畸变产物耳声发射在感音性聋测试中的应用

目的　采用低强度原始音 L1=6 5 d B,L2 =5 0 d B,探讨畸变产物耳声发射 (distortion product otoa-coustic emission,DPOAE)在感音性聋测试中的应用。方法　在听力正常组和感音性聋组 1k Hz,2 k Hz,4 k Hz和 6k Hz刺激点 ,分析反应频率为 2 f1- f2处 DPOAE幅值的引出率 ,大小和其与纯音听阈的相关性 ,并计算测试的敏感度和特异度。结果　听力正常组 2 5例 (5 0耳 )全部引出 DPOAE,感音性聋组 4 0例 (5 3耳 )高频 DPOAE5 1/ 5 3引出 ,1、2 k Hz处 5 3/ 5 3引出 DPOAE。正常组在各频率 DPOAE的幅值均较感音性聋组高 (P<0 .0 5〉。等级相关分析显示感音性聋组 DPOAE幅值与纯音听阈在各频率处均呈负相关。 DPOAE对感音性聋检测有较文献报道更好的敏感度和特异度。结论　低强度原始音刺激诱发出的 DPOAE,主要反映耳蜗外毛细胞的功能 ,在一定程度上可为感音性聋的临床诊断和治疗提供指导和帮助。

Applying Distortion Product Otoacoustic Emission in Testing Human Sensory Hearing Loss

Objective To probe into the application of distortion product otoacoustic emission (DPOAE) test in human sensory hearing loss (SHL) research using lower stimulus parameter L1=65 dB, L2=50 dB. Methods Elicitation rate, size of DPOAE and correlation between DPOAE and pure tone auditory threshold were analyzed, and then the sensitivity and specificity were calculated. Results DPOAE was elicited in all of the hearing normal controls (25 subjects, 50 ears). In SHL cases ( 40 patients, 53 ears), DPOAE was elicited in 51 ears at 4 kHz and 6 kHz, and in 53 ears at 1 kHz and 2 kHz. The DPOAE size at each frequency in the normal group was higher than that in the SHL group (P<0.05). A negative correlation between DPOAE size and pure tone auditory threshold was revealed by means of Spearman rank sum test. The sensitivity and specificity of DPOAE for testing SHL were better than those in literature reports. Conclusion The DPOAE elicited by lower stimulus parameter mainly reflects the function of outer hair cells of inner ear, and thus it may provide some guidance or information for clinical diagnosis and treatment of SHL.