听外周偏侧性的病理发现  

Pathological Findings of Peripheral Auditory Lateralization

作　　者：徐进[1] 刘鋋[2] 廉能静[2] 陈秀伍[2] 

机构地区：[1]北京医院耳鼻咽喉科,北京100730 [2]北京市耳鼻咽喉科研究所

出　　处：《听力学及言语疾病杂志》2002年第1期3-5,共3页Journal of Audiology and Speech Pathology

摘　　要：目的 观察生理和蜗后病理条件下听觉外周系统的偏侧性，以加深对双侧对称性疾病的认识。方法 检测６５例听神经病患者和的例正常健康青年纯音测听、自发性耳声发射（ＳＯＡＥ）、瞬态诱发性耳声发射（ＴＥＯＡＮ）及其对侧抑制效应，从耳蜗和传出神经两个水平分析左右听活动。结果①听神经病患者右耳各频率平均纯音听阈约高于左耳５ｄＢ；②正常组ＴＥＯＡＥ幅值右耳大于左耳（Ｐ＜０．０１），听神经病患者组ＴＥＯＡＥ幅值右耳大于左耳（Ｐ＜０．０５）；③正常组传出抑制功能右耳大于左耳（Ｐ＜０．０１），听神经病患者组传出抑制功能左、右耳均有障碍，右耳略重于左耳，但无统计学差异（Ｐ＞０．０５）；④无论是正常组还是听神经病患者组均在右耳较易记录到ＳＯＡＥ；⑤正常组ＳＯＡＥ强弱左右耳间无统计学差异（Ｐ＞０．０５；听神经病患者组ＳＯＡＥ右耳强于左耳（Ｐ＜０．０１）。结论 听觉外周系统具有偏侧性（右侧优于左侧）；在同一蜗后病理条件下，听活动较强的一侧病理损害则较重，听活动较弱的一侧病理损害则较轻；听神经病患者右耳听力损失稍重于左耳，可能来源于听外周系统本身的固有属性。Objective To explore peripheral auditory lateralization under the conditions of physio pathology and improve the understanding of bilateral symmetry diseases. Methods Pure tone audiometry, SOAE, TEOAE and contralateral suppressive effect of TEOAE were conducted on 65 patients with auditory neuropathy and 65 normal young adults, the left and tight auditory activities were analyzed at the level of cochlear and efferent nerve. Results ① Average heating threshold at every frequency( 125 -000 Hz) was about 5 dB HL more in the right than in the left ear in patients with auditory neuropathy.②TEOAE amplitudes were significantly higher in the right ear than in the left ear in patients with auditory neuropathy and in normals. ③TEOAE suppression was significantly larger in the tight ear than in the left ear in normal adult, efferent suppression dysfunction was found in both tight and left ear in patients with auditory neuropathy. ④A higher SOAE prevalence was more observed in tight than in left ear in normals and in patients with auditory neuropathy. ⑤SOAE was significantly stronger in the tight ear than in the left ear in patients with auditory neuropathy, but no statistical differences was found in normal adults. Conclusion This study shows the notion of peripheral izationauditory lateralizition in humans, with a right ear advantage. The lateralization of stronger auditory activties suffered relatively more serous pathological lesion than that of weaker auditory activities under the same retrocochlear pathology. Hearing loss was larger in the tight ear than in the left ear in patients with auditory neuropathy, possibly due to the property of peripheral auditory system.

关 键 词：听觉外周系统 听非对称性听神经病 耳声发射 传出抑制 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]