听神经病患者畸变产物耳声发射的特征  

Distortion Product Otoacoustic Emissions in the Diagnosis of Auditory Neuropathy

作　　者：薛飞[1] 王锦玲[1] 孟美娟[1] 高磊[1] 韩丽萍[1] 

机构地区：[1]第四军医大学西京医院耳鼻咽喉科全军耳鼻咽喉专科中心

出　　处：《听力学及言语疾病杂志》2003年第4期258-260,共3页Journal of Audiology and Speech Pathology

摘　　要：目的　观察听神经病患者的畸变产物耳声发射 (distortionproductotoacousticemissions,DPOAE)基本特征 ,探讨DPOAE在听神经病诊断中的意义。方法　用IHSVersion 3 .2型耳声发射仪对 70例 (14 0耳 )听神经病患者、3 0例 (60耳 )听力正常者行DPOAE测试 ,并对 13例 (2 6耳 )听神经病患者在对侧声刺激条件下行DPOAE测试 ,比较两组人群或两种条件下的DPOAE听力图 (DP图 )。结果　听神经病组的DPOAE全部可引出。DP图幅值在低频 (0 .5、0 .7kHz)高于正常对照组 ,平均约高 3 .1dBSPL ,两组间的差异有显著性意义 (P <0 .0 5) ;在中频 (1.0～ 2 .0kHz)、高频 (3 .0～ 8.0kHz)两组间的差异无显著性意义 (P >0 .0 5)。有 /无对侧声刺激两种条件下DP图幅值间的差异亦无显著性意义 (P >0 .10 )。结论　听神经病患者的DPOAE全部可引出 ,DP图幅值在低频高于正常人 ,且对侧声抑制反应消失 ,提示听神经病患者的低频区外毛细胞处于失抑制的超常活动状态 ,听神经病的病变部位可能位于听神经和脑干内侧橄榄耳蜗系统。Objective To observe the basic charac te ristics of distortion product otoacoustic emissions (DPOAEs) in patients with au ditory neuropa thy, and to discuss the significance of DPOAEs in the diagnosis of audi tory neuropathy. Methods The DPOAEs of 70 auditory neuropathy patients (14 0 ears) and 30 young subjects (60 ears) with normal hearing were examined with I HS Version 3.2 Otodynamics Analyzer. The DPOAEs of 13 auditory neuropathy patien ts (26 ears) were examined with or with out the contralateral acoustic st imulation. The DPOAEs-gram of both groups and both conditions were recorded and analyzed. Results The DPOAEs were normal in all auditory neuropathy patients. But, the DP-gram amplitude of the auditory neuropathy group was highe r (average 3.1 dB SPL) obviously (P<0.05) than the normal control group at low frequencies (0.5、0.7 kHz), but similar (P>0.05) at intermediate freq uencies (1.0～2.0 kHz) and high frequencies (3.0～8.0 kHz). The DP-gram amplitudes of both conditions had no sig nificant difference (P>0.10). Conclusion The DP-gram amplitudes of auditory neuropathy patients are higher th an normal subjects at low frequencies, and the contralateral suppression effects are disappeared. It seems that the outer hair cells of low frequency area in auditory neuropathy patients are at the state of over vigorou s activity for the lost of suppression. Now the lesions of auditory neuropathy are focused on acoustic nerv e and brain stem medial olivocochlear system.The DPOAEs are most important in the diagnosis and rese arches of auditory neuropathy.

关 键 词：听神经病 感音神经性聋 畸变产物耳声发射 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]