纯音听阈值正常的中青年耳鸣群体耳蜗功能分析  

Analysis of Cochlear function in young and middle-aged tinnitus patients with normal pure tone audiometry threshold

作　　者：熊彬彬 卢子昂 杨晶 徐文强 周潞茹 孙平原 袁丁 朱佳浩 XIONG Binbin;LU Ziang;YANG Jing;XU Wenqiang;ZHOU Luru;SUN Pinyuan;YUAN Ding;ZHU Jiahao(Center for hearing and balance,Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine,Zhuhai 519000,Guangdong,China;Department of Otorhinolaryngology,Shenzhen Longhua District Central Hospital,Shenzhen 518110,Guangdong,China)

机构地区：[1]珠海市中西医结合医院听力障碍与眩晕诊疗中心,广东珠海519000 [2]深圳市龙华区中心医院耳鼻咽喉科,广东深圳518110

出　　处：《山东大学耳鼻喉眼学报》2023年第4期62-67,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：2022年珠海市社会发展领域科技计划重点项目(222000400085);2021年广东省临床教学基地教学改革研究项目(2021JD152)。

摘　　要：目的通过纯音听阈值正常的中青年耳鸣群体的耳声发射结果探讨耳鸣群体的耳蜗功能对耳鸣发生的作用。方法回顾性分析比较64例中青年耳鸣患者和30例纯音听阈值正常的无耳鸣人群畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)、瞬态诱发耳声发射(transient evoked otoacoustic emission,TEOAE)、自发性耳声发射(spontaneous otoacoustic emission,SOAE)的结果,并对SOAE的频率和耳鸣群体的耳鸣匹配频率进行分析和比较。结果耳鸣组和对照组性别、年龄和平均纯音听阈阈值差异均无统计学意义(P=0.079,P=0.078,P=0.081)。耳鸣组和对照组DPOAE测试所有频率的通过率,除6000 Hz(P=0.012)外,两组之间差异无统计学意义(P均>0.05)。耳鸣组和对照组TEOAE测试所有频率的通过率两组之间差异有统计学意义(P均<0.05)。对照组SOAE引出率为31.67%,频率范围分布在1211~4453 Hz;耳鸣组SOAE引出率为43.62%,频率范围分布在859~4570 Hz,两组之间无统计学差异(χ^(2)=2.199,P=0.138)。SOAE的频率和耳鸣匹配的频率之间无明显相关性(r=0.1143,P=0.540)。结论纯音听阈值正常的中青年耳鸣患者的DPOAE和TEOAE的通过率与无耳鸣人群有明显差异,但仅在某些频率点出现异常,提示大部分听力正常的耳鸣患者耳蜗功能可能存在轻度损伤,虽不影响阈值,但作为参与耳鸣发生的一种隐匿性损伤值得关注和重视。Objective Otoacoustic emission(OAE)data were analyzed to explore cochlear function in young and middleage adults with tinnitus and normal puretone thresholds.Methods Data from 30 non-tinnitus patients with normal puretone average(PTA)threshold and 64 young and middleage patients with tinnitus were collected from a tinnitus clinic from September 2021 to June 2022.All patients underwent objective testing by audiologists including distortion product otoacoustic emission(DPOAE),transient evoked otoacoustic emission(TEOAE),and spontaneous otoacoustic emission(SOAE).Results were compared,and the frequency of SOAE and the frequency of precision tinnitus matching were analyzed and compared.Results There were no statistically significant differences in sex,age,or average PTA threshold between the tinnitus patients and normal young individuals(P1=0.079,P2=0.078,P3=0.0810,respectively).DPOAE testing revealed no statistically significant differences in pass rates for all frequencies between the tinnitus and the control groups(P>0.05)except at 6000 Hz(P<0.05).In contrast,TEOAE testing revealed a statistically significant difference in pass rate for all frequencies between the two groups(P<0.05).Elicited SOAE rates in the control and tinnitus groups were 31.67%and 43.62%,respectively,ranging from 1211 Hz to 4453 Hz and 859 Hz to 4570 Hz,respectively,with no statistical difference between the groups(χ^(2)=2.199,P=0.138).Finally,there was no significant correlation between the frequency of SOAE and the frequency of precision tinnitus matching(r=0.1143,P=0.540).Conclusion DPOAE and TEOAE pass rates in young and middleage patients with tinnitus and normal PTA threshold were significantly different from individuals without tinnitus.The differences occurred at some frequency points,which suggests early stages of mild cochlear damage but not yet affecting the threshold.As a“hidden”injury among patients with tinnitus,this warrants attention.

关 键 词：耳鸣 瞬态耳声发射 畸变耳声发射 自发性耳声发射 耳鸣精细化测试 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]