扩展高频畸变产物耳声发射在纯音听阈正常的耳鸣患者中的临床应用
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1.中南大学湘雅二医院;2.广州优听电子科技有限公司

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高频畸变产物耳声技术在轻度或不伴耳聋的耳鸣患者中的应用研究,长沙市自然科学基金,kq2208327


The investigation of Extended High Frequency in diagnosis the hidden hearing loss for the Idiopathic Tinnitus Patient with "Normal Hearing"
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    摘要:

    目的 分析纯音听阈正常的耳鸣患者扩展高频耳声发射畸变产物(EHF DPOAE)的特点,探讨在常规纯音检测结果正常情况下,EHF DPOAE发现早期隐匿性听力损失的临床意义。方法 选取常规纯音听阈正常的耳鸣患者100例(164耳)为实验组,对照组为纯音听阈无耳鸣症状的志愿者50(100耳)。两组均用Neuro-Audio耳声发射仪进行常规频率(1-6 kHz)畸变产物(DPOAE)测试 、EHF DPOAE(8-12kHz) DPOAE测试。结果 对照组常规频率DPOAE的平均检出率为97.225%,EHF DPOAE的检出率为88.7%;实验组中常规频率DPOAE的检出率为72.2%,EHF DPOAE的检出率为51.23%。对照组EHF DPOAE 8 kHz、10 kHz、12 kHz平均幅值(DP)分别为:3.00、1.75、-2.90dB。实验组EHF DPOAE 8 kHz、10 kHz、12 kHz平均幅值(DP)分别为:-8.39、-11.55和-17.93dB。对照组EHF DPOAE 8 kHz、10 kHz、12 kHz平均信噪比(SNR)分别为:11.4119、10.6407、5.4898dB。实验组EHF DPOAE 8 kHz、10 kHz、12 kHz平均信噪比(SNR)分别为:4.4795、2.4419、-3.8128dB。实验组EHF DPOAE引出率明显低于对照组EHF DPOAE 引出率(P<0.001)。实验组EHF DPOAE中DP值明显低于对照组EHF DPOAE的DP值(P<0.001)。实验组EHF DPOAE的SNR值明显低于对照组EHF DPOAE的SNR值(P<0.001)。结论 在常规纯音听力检测正常的特发性耳鸣患者中,EHF DPOAE的引出率明显低于常规频率DPOAE的引出率,且EHF DPOAE的每个频率DP值有明显下降,提示EHF DPOAE相对于常规频率DPOAE对“听力正常”耳鸣患者的隐匿性听力损失有较高的敏感性,能较早地反映其耳蜗外毛细胞功能状态。

    Abstract:

    Objective: To investigate the characteristic of Extended High Frequecy DPOAE for the Idiopathic Tinnitus patient with normal hearing threshold,and investigate the clinical values for finding the earlier hidden hearing loss with Extended High Frequency DPOAE. Method: The experimental group was including 68 tinnitus subjects with normal PTA (104 ears) , and control group was including 40 normal PTA subjects without tinnitus (40 ears) , both of two groups subjects were measured the routine DPOAE( frequencies ranged from 1-6kHz) and Extended 8-12kHz DPOAE by using Neuro-Audio Otoacoustic Emission Analyzer. Result: The detectable rate of routine DPOAE measurement for control group was 97.225%, and Extended High Frequency DPOAE 88.7%; the routine DPOAE for experimental group 72.2%, Extended High Frequency DPOAE 51.23%. the averaged DP level of control group for frequencies 8 kHz、10 kHz、12 kHz were 3.00、1.75 and-2.90dB, the experimental group were -8.39、-11.55 and -17.93dB. the averaged SNR of control group for frequencies 8 kHz、10 kHz、12 kHz were 11.4119、10.6407 and 5.4898dB, the averaged SNR of experimental group for frequencies 8 kHz、10 kHz、12 kHz were 4.4795、2.4419 and -3.8128dB.The detectable rate of Extended High Frequency DPOAE for experimental group was significantly lower than the control group(P<0.001),and also was significantly lower than the routine DPOAE measurement(P<0.05), the DP level of Extended High Frequency DPOAE for experimental group was also significantly lower than the control group(P<0.001, and the averaged SNR of experimental group was significantly lower than the control group(P<0.001). Conclusion: The detectable rate of Extended High Frequency DPOAE was significantly lower than the routine DPOAE measurement for normal PTA subjects with tinnitus ,the DP level of Extended High Frequency DPOAE was decreased significantly, indicated that the Extended High Frequency DPOAE has higher sensitivity in diagnosis the hidden hearing loss for the Idiopathic Tinnitus Patient with "Normal Hearing" than the routine DPOAE measurement, and can reflect the earlier functional status of cochlear outer hair cell.

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  • 收稿日期:2023-03-31
  • 最后修改日期:2023-05-19
  • 录用日期:2023-05-25
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