耳声发射在早期梅尼埃病和前庭性偏头痛鉴别诊断中的价值初探  

Preliminary exploration of the differential diagnostic value of otoacoustic emissions in early Meniere's disease and vestibular migraine

作　　者：孙政涛 刘博[1] 张祎[1] SUN Zhengtao;LIU Bo;ZHANG Yi(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,BeijingInstitute of Otolaryngology,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministryof Education,Beijing,100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京市耳鼻咽喉科研究所,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730

出　　处：《中国耳鼻咽喉头颈外科》2024年第8期497-500,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家重点研发计划(2020YFC2005200);北京同仁医院重点医学发展计划(trzkyxzy201802)。

摘　　要：目的分析梅尼埃病和前庭性偏头痛的畸变产物耳声发射(DPOAE)特征,探讨DPOAE在二者鉴别诊断中的参考价值。方法纳入在北京同仁医院确诊并连续入组的单侧梅尼埃病患者35例,年龄(41.86±10.77)岁,男21例,女14例;前庭性偏头痛患者32例,年龄(39.97±8.99)岁,男7例,女25例,分析两组纯音听阈和DPOAE的反应幅值及信噪比,并对两组患者中平均听阈正常者进一步对比分析。结果(1)纳入的全部患者中,梅尼埃病组DPOAE在0.7~8 kHz范围内的反应幅值及信噪比均低于前庭性偏头痛组(P均<0.05);(2)平均听阈正常者中,梅尼埃病组在1 kHz处较前庭性偏头痛组的DPOAE信噪比低(Z=-2.495,P=0.013)。结论DPOAE可评估梅尼埃病及前庭性偏头痛患者的耳蜗功能并辅助早期疾病的鉴别诊断。OBJECTIVE To analyze the distortion product otoacoustic emissions(DPOAE)characteristics in patients with Ménière disease(MD)and vestibular migraine(VM),and explore the diagnostic value of DPOAE in MD and VM.METHODS There were 35 unilateral MD patients[age(41.86±10.77)years;21 males,14 females]and 32 VM patients[age(39.97±8.99)years;7 males,25 females]who were diagnosed at Beijing Tongren Hospital were included.Pure-tone audiometry thresholds and DPOAE response amplitudes and signal-to-noise ratios(SNR)were analyzed.Further analysis was conducted on DPOAE results in patients with normal average hearing thresholds in both groups.RESULTS 1.DPOAE results of all included patients indicated that DPOAE response amplitudes and SNR in the MD group were lower than those in the VM group within the 0.7-8 kHz range(P<0.05);2.Comparative analysis of the two groups with normal average hearing thresholds revealed a lower DPOAE SNR at 1 kHz in the MD group compared to the VM group(Z=-2.495,P=0.013).CONCLUSION The MD group exhibited lower DPOAE response amplitudes and smaller SNR;a comparison of the two groups with normal mean hearing thresholds also showed a reduced SNR at 1 kHz in the MD group.These findings suggest that DPOAE assessment can be a valuable tool in evaluating cochlear function and aiding in the early differential diagnosis of MD and VM.

关 键 词：偏头痛 梅尼埃病 诊断 畸变产物耳声发射 前庭性偏头痛 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]