正常听阈单侧耳鸣者电生理特征及临床意义  

Electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold

作　　者：吴文静 姜振东 兰发璋 何亚 钟诚 WU Wenjing;JIANG Zhendong;LAN Fazhang;HE Ya;ZHONG Cheng(Department of Otolaryngology,Head and Neck Surgery,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038,China)

机构地区：[1]陆军军医大学(第三军医大学)第一附属医院耳鼻咽喉头颈外科,重庆400038

出　　处：《陆军军医大学学报》2024年第17期2016-2020,共5页Journal of Army Medical University

摘　　要：目的探究正常听阈单侧耳鸣患者电生理特征及临床意义。方法选取2022年5月至2023年2月陆军军医大学第一附属医院耳鼻咽喉头颈外科收治的34例听力正常主诉单侧耳鸣患者作为研究对象,以患侧组与健侧组检测数据进行对比。对患者双侧分别进行纯音听阈检测、畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)、听性脑干反应(auditory brainstem response,ABR)检测及扩展高频测听。结果ABR的波Ⅰ潜伏期患侧组较健侧组明显缩短,且差异具有统计学意义(1.60 vs 1.73 ms,P=0.018)。ABR的波Ⅰ幅值患侧组较健侧组明显下降(0.19 vs 0.23μV,P=0.003)。患侧组34耳中波Ⅲ波幅大于波Ⅴ波幅有18耳(52.94%),健侧组未发现波Ⅲ波幅大于波Ⅴ波幅,2组比较差异具有统计学意义(χ^(2)=24.480,P<0.001)。在12.5、14.0、16.0、18.0、20.0 kHz患侧组34耳扩展高频测听平均听阈值均高于健侧组,差异具有统计学意义(P<0.05)。结论正常听阈主观性耳鸣者进行ABR检查可有助于初步判断听觉通路是否出现隐性功能改变,波Ⅰ幅值下降、波Ⅰ潜伏期缩短、波Ⅲ波幅大于波Ⅴ波幅等可作为客观参考指标。Objective To investigate the electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold.Methods A total of 34 patients with normal hearing but unilateral tinnitus admitted to our department from May 2022 to February 2023 were recruited as the study subjects.Pure tone hearing threshold detection,distortion product otoacoustic emission(DPOAE),auditory brainstem response(ABR)detection and extended high-frequency pure tone audiometry were performed on both ears(affected side and healthy side)of every patient.The data of the affected side group and those of healthy side group were compared.Results TheⅠ-wave latency of ABR was significantly shorter(1.60 vs 1.73 ms,P=0.018),and its amplitude was obviously decreased(0.19 vs 0.23μV,P=0.003)in the affected side group when compared with the healthy side group.In the affected group(34 ears),there were 18 ears(52.94%)having amplitude of waveⅢgreater than that of waveⅤ,while in the healthy group,no such difference in the amplitude between waveⅢand waveⅤwas observed.There was statistical significance between the 2 groups(Chi-square=24.480,P<0.001).In the 12.5,14.0,16.0,18.0 and 20.0 kHz conditions,the average hearing threshold of extended high-frequency audiometry was all significantly higher in the affected side group than the healthy group(P<0.05).Conclusion For subjective tinnitus patients with normal hearing threshold,ABR examination is helpful in preliminarily determining whether there are hidden functional changes in the auditory pathway.DecreasedⅠ-wave amplitude,shortenedⅠ-wave latency,and waveⅢamplitude greater than waveⅤamplitude can be used as objective reference indicators.

关 键 词：听阈正常 单侧耳鸣 隐性听力损失 听性脑干反应 

分 类 号：R338.8[医药卫生—人体生理学] R339.16[医药卫生—基础医学] R764.45