老年性痴呆患者的听觉损害

目的　确定老年性痴呆患者 (seniledementiaoftheAlzheimer′sdisease ,AD)有无周围性听功能障碍及其与认知障碍的关系。方法　利用纯音测听、言语识别率、声导抗、听觉脑干反应检测AD患者 43例 ,健康老年人 50例 ,评定受试者测听可信度 ,统计测试结果 ,并将上述结果同受试者简易精神状态量表 (mini mentalscaleofequastionnaire ,MMSE)得分进行对照分析 ,寻找二者之间的关系。结果　受试者两耳间周围听力差异无显著性 ,以右耳听力结果 ( x±s)进行统计。AD组纯音听阈为 (2 6 3± 8 5)dBHL和 (2 9 1± 8 7)dBHL ,言语识别率为 (85 5± 5 5) % ;对照组纯音听阈为 (2 3 2± 1 0 6)dBHL和 (2 6 2± 1 1 8)dBHL ,言语识别率为 (87 6± 6 8) %。虽然AD组周围听功能检查结果低于对照组 ,但无统计学意义 (P >0 0 5)。测听可信度、声导抗和ABR阈值两组间差异无显著性 (P >0 0 5)。结论　老年性痴呆患者纯音听阈和言语识别率与老年聋相似 ,其周围听功能障碍与MMSE认知量表得分无关。     

0.25%氯霉素浸棉膜片贴补法治疗外伤性鼓膜穿孔

目的　研究 0 .2 5 %氯霉素浸棉膜片贴补法治疗外伤性鼓膜穿孔的疗效。方法　治疗组 4 7例 (5 8耳 )鼓膜穿孔采用 0 .2 5 %氯霉素浸棉膜片贴补修复 ,并于每日早晚用 0 .2 5 %氯霉素滴耳剂滴耳。对照组 4 3例 (5 2耳 )仅用抗生素预防感染。观察并比较两组的鼓膜穿孔愈合情况及听力提高程度。结果　治疗组治愈率 93.6 2 (44 / 4 7) ,语频气导听阈平均提高 2 2 .5± 5 .0dBHL ;对照组治愈率 6 7.4 4 (2 9/ 4 3) ,语频气导听阈平均提高 2 0 .0± 5 .0dBHL ,两组比较 ,有显著性差异 (P <0 .0 1)。结论　 0 .2 5 %氯霉素棉膜片贴补法治疗外伤性鼓膜穿孔效果满意 ,值得推广。     

正常青年人常用频率及延伸高频声场测试的比较研究

目的　探讨和比较正常青年人常用频率 (12 5Hz～ 8kHz)与延伸高频 (9～ 16kHz)声场 (啭音 )听阈测试结果的不同特点 ,为延伸高频声场测试的临床应用提供参考依据。方法　对一组听力正常青年人 (男 5 2人 ,女48人 )行常用频率及延伸高频声场 (啭音 )听阈测试 ,并对结果进行统计学处理。结果　听力正常青年男女间声场(啭音 )延伸高频平均听阈 (HFA)、常用频率平均听阈 (CFA)和言语频率平均听阈 (SFA)无显著差异 (P >0 .0 5 )。测试样本各频率间平均听阈的比较显示 ,延伸高频的测听阈值随着频率的提高而增大。延伸高频平均听阈 (HFA)、常用频率平均听阈 (CFA)和言语频率平均听阈 (SFA)分别为 17.60 3 1± 6.8679;8.90 62± 2 .5 82 9;5 .80 0 0± 3 .2 2 62 ,相互比较显示 ,前者显著高于后二者 (P <0 .0 1) ,并呈显著的正相关 (P <0 .0 5 )。结论　延伸高频听阈对常用频率听阈、语言频率听阈损失具有一定的早期预示作用 ,但在临床应用延伸高频声场 (啭音 )的听力测试来评估听力损害时 ,应考虑到频率的影响作用     

正常青年人多频稳态听觉诱发反应测试

目的 :测定正常青年人多频稳态听觉诱发反应 (ASSR)阈值 ,为临床诊断提供客观依据。方法 :选正常青年人 2 2例 (4 4耳 ) ,行ASSR阈值测试。结果 :在 0 .2 5～ 8.0kHz频区间 ,ASSR平均阈值约在 4 0～ 6 0dBHL之间 ,从低频到高频其阈值越来越高 ,0 .2 5kHz、0 .5kHz、1.0kHz处的ASSR平均阈值约为 4 0dBHL ,2 .0kHz处约为 4 5dBHL ,4 .0kHz处约为 5 0dBHL ,8.0kHz处约为 6 0dBHL。ASSR阈值与纯音听阈间差值多在2 5～ 5 5dBHL之间 ,从低频到高频其阈差值越来越高 ,0 .2 5kHz处的差值约为 2 5dBHL ,0 .5kHz处约30dBHL ,1.0kHz处约 35dBHL ,2 .0kHz处约 4 0dBHL ,4 .0kHz处约 5 0dBHL ,8.0kHz处约 5 5dBHL。结论 :正常青年人ASSR阈值与纯音听阈间有一定差值。利用这一差值 ,通过测试ASSR阈值可推断出被检查者纯音听阈的阈值     

双瓣后推法先天性腭裂修复术对听力的影响

我院自 2 0 0 0～ 2 0 0 2年共发现 2 0例先天性腭裂患者行双瓣后推法修复术后 ,出现听力下降症状 ,现总结报告如下 :1　资料与方法1.1　一般资料　本组共 2 0例 ( 4 0耳 ) ,男 12例 ,女 8例 ;年龄6～ 12岁 12例 ,13～ 18岁 8例 ;Ⅱ度腭裂 9例 ,Ⅲ度腭裂 11例 ,其中Ⅲ度右侧腭裂 7例 ,左侧腭裂 4例。1.2　临床检查　术前所有病例鼓膜完整 ,但内陷 ,而且部分患者鼓膜运动受限 ,后者主要是表现在年龄较大者。术前患者纯音听阈测试 0 .5、1.0和 2 .0kHz的气导听阈分别为 2 8.75± 7.75、31.75± 6 .0 3和 2 9.2 5± 10 .2 5dBHL ,骨导正常 (…     

甘油对突发性聋的治疗作用

目的　观察甘油对突发性聋的治疗作用。方法　将 6 0例突聋者分成甘油治疗组 (A组 )和对照组 (B组 ) ,A组除加服 5 0 %甘油盐水外 ,其余治疗与B组相同 ,包括高压氧、扩血管药、能量制剂和激素治疗。并分别于治疗前和治疗后 10天测试患者的听力。结果　治疗前A组和B组的平均听阈分别为 70 .6 7± 2 0 .43dBHL和 6 7.5 8± 36 .18dBHL(P >0 .0 5 ) ,治疗后两组听力平均提高分别为 30 .0 9± 2 0 .43dB和 18.42± 18.0 5dB(P <0 .0 5 )。结论　甘油有助于提高突聋的治疗效果     

社区老年人群纯音听阈测试结果分析

目的获得社区老年人群纯音听阈的正常值，为选取敏感频率测试老年人听阈提供参考依据。方法采用整群随机抽样方法，选取60岁以上社区老年人845例，按平均听阈（0．5、1、2和4kHz听阈平均值）≤40dBHL为正常或轻微损失，筛选205人，按60～65岁、66～70岁、71～75岁和76岁以上分组，计算各年龄组在0．5、1、2、3、4和8kHz的听阈及听阈检出率，采用SPSSl3．0软件进行）x^x检验和方差分析。结果听力正常老年人群不同年龄组听阈值存在显著差异（P〈0．01），随着年龄增长，听阈值呈增高趋势；不同频率听力测试显示不同频率组听阈值存在显著差异（P〈0．01）。各年龄组的听阈随频率的增高而增高，随频率、年龄增高，听阈检出率呈下降趋势。结论高频较低频测听能够早诊断老年人听力损失，可作为检测老年人早期听力损失的客观手段。     

坑道噪声及MP3对某部队官兵听力影响的调查研究

目的为研究坑道混合型噪声及随身听设备对人体听觉系统的影响规律,进一步加强对坑道作业人员的听力防护,调查坑道作业噪声及随身听对部队官兵听觉系统的危害。方法对总参某部从事坑道作业人员73人和长时间使用MP3的人员53人进行问卷调查,除外耳鼻咽喉科其他疾病,进行纯音测听和声导抗检查。听力检查前脱离噪声20小时以上,在隔音室内进行纯音和声导抗检查。用Stata软件对听力检查结果进行统计分析。结果听力检查发现坑道作业组出现语频听力下降3人(4.11%,3/73),平均听阈50dBHL;出现高频听力损伤30人(41.10%,30/73),频率主要为3.0kHz、4.0kHz、6.0kHz、8.0kHz高频区,平均听阈46dBHL。使用MP3的人员中无语频听力下降,高频听力损伤人数为17人(32.08%,17/53),平均听阈45dBHL。坑道作业组语频听力损失比例与长期使用MP3组无统计学差异(P>0.05),高频听力损失两组发生比例差异无显著性(P>0.05)。结论坑道噪声可能引起坑道作业人员的听力下降,需进一步加强噪声防护。长期使用MP3也可引起听力损伤。     

正常人扩展高频测听结果报告

目的研究正常人扩展高频听敏度,观察扩展高频听力随年龄增加的细微变化.方法用意大利Amplaid-460型听力计,频率范围8～18kHz.测试正常人128人、256耳,17～50岁,男92人,女36人,其中17～29岁90人,30～50岁38人,125Hz～8kHz纯音各频率听阈≤20dBHL,声导抗测听正常.以5岁为一年龄段分5组进行分析.结果1.正常年轻人(17～29岁)高频听阈总的趋势是随频率提高,听阈逐渐增加,出现率逐渐下降,在14kHz以上频率更为显著;2.正常人17～19岁、20～24岁、25～29岁、30～34岁、35岁以上各年龄组间12、14、16、18kHz听阈相比差异有显著性(P＜0.05),随年龄增加听阈逐渐提高,高频听阈出现率逐渐下降,随频率增加各年龄组差距逐渐明显,14kHz以上频率最为明显.结论人耳的老化是一个逐渐的过程,随年龄增加听阈提高.频率越高受影响越明显.扩展高频纯音测听结果可反映耳蜗亚临床病理状态,有利于早期发现听觉感受器病变,可用于临床监测耳毒性听力损失和早期诊断梅尼埃病等.     

急性低频感音神经性聋的临床研究

目的探讨急性低频感音神经性聋（acute low-frequency sensorineural hearing loss,ALHL）的临床特征和疗效,提高对该疾病的认识和鉴别能力。方法回顾性分析42例（42耳）ALHL的临床表现、听力学检测结果和2～5年的随访情况,总结ALHL的临床发病特征。结果本组42例（42耳）ALHL呈急性发病,年龄27～44岁。男16例（38.10%）,女26例（61.90%）。20例（20耳）伴低调耳鸣,17例（17耳）伴耳部堵闷,11例（11耳）伴听觉过敏现象,6例（6耳）伴有头昏。0.125～1kHz平均听阈为（38.74&#177;4.62）dBHL,2～8kHz平均听阈为（13.52&#177;3.86）dBHL,治疗后上述平均听阈分别为（21.05&#177;9.74）dBHL和（19.85&#177;9.44）dBHL。所有病人的听性脑干反应（auditory brainstem response,ABR）各波潜伏期及波间期正常。畸变产物耳声发射（distortion product otoacoustic emissions,DPOAE）在低频区引出率为16.67%,高频区引出率为85.71%。结论ALHL以单侧发病为主,常伴低调耳鸣、耳部堵闷及胀满感。该病多见于青年女性。纯音听阈以低频听阈升高为特征,ABR正常。病变可能位于耳蜗顶周。     

Extra-High Frequency Hearing Loss and Hyperlipidemia

Auditory thresholds in the extra-high frequency (EHF) range (10-18 kHz) were determined for twenty normal and twenty hyperlipidemic subjects. Subjects all passed a standard frequency auditory screening; all were otologically normal; all were aged between 20 and 50 years; none had a positive history of noise exposure. Modest, although significant, relationships were found between serum lipid levels and EHF acuity. Right ear thresholds and thresholds at 14 kHz showed the larger differences between the normals and hyperlipidemics     

高频测听在语频听力正常的耳鸣患者中的应用及其意义

目的 观察语频听力正常的耳鸣患者的高频测听结果并探讨其临床意义。方法 应用8－20kHz的纯音听力计对语频听力正常（≤25dB HL）的耳鸣组患者35例（60耳）和相同年龄段的正常对照组人群30例（60耳）进行高频测听。结果 耳鸣组患者的高频听阈检测结果显示，随频率增高，听阈逐渐提高，听阈检出率逐渐下降。相同频率耳鸣组患者与对照组人群移的差异有显著性意义（P＜0.05），14－20kHz范围内两组听阈检出率差异也有显著性意义（P＜0.01）。结论 耳鸣组患者高频听阈明显高于正常对照组，在14kHz以上听阈检出低于正常对照组。高频测听能够在早期为耳鸣患者提供听力受损的直接参考依据，患者的高频听务损失，可能在最初的耳鸣发生中起一定的作用。     

Specificity of the Human Frequency Following Response for Carrier and Modulation Frequency Assessed Using Adaptation

The frequency following response (FFR) is a scalp-recorded measure of phase-locked brainstem activity to stimulus-related periodicities. Three experiments investigated the specificity of the FFR for carrier and modulation frequency using adaptation. FFR waveforms evoked by alternating-polarity stimuli were averaged for each polarity and added, to enhance envelope, or subtracted, to enhance temporal fine structure information. The first experiment investigated peristimulus adaptation of the FFR for pure and complex tones as a function of stimulus frequency and fundamental frequency (F0). It showed more adaptation of the FFR in response to sounds with higher frequencies or F0s than to sounds with lower frequency or F0s. The second experiment investigated tuning to modulation rate in the FFR. The FFR to a complex tone with a modulation rate of 213 Hz was not reduced more by an adaptor that had the same modulation rate than by an adaptor with a different modulation rate (90 or 504 Hz), thus providing no evidence that the FFR originates mainly from neurons that respond selectively to the modulation rate of the stimulus. The third experiment investigated tuning to audio frequency in the FFR using pure tones. An adaptor that had the same frequency as the target (213 or 504 Hz) did not generally reduce the FFR to the target more than an adaptor that differed in frequency (by 1.24 octaves). Thus, there was no evidence that the FFR originated mainly from neurons tuned to the frequency of the target. Instead, the results are consistent with the suggestion that the FFR for low-frequency pure tones at medium to high levels mainly originates from neurons tuned to higher frequencies. Implications for the use and interpretation of the FFR are discussed.     

分泌性中耳炎的中耳共振频率变化

对正常人６０耳及分泌性中耳炎８４耳，进行中耳共振频率和鼓室导抗图测试，显示正常人组中耳共振频率为８１４±１６４Ｈｚ，中耳积液组中耳共振频率为２９２±１３４Ｈｚ，中耳积液时，质量增大，要达到共振，共振频率必须向低频区移动。治愈后１～２个月，有３８耳再进行多频率扫描，中耳共振频率为７８６±１３９Ｈｚ，与正常人组接近。分泌性中耳炎８４耳中，鼓室导抗图分别为：Ｂ型６９耳、Ｃ型１０耳、Ａ型５耳；而８４耳中中耳共振频率有７９耳＜４２６Ｈｚ（积液组Ｘ＋Ｓ）。在临床上，中耳共振频率的改变、Ｂ型鼓室导抗图，结合鼓膜改变，能更迅速、更准确地诊断本病     

Frequency map variations in squirrel monkey primary auditory cortex

OBJECTIVE: The goal of this work is to understand the neural basis for cortical representation of hearing in highly vocal primates to gain insights into the substrates for communication. Variation patterns in frequency representation among animals are incorporated into an explanatory model to reconcile heterogeneous observations. STUDY DESIGN: Prospective. METHODS: Thirty-four squirrel monkeys underwent microelectrode mapping experiments in primary auditory cortex (AI) using tone pip stimuli. Characteristic frequency (CF) was extracted from the excitatory frequency receptive field. Frequency maps were reconstructed using Voronoi-Dirichlet tessellation. The spatial locations (rostral vs. caudal) of highest CF isofrequency contours (minimum length 1 mm) and highest CF neuronal clusters on the temporal gyral surface were analyzed. RESULTS: Isofrequency contours at least 1 mm long with CFs greater than 2.9 kHz (75% cases) are accessible on the temporal gyrus. Variability of the highest CF isofrequency contours accessible on the temporal gyrus has an interquartile range from 2.9 to 5.1 (mean 4.3) kHz. The highest CF isofrequency contours are located mainly in rostral AI, whereas the highest CF neuronal clusters flanking fully expressed isofrequency contours are equally distributed in rostral and caudal locations. CONCLUSIONS: Squirrel monkey AI frequency map variations are sizeable across animals and small within single animals (interhemispheric comparison). AI frequency map variations, modeled as translations and rotations relative to the lateral sulcus, are independent transfers. Caution must be exercised when interpreting nominal frequency map changes that are attributed to hearing loss and auditory learning effects.     

Performance of High Frequency Impaired Listeners with Conventional and Extended High Frequency Amplification

This study sought to determine if a high-pass hearing aid can provide increased improvement in word recognition and consonant discrimination over that of a conventional high frequency emphasis hearing aid in listeners with hearing loss limited to frequencies above 1 000 Hz. Word and consonant discrimination were assessed in quiet and in the presence of 12 talker speech babble for 10 subjects under three listening conditions: (1) unaided; (2) wearing a conventional high frequency emphasis hearing aid, and (3) wearing an experimental high-pass instrument. The speech testing materials included: (1) Northwestern University Auditory Test No. 6; (2) California Consonant Test, and (3) eight voiceless English consonants. Results suggested that both instruments provided similar benefit in quiet for improving word recognition and resolving consonant errors. For the noise condition, however, the experimental high-pass aid provided a considerable advantage in both word recognition and consonant identification and was particularly sensitive to reducing within- and between-manner voiceless consonant confusions. Furthermore, measurements of real-ear gain revealed that the high-pass aid afforded considerably greater acoustic gain above 4 000 Hz than that shown for the conventional high frequency emphasis hearing aid.

Nous avons, chez 10 sujets atteints d'une pertc d'audition pour les fréquences supérieures à 1 kHz, cherché à établir si un appareil expérimental de correction auditive passe-haut peut, davantage qu'un appareil classique à amplification préférentielle pour les fréquences hautes et dont le gain chute après 4 kHz, améliorer la discrimination de mots et de consonnes dans le calme et aussi en présence d'un bruit de conversation de 12 personnes. Les deux appareils se sont révélés identiques pour la discrimination dans le calme; mais dans le bruit, l'appareil expérimental s'est révélé etre nettement plus efficace.     

多频率扫描声导抗测试对中耳病变的诊断价值

目的　进一步了解多频率扫描声导抗测试对鼓室完整的中耳病变的诊断价值。方法　对正常耳 (2 3耳 )、听骨链固定 (2 0耳 )、听骨链中断 (18耳 )、分泌性中耳炎 (2 0耳 )进行了多频率扫描声导抗测试。结果　正常耳中耳共振频率为 10 41± 191.1Hz;听骨链固定耳中耳共振频率为 12 17.5± 199.5Hz ,较正常耳高 (P <0 .0 1) ;听骨链中断耳中耳共振频率为 6 2 2 .2± 15 3.6Hz,较正常耳及听骨链固定耳均低 (P <0 .0 1) ;分泌性中耳炎中耳共振频率为 42 7.5± 139.1Hz ,较前三者均低 (P <0 .0 1)。结论　多频率扫描带导抗测试对鼓膜完整的中耳病变的鉴别诊断有一定的参考价值     

梅尼埃病的高频测听观察

本文报告34例30～40岁梅尼埃病患者常规测听(0.25～8kHz)和高频测听(9～20kHz)与相同年龄组正常人比较的结果.发现梅尼埃病早期常规测听低频听力下降的同时,也存在高频听力下降,并非到病变后期才出现高频下降,若能及时行高频测听检查,有利于梅尼埃病的早期诊断.本文还对高频听力下降的机理进行初步探讨.     

Frequency discrimination in ears with and without contralateral cochlear dead regions

Abstract

Objective: The purpose of this study was to test the ability to discriminate low-frequency pure-tone stimuli for ears with and without contralateral dead regions, in subjects with bilateral high-frequency hearing loss; we examined associations between hearing loss characteristics and frequency discrimination of low-frequency stimuli in subjects with high-frequency hearing loss. Design: Cochlear dead regions were diagnosed using the TEN-HL test. A frequency discrimination test utilizing an adaptive three-alternative forced choice method provided difference limens for reference frequencies 0.25 kHz and 0.5 kHz. Study sample: Among 105 subjects with bilateral high-frequency hearing loss, unilateral dead regions were found in 15 subjects. These, and an additional 15 matched control subjects without dead regions, were included in the study. Results: Ears with dead regions performed best at the frequency discrimination test. Ears with a contralateral dead region performed significantly better than ears without a contralateral dead region at 0.5 kHz, the reference frequency closest to the mean audiogram cut-off, while the opposite result was obtained at 0.25 kHz. Conclusions: Results may be seen as sign of a contralateral effect of unilateral dead regions on the discrimination of stimuli with frequencies well below the audiogram cut-off in adult subjects with bilateral high-frequency hearing loss.