自觉听力正常耳鸣患者纯音听力及畸变产物耳声发射临床分析  

Audiometry and distortion product otoacoustic emissions in tinnitus patients without hearing complaints

作　　者：王晓晖[1] 肖玉丽[1] 

机构地区：[1]哈尔滨医科大学附属第二医院耳鼻咽喉-头颈外科,哈尔滨150081

出　　处：《中华耳科学杂志》2011年第3期303-307,共5页Chinese Journal of Otology

摘　　要：目的分析自觉听力正常耳鸣患者的纯音听力特征,并探讨自觉听力正常耳鸣患者畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)测定值与纯音听阈值之间的相关性及其意义。方法 2010—2011年在我科就诊的以耳鸣为第一主诉但无明显自觉听力障碍患者114例(190耳),对所有入组患者进行纯音测听及DPOAE检测。分析DPOAE测定值与纯音听阈值之间的相关性,并结合其发病的可能危险因素进行相关分析。结果自觉听力正常的耳鸣患者中,听力异常可达76.84%(146/190)。纯音测听表现为:高频下降型46.31%(88/190);低频下降型14.73%(28/190);正常23.15%(44/190);其它类型15.78%(30/190)。其危险因素主要为:噪声接触,疲劳和/或精神压力、其他基础疾病等。所有频率(f0)的DPOAE幅值与各频率纯音听阈间存在负相关,且有明显的频率对应关系。结论自觉听力正常的耳鸣患者存在一定程度的听力损失,尤其以高频听力下降为多见。DPOAE测定值与其纯音听阈之间呈明显的负相关关系,且DPOAE测试频率与纯音听阈频率间存在明显的对应关系,DPOAE检测作为一种客观指标,可以在一定程度上反映自觉听力正常耳鸣患者的听力损失程度,有一定的临床应用价值。Objective To study pure tone audiometry and distortion product otoacoustic emissions （DPOAE） features in tinnitus patients who do not perceive hearing loss. Methods Pure tone threshoId, hearing loss, SNR of DPOAE were performed in 114 （190 ears） adults with tiunitus cases with never perceived hearing loss. investigate the relationship between every risk factor and tinnitus. Results Audiometry showed high frequency hearing loss in 46.31% （88/ 190）, low frequency hearing loss in 14.73% （28/190）, normal hearing in 23.15% （44/190）, and other types of audiograms in 15.78%（30/190） of the patients. Risk factors included noise exposure, fatigue, stress, and pre-existing diseases. There was a negative correlation between DPOAE amplitude and pure tone threshold. DPOAE response frequencies were closely related to frequency distribution of pure tone thresholds. Conclusion A significant number of patients with tinnitus but no hearing complaints may still have abnormal hearing, especially in the high frequency range. A negative correlation exists between DPOAE amplitude and pure tone threshold. DPOAEs may serve as an objective indicator of the level of hearing loss in tinnitus ~atients with no hearing coumlaints, which may be of value in the clinic.

关 键 词：畸变产物耳声发射 纯音测听 耳鸣 

分 类 号：R764.45[医药卫生—耳鼻咽喉科] R741.044[医药卫生—临床医学]