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目的:分析听力正常的耳鸣患者的耳蜗功能,探讨耳鸣的客观检查手段。方法:对听力正常的单侧 耳鸣患者50例(50耳,耳鸣1组)、听力正常的双侧耳鸣患者23例(46耳,耳鸣2组)和正常人34例(68耳,对照 组)进行瞬态诱发耳声发射(TEOAE)和畸变产物耳声发射(DPOAE)。耳鸣1、2组同时进行耳鸣频率匹配检查, 并分析在TEOAE及DPOAE测试结果中有无相应表现。结果:①TEOAE通过率,耳鸣1组为64.0%,耳鸣2组 为91.3%,对照组为100%(1组P<0.01,2组P>0.05);②DPOAE通过率,3组均为100%;但耳鸣1组在 3.125kHz及8.837kHz的波幅均值较对照组低,两组差异具有统计学意义(P<0.05);③耳鸣音调分布为0.25 ～8.00kHz。在TEOAE频谱中及DPOAE听力图中,部分耳表现出与匹配频率相对应的低反应峰或频率成分 缺失以及低幅值。结论:部分听力正常的耳鸣患者已有耳蜗毛细胞的损害;TEOAE及DPOAE可以作为外周性 耳鸣诊断的一种客观检测方法;前者对耳蜗性耳鸣的早期诊断敏感而直观,而后者适用于耳鸣的频率分析。
Objective: To analyze the cochlear function of tinnitus patients with normal hearing and to explore the objective examination method of tinnitus. Methods: Fifty patients with unilateral tinnitus (50 ears and 1 group of tinnitus) with normal hearing, 23 patients with bilateral normal tinnitus (46 ears and 2 groups with tinnitus) and 34 normal subjects (68 ears and control group) Transient Evoked Otoacoustic Emissions (TEOAE) and Distortion Product Otoacoustic Emissions (DPOAE) were performed. The tinnitus group 1 and group 2 were examined for tinnitus frequency matching at the same time, and analyzed whether TEOAE and DPOAE test results had any corresponding performance. Results ① The passing rate of TEOAE was 64.0% in group 1 with tinnitus, 91.3% in group 2 with tinnitus and 100% in control group (P <0.01 in group 1 and group P> 0.05). ② The passage rate of DPOAE was 100% in 3 groups. However, the mean amplitude of the tinnitus group at 3.125kHz and 8.837kHz was lower than that of the control group, and the difference between the two groups was statistically significant (P <0.05). The tinnitus tone distribution was 0.25-8.00kHz. In the TEOAE spectrum and in the DPOAE audiogram, some of the ears showed a low response peak or loss of frequency component and a low amplitude corresponding to the matching frequency. CONCLUSION: Some patients with normal hearing tinnitus have damaged cochlear hair cells. TEOAE and DPOAE can be used as an objective method for the diagnosis of peripheral tinnitus. The former is sensitive and direct to the early diagnosis of cochlear tinnitus, while the latter is suitable for tinnitus Frequency analysis.