学术机构成人群体中的整合耳科与功能性听力特征：隐藏风险亚组、耳鸣及噪声中言语易损性

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中文摘要

背景： 日常噪声以及声学要求较高的学习和工作环境可能在临床诊断听力损失之前很久就诱发早期听觉功能障碍、耳鸣和噪声中言语困难。学术群体兼具高认知与交流需求和长期噪声暴露，但此类环境中的听力问题常被低估或被正常化。
目的： 描述大学人群中耳科病史、自报听力、耳鸣和噪声中言语困难的特征；推导整合的耳科-听力风险特征；并提出在学术环境中开展耳科-声学意识的构想。
方法： 我们在波兰弗罗茨瓦夫科技大学的师生中开展了一项横断面问卷调查。问卷涵盖耳科病史、自评听力、耳鸣、噪声中言语困难及听觉行为。我们分析了年龄和性别特异性模式，并通过结合耳科病史与自报听力状况定义了三个整合耳科-听力组（“一致受损”、“一致健康”和“可能隐藏风险”）。
结果： 四分之一的受访者报告有阳性耳科病史，呈明显年龄梯度，在51-65岁年龄组达到峰值。尽管自评听力总体良好（88.8%为很好/好），11.0%报告自己“听力变差”，超过三分之一报告噪声中言语理解至少较差，35.3%经历过短暂或持续耳鸣。出现三个整合组：6.6%为“一致受损”，64.7%为“一致健康”（耳科病史阴性且听力良好），28.7%为特征不一致的“隐藏风险”。耳鸣负担和噪声中言语困难集中在“可能隐藏风险”组，而助听器使用率仍极低（总体1.7%；在听力变差/很差者中为13.0%）。
结论： 在学术人群中，耳科疾病、耳鸣和功能性聆听困难较为常见，近三分之一受访者尽管耳科病史以阴性为主且自报听力“良好”，仍属于“可能隐藏风险”特征。整合耳科-听力特征或可作为一种实用工具，用于识别易损亚组，并指导耳科-声学意识倡议、早期筛查和预防性干预。

英文摘要

BACKGROUND: Everyday noise and acoustically demanding study and work environments may induce early auditory dysfunction, tinnitus, and speech‑in‑noise difficulties, long before clinically hearing loss is diagnosed. Academic communities combine high cognitive and communicative demands with long-term noise exposure, yet hearing problems in these settings are often under-recognized or normalized.
OBJECTIVES: To characterize otologic history, self‑reported hearing, tinnitus, and speech‑in‑noise difficulties in a university population; to derive integrated otologic-hearing risk profiles; and to propose a conception for otologic-acoustic awareness in academic environments.
METHODS: We conducted a cross‑sectional survey among students and staff at the Wroclaw University of Science and Technology in Poland. The questionnaire covered otologic history, self‑rated hearing, tinnitus, speech‑in‑noise difficulties, and auditory behaviors. We analyzed age‑ and gender‑specific patterns and defined three integrated otologic-hearing groups by combining otologic history and self‑reported hearing status ("concordant impaired," "concordant healthy," and "possible hidden‑risk").
RESULTS: One quarter of respondents reported a positive otologic history, with a clear age gradient peaking in the 51-65‑year age group. Despite generally favorable self‑rated hearing (88.8% very good/good), 11.0% reported that they "hear worse," more than one-third reported at least poor speech understanding in noise, and 35.3% experienced short‑lasting or constant tinnitus. Three integrated groups emerged: 6.6% "concordant impaired," 64.7% "concordant healthy" (negative otologic history and good hearing), and 28.7% "hidden‑risk" with discordant profiles. Tinnitus burden and speech‑in‑noise difficulties were concentrated in the "possible hidden‑risk" group, while hearing‑aid uptake remained extremely low (1.7% overall; 13.0% among those with worse/very poor hearing).
CONCLUSIONS: In the academic population, otologic morbidity, tinnitus, and functional listening difficulties are common, and nearly one-third of respondents fall into a "possible hidden-risk" profile despite a predominantly negative otologic history and self‑reported "good" hearing. Integrated otologic-hearing profiles may provide a pragmatic tool to identify vulnerable subgroups and to guide otologic-acoustic awareness initiatives, early screening, and preventive interventions.