听力正常耳鸣与诱发性耳声发射的关系  

Tinnitus with normal hearing and evoked otoacoustic emissions

作　　者：毛晓梅[1] 郑朝生[1] 郑瑞容[1] 林心强[1] 沈志忠[1] 

机构地区：[1]汕头大学医学院第一附属医院耳鼻咽喉科,广东汕头515041

出　　处：《临床耳鼻咽喉科杂志》2005年第1期14-16,共3页Journal of Clinical Otorhinolaryngology

摘　　要：目的:分析听力正常的耳鸣患者的耳蜗功能,探讨耳鸣的客观检查手段。方法:对听力正常的单侧 耳鸣患者50例(50耳,耳鸣1组)、听力正常的双侧耳鸣患者23例(46耳,耳鸣2组)和正常人34例(68耳,对照 组)进行瞬态诱发耳声发射(TEOAE)和畸变产物耳声发射(DPOAE)。耳鸣1、2组同时进行耳鸣频率匹配检查, 并分析在TEOAE及DPOAE测试结果中有无相应表现。结果:①TEOAE通过率,耳鸣1组为64.0%,耳鸣2组 为91.3%,对照组为100%(1组P<0.01,2组P>0.05);②DPOAE通过率,3组均为100%;但耳鸣1组在 3.125kHz及8.837kHz的波幅均值较对照组低,两组差异具有统计学意义(P<0.05);③耳鸣音调分布为0.25 ～8.00kHz。在TEOAE频谱中及DPOAE听力图中,部分耳表现出与匹配频率相对应的低反应峰或频率成分 缺失以及低幅值。结论:部分听力正常的耳鸣患者已有耳蜗毛细胞的损害;TEOAE及DPOAE可以作为外周性 耳鸣诊断的一种客观检测方法;前者对耳蜗性耳鸣的早期诊断敏感而直观,而后者适用于耳鸣的频率分析。Objective:To investigate the objective methods for tinnitus exploration by analysing the cochlear activity in tinnitus patients with normal hearing.Method:The 50 cases(50 ears) of unilateral tinnitus with normal hearing (the plastic group 1) , 24 cases (46 ears) of bilateral tinnitus with normal hearing(the plastic group2) and the 34 persons(68 ears) of normal hearing without tinnitus (control group) were measured by evoked otoacoustic emissions (TEOAE and DPOAE).All the tinnitus patients were also tested by the subjective tinnitus frequency and analysed with appropriate characteristic in TEOAE and DPOAE audiogram.Result:①The passing rate of TEOAE was 64.0% in the tinnitus group 1, 91.3% in the group 2,and 100% in the control group (group 1 P< 0.01, group 2 P> 0.05 ).②The passing rate of DPOAE was 100% in three groups. But comparing to the control group,the amplitudes of DPOAE at the limited frequency ranges (3.125 kHz and 8.837 kHz) of the tinnitus group 1 was significant decreased (P< 0.05).③The subjective tinnitus frequencies were 0.25~8.00 kHz. The decreases in amplitudes and absent within the tinnitus frequencies were observed in TEOAE and DPOAE audiogram.Conclusion:Some patients of normal hearing with tinnitus have had early harmness of outer hair cell in cochlear.Evoked otoacoustic emissions is one of worthy methods to evaluated objectively the tinnitus. TEOAE is more susceptible to harmness in cochlear than DPOAE. DPOAE is superior to the analysis of tinnitus frequencies.

关 键 词：诱发性耳声发射 耳鸣 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]