总数据不支持建立有效的新合并相关性或预测模型。
结论： 不安全收听——高音量、每日使用时间过长、在嘈杂环境中收听以及累积暴露——与年轻人的听觉风险相关。青少年特异性证据仍然有限，而前庭研究结果具有假设生成性，不足以确立一致的关联。未来的前瞻性研究需要客观的声音剂量追踪以及标准化的听觉和前庭测试。

英文摘要

BACKGROUND: Personal listening devices (PLDs)-earbuds, earphones, and headphones-are nearly ubiquitous among adolescents. We evaluated whether PLD exposure was associated with hearing loss, tinnitus, subjective auditory difficulty, or vestibular dysfunction in adolescents and young adults.
METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, we searched PubMed/MEDLINE (June 2021-June 2026) and verified citations through publisher pages, open-access sources, and citation tracking. Eligible studies reported PLD exposure and auditory or vestibular outcomes in adolescents, school students, or young adults.
RESULTS: Twenty-five studies were synthesized; 13 provided extractable quantitative signals. The strongest adolescent-specific evidence showed that earphone use in noisy environments was associated with hearing loss (pOR 4.54) and subjective hearing problems (pOR 8.39). The self-reported hearing decline increased from 14.2% (middle) to 32.2% (high school). Objective dosimetry showed that longer exposure was negatively correlated with self-rated hearing ( r  = -0.21 to -0.32). Vestibular evidence was extremely limited and was derived primarily from a single study, which reported a moderate association between PLD exposure and saccular function in an adolescent subgroup ( r  = 0.406). Aggregate data did not support a valid new pooled correlation or prediction model.
CONCLUSION: Unsafe listening-high volume, prolonged daily use, listening in noisy environments, and cumulative exposure-is associated with auditory risk in young people. Adolescent-specific evidence remains limited, while vestibular findings are hypothesis-generating and insufficient to establish a consistent association. Future prospective studies require objective sound-dose tracking and standardized auditory and vestibular testing.