单侧急性耳鸣患者耳蜗电生理学研究  

Electrophysiological study of the cochlea in patients with unilateral acute tinnitus

作　　者：吴文丽 丁雷[1] 高铭媛 黄创惠 王冬梅[1] 姜辉[1] 魏然[1] WU Wenli;DING Lei;GAO Mingyuan;HUANG Chuanghui;WANG Dongmei;JIANG Hui;WEI Ran(Department of Otolaryngology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing,100078,China)

机构地区：[1]北京中医药大学东方医院耳鼻咽喉科,北京100078

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第5期357-361,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析单侧急性耳鸣患者纯音测听(PTA)、扩展高频测听(EHFA)、畸变产物耳声发射(DPOAE)、听性脑干反应(ABR)、耳蜗电图(ECochG)的客观检测结果,探讨其对隐性听力损失的临床应用价值。方法:对33例以单侧急性耳鸣为主诉的患者进行PTA、DPOAE、ABR、ECochG检测,对DPOAE各频率检出率及反应幅值、ABR各波潜伏期及波间期、ECochG中-SP/AP的结果进行分析。结果:(1)双耳PTA在0.25~8 kHz各频率阈值结果均在正常范围内(P>0.05),患耳在9~16 kHz各频率听阈均高于健耳(P<0.001);(2)DPOAE在3、4、6、8 kHz 4个高频频率检出率和反应幅值双耳差异有统计学意义(P<0.05);(3)ABRⅠ波患耳潜伏期为(1.55±0.17)ms,健耳潜伏期为(1.50±0.14)ms,患耳潜伏期较健耳延长(P<0.05);(4)ECochG中-SP振幅耳间差异无统计学意义(P>0.05),AP振幅及-SP/AP振幅比耳间差异有统计学意义(P<0.05)。结论:EHFA、DPOAE、ABR、ECochG检测对于耳鸣患者的耳蜗功能评价具有临床意义。Objective:To analyze the objective test results of the pure-tone audiogram(PTA),extended high-frequency audiometry(EHFA),distortion product otoacoustic emission(DPOAE),auditory brainstem response(ABR),and electrocochleogram(ECochG)in patients with unilateral acute tinnitus,summarize their characteristics and explore their clinical application value in hidden hearing loss.Methods:PTA,DPOAE,ABR,and ECochG tests were performed in 33 patients with unilateral acute tinnitus as the chief complaint.The detection rate and response amplitude of each DPOAE frequency,incubation period,and interval of ABR waves and-SP/AP in ECochG were analyzed.Results:(1)The thresholds of PTA at 0.25-8 kHz in both ears were in the normal range(P>0.05),and the thresholds of PTA at 9-16 kHz in affected ears were higher than those in healthy ears(P<0.001);(2)There was statistical significance in the detection rate and response amplitude of DPOAE at 3,4,6,8 kHz between ears(P<0.05);(3)The incubation period of ABRⅠwave in affected ears was(1.55±0.17)ms,that in the healthy ear was(1.50±0.14)ms,among them,the incubation period of ABRⅠwave in the affected ear was longer than that in the healthy ear,and the difference was statistically significant(P<0.05);(4)In ECochG,there was no significant difference in-SP amplitude between ears(P>0.05),but there was a significant difference in AP amplitude and-SP/AP amplitude between ears(P<0.05).Conclusion:EHFA,DPOAE,ABR,and ECochG have clinical significance in evaluating cochlear function in tinnitus patients.

关 键 词：耳鸣 扩展高频测听 畸变产物耳声发射 听性脑干反应 耳蜗电图 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]