客观测听技术在鉴别伪聋中的临床应用

目的探讨聋人运动员伪聋鉴别客观、有效的测听方法。方法运用畸变产物耳声发射技术（distortion product otoacoustic emission，DPOAE）对聋人运动员进行听力初筛，初筛通过者再行中耳声导抗测试，应用声镫骨肌反射客观性推算其听敏度。对伪聋检查结果有异议的运动员和需做听神经病鉴别的运动员，再行脑干电反应测昕。结果初筛855人共有5名运动员8耳通过耳声发射检查，DPOAE耳通过率为0．47％，人通过率为0．58％。复查中耳声导抗测试3人4耳引出镫骨肌反射且阈值正常。脑干电反应测昕2人反应阈正常，2人反应阈≥100 dB nHL。结论耳声发射、中耳声导抗测试和脑干电反应测听可作为聋人运动员伪聋鉴别客观、有效的测听方法。

The clinical application of objective audiometry to distinguishing pseudohypacusis

Objective To explore the objective and effective audiometry for distinguishing pseudohypacusis in deaf athletes. Methods Distortion product otoacoustic emission （DPOAE） was applied for the initial hearing screening of 855 deaf athletes （1710 ears）. Then acoustic immittance measurement was performed for 5 athletes who passed the initial screening and acoustic stapedius reflex was used to evaluate their hearing sensitivity. Auditory brainstem response （ABR） test was conducted on 4 athletes for further diagnosis. Results Five athletes （8 ears） passed the initial screening. The passing rate of DPOAE was 0.47% （ears） or 0.58% （persons）. In the follow-up screening, stapedius reflexes were obtained from 3 athletes （4 ears） and the thresholds were normal. The ABR thresholds were normal in the 2 athletes who passed the initial and follow-up screening, and were higher than 100 dB nHL in the other 2 athletes. Conclusion DPOAE, acoustic immittance measurement and ABR are useful instruments for the diagnosis of pseudohypacusis.