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目的:对纯音听阈正常的耳闷患者进行诱发性耳声发射分析,以早期发现这些患者的耳蜗损害。方法:采用丹麦Madsen公司Capella耳声发射仪对纯音听阈正常的耳闷患者43例(72耳,耳闷组)及正常人30例(60耳,对照组)分别进行TEOAE及DPOAE检测,记录和分析各频率DPOAE的检出率、幅值,TEOAE的通过率、反应波信噪比、波形重复性及各频带反应波信噪比和重复性。结果:①DPOAE检出率仅在0.50、0.75kHz两频点上耳闷组明显低于对照组(P<0.05),其余各频率点差异均无统计学意义(P>0.05);②TEOAE通过率对照组为100%,耳闷组为90.28%,2组比较差异有统计学意义(χ2=6.16,P<0.05);③与对照组相比,纯音听阈正常的耳闷患者各频率DPOAE的幅值、TEOAE的反应波信噪比、波形重复性及各频带反应波信噪比和重复性均降低,差异有统计学意义(P<0.05或P<0.01)。结论:部分纯音听阈正常的耳闷患者已存在耳蜗外毛细胞的损害,利用诱发性耳声发射的方法可在其听力损失出现之前早期发现此类病变。
OBJECTIVE: To analyze induced otoacoustic emissions in patients with normal ears with pure tone hearing thresholds to detect early cochlear damage in these patients. Methods: Forty-three cases (72 ears, stuffy ears group) and 30 normal subjects (60 ears, control group) with Capella otoacoustic emissions were used to detect TEOAE and DPOAE, The DPOAE detection rate, amplitude, TEOAE passing rate, response signal-to-noise ratio, waveform repeatability and signal-to-noise ratio and repeatability of each band were analyzed. Results: (1) The detection rate of DPOAE was significantly lower than that of the control group (P <0.05) at the frequencies of 0.50,0.75 kHz, while there was no significant difference among the other frequencies (P> 0.05); ②The TEOAE passing rate (Χ2 = 6.16, P <0.05); ③ Compared with the control group, the amplitude of DPOAE in each group of patients with normal tone of pure tone hearing threshold , TEOAE signal-to-noise ratio, waveform repeatability and signal-to-noise ratio and repeatability of each band are all reduced, the difference was statistically significant (P <0.05 or P <0.01). CONCLUSION: Cochlear outer hair cells are already damaged in some patients with normal hearing loss in pure tone threshold. The use of evoked otoacoustic emission can detect such lesions early before hearing loss occurs.