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目的:总结听神经病患者的纯音听阈和声导抗测试特征,探讨纯音听阈和声导抗测试在听神经病诊断中的应用。方法:对确诊听神经病37例(74耳)患者的临床资料、纯音听阈和声导抗测试结果进行总结,并与一般感音神经性耳聋患者30例(49耳)的听力学测试结果比较。结果:听神经病组37例(74耳)纯音听力图上升型53耳(71.6%)。听神经病组纯音听力图左、右耳对称。37例听神经病患者左、右耳的气导纯音听阈升高程度在0.25～4.0kHz,两耳间差异无统计学意义(P>0.10)。镫骨肌声反射21例同侧及交叉声反射均未引出,16例28耳的单项或多项频率镫骨肌声反射可引出,但镫骨肌声反射阈值均升高。听神经病组所有患耳均无响度重振现象,感音神经性聋组9耳重振现象阳性。结论:听神经病表现为双侧对称性、渐进性听力减退,辨不清言语,部分可伴有耳鸣或头晕。纯音听阈多为双侧对称性、低频上升型听力图;言语听力明显差于纯音听力;声导抗测试双耳鼓压导抗图为“A”型曲线;镫骨肌声反射阈值升高或引不出,无响度重振现象。
OBJECTIVE: To summarize the pure tone threshold and the acoustic impedance test characteristics of patients with auditory neuropathy and to explore the application of pure tone threshold and acoustic impedance test in the diagnosis of auditory neuropathy. Methods: The clinical data, pure tone threshold and acoustic impedance test results of 37 patients with auditory neuropathy (74 ears) were summarized and compared with the results of audiometry in 30 patients (49 ears) with sensorineural hearing loss. Results: 37 patients (74 ears) in auditory neuropathy group had 53 ears (71.6%) in pure tone audiogram. Listen neuropathy group pure tone audiogram left and right ear symmetry. Thirty-seven patients with auditory neuropathy left and right ears of the air-conduction pure tone hearing threshold increased at 0.25 ~ 4.0kHz, no significant difference between the two ears (P> 0.10). Twenty-two cases of ossicular acoustical reflex ipsilateral and cross-reflex did not lead to 16 cases of 28 ears single or multiple frequency stapes muscle acoustic reflex leads to, but the stapes muscle acoustic reflex threshold were increased. All patients with auditory neuropathy had no loudness reverberations, and 9 ears with positive sensorineural deafness were positive. Conclusion: Auditory neuropathy is manifested as bilateral symmetry, progressive hearing loss, discernible language, and some may be accompanied by tinnitus or dizziness. Pure tone threshold mostly bilateral symmetry, low frequency rising audiogram; speech audiometry was significantly worse than pure tone hearing; acoustical impedance test of the ear drum pressure transfusions map for the “A” type curve; stapedius muscle acoustic reflex threshold increased Or lead to no loudness revival phenomenon.