畸变产物耳声发射与响度重振现象关系的探讨

目的探讨响度重振与耳蜗主动机制异常之间的关系，为耳声发射用于诊断耳蜗性病变提供更多指标。方法通过对２０例（４０耳）健康人、５０例（６３耳）常规重振检测频率阳性者和１１例（１５耳）蜗后性聋耳进行畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎｐｒｏｄｕｃｔｏｔｏａｃｏｕｓｔｉｃｅｍｉｓｉｏｎ，ＤＰＯＡＥ）的输入－输出（Ｉ／Ｏ）曲线的测试和分析。结果重振检测阳性的患耳不同频率ＤＰＯＡＥ的Ｉ／Ｏ曲线斜率的均值与健康人对应频率Ｉ／Ｏ曲线斜率的均值相比明显增大（Ｐ＜０．０１），其ＤＰＯＡＥ的检测阈也明显提高。结论响度重振与耳蜗主动机制异常有特定联系，ＤＰＯＡＥ的Ｉ／Ｏ曲线对耳蜗主动机制的评价更直观、准确，可能成为一种有价值的诊断耳蜗性病变的指标。     

耳鸣与耳声发射

为探讨耳鸣的产生原因和客观检测手段以及耳鸣与耳声发射（ＯＡＥ）的关系，报道耳鸣患者２７３例（３０６耳）畸变产物耳声发射（ＤＰＯＡＥ）、自发性耳声发射（ＳＯＡＥ）和瞬态诱发性耳声发射（ＴＥＯＡＥ）的特点。结果提示：①耳鸣频率与ＳＯＡＥ频率不一致；②９４．８％感音神经性聋伴耳鸣患者ＤＰＯＡＥ图在相应频率有振幅下降或缺失，５９％听力正常耳鸣耳出现某些频率ＤＰＯＡＥ振幅下降和反应缺失，且不能记录到ＳＯＡＥ，而在ＳＯＡＥ频率附近ＤＰＯＡＥ有良好反应高峰。耳声发射可望用于发现早期耳蜗病变。     

耳声发射对侧抑制效应的频率特异性研究

目的　观察耳声发射对侧抑制效应是否有频率特异性。方法　分别测试７ 例正常人（１４耳） 畸变产物耳声发射（ＤＰＯＡＥ） 和２ 例正常人（２ 耳） 自发性耳声发射（ＳＯＡＥ） 的对侧抑制效应,对侧声刺激为窄带噪声（ＮＢＮ） 。结果　当对侧ＮＢＮ 中心频率等于ＤＰＯＡＥ 的初始音ｆ２ 频率和ＳＯＡＥ 频率时,ＤＰＯＡＥ 和ＳＯＡＥ 发生最大抑制。结论　本实验进一步表明耳声发射对侧抑制效应有频率特异性,提示内侧橄榄耳蜗系统和耳蜗外毛细胞参与了耳蜗频率特性的主动调谐过程,提高了耳蜗频率分辨率。文中讨论了频率特异性的发生机理     

畸变产物耳声发射在突发性聋在突发性聋恢复过程中的变化

目的：探讨畸变产物耳声发射（ＤＰＯＡＥ）测试对于耳蜗功能损害的检测价值。方法：ＧＳＩ－６０型耳声发射检测２仪,对３０例（６０耳）突发性聋（突聋）患者进行ＤＰＯＡＥ测试,观察其发病和恢复过程中的耳声发射（ＯＡＥｓ）变化,及其与纯间听阈变化的关系。并对患者进行治疗与随访。结果：患耳的ＤＰＯＡＥ检出率、幅值低于健耳,检出阈升高;在恢复过程中,ＤＰＯＡＥ的幅值、检出阈也随听阈一起改善;听阈的恢复率高于幅值     

耳声发射应用于新生儿听力筛选的研究

目的 研究瞬态诱发耳声发射（ｔｒａｎｓｉｅｎｔ ｅｖｏｋｅｄ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＴＥＯＡＥ）产畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｔ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＤＰＯＡＥ）应用于新生儿听力筛选的可行性，控诉听力筛选的标准。方法 应用Ｃｅｌｅｓｔａ５０３型耳声发射分析仪对１０８名新生儿（２１６耳）进行ＴＥＯＡＥ和ＤＰＯＡＥ听力筛选，与听性脑     

耳鸣与耳声发射

为探讨耳鸣的产生原因和客观检测手段以及耳鸣与耳声发射（ＯＡＥ）的关系，报道耳鸣患者的２７３例（３０６耳）畸变产物耳声发射（ＤＰＯＡＥ），自发性耳声发射（ＳＯＡＥ）和瞬态诱发性耳声发射（ＴＥＯＡＥ）的特点，结果提示：（１）耳鸣频率与ＳＯＡＥ频率不一致，（２）９４．８％感音神经性聋性耳鸣患者ＤＰＯＡＥ图在相应频率有振幅下降或缺失，５９％听力正常耳鸣耳出现某些频率ＤＰＯＡＥ振幅下降和反应缺失，且不能记录     

新生儿畸变产物耳声发射（DPOAE）检出率特性分析

本文分别对正常足月新生儿组和新生儿群体（正常足月新生儿和非正常足月新生儿） 变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｔ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＤＰＯＡＥｓ）的检出率进行分析，并将ＤＰＯＡＥ技术作为新生儿听力筛查方法对新生儿群体的听功能进行检测。结果显示：①正常足月测试频率（ｆ２）＝１．０ｋＨｚ的ＤＰＯＡＥｓ检出率低于其他各检测频率；②正常足月儿在ｆ２＝１．０，１．３     

畸变产物耳声发射的基础研究和临床应用

畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｔｓ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｉｓｓｉｏｎｓ，ＤＰＯＡＥ）是诱发性耳声发射（ｅｖｏｋｅｄ ｏｔｏａｃｏｕｓｔｉｃ ｍｉｓｓｉｏｎｓ，ＥＯＡＥ）的一种，由于具有显的频率特性，可客观而精细的评估耳蜗功能状态，因此有较为广泛的临床应用前景。本就其记录方法、物理特性及影响因素的有关研究及临床应用资料进行综述，以供同道参考。     

豚鼠噪声暴露后畸变产物耳声发射与外毛细胞的改变

为观察豚鼠噪声暴露后畸变产物耳声发射（ＤＰＯＡＥ）与内耳毛细胞的改变，将１６只健康豚鼠分为３组，正常对照组３只，噪声后即刻组３只，７ｄ组１０只。暴露于１１５ｄＢ ＳＰＬ模拟潜艇机舱噪声中４ｈ，暴露后即刻及７ｄ检测ＤＯＰＡＥ听力图及Ｉ／Ｏ函数曲线，光镜及扫描电镜观察耳蜗毛细胞的改变。暴露即刻组ＤＰＯＡＥ振幅消失（Ｐ〈０．０１），７ｄ后又恢复至暴震前的基线水平（Ｐ〉０．０５）。光镜及扫描电镜显示耳蜗２     

畸变产物耳声发射幅值与超高频纯音听阈的关系

目的 探讨畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｌｓ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｍｉｓｓｉｏｎ，ＤＰＯＡＥ）与超高频纯音听阈用于早期耳蜗性听力损害的听力监测的可能性。方法 ＤＰＯＡＥ以配对初始音诱发，两音强度均为７０ｄＢ ＳＰＬ，频率比为１：１．２，频率范围０．５￣８ｋＨｚ。测定常规频率（１２５Ｈｚ￣８ｋＨｚ）及超高频率（９￣２０ｋＨｚ）的纯音听阈。比较正常听阈组与不正常听阈值的Ｄ     

耳蜗性聋的畸变产物耳声发射测试

目的：通过畸变产物耳声发射(DPOAE)测试耳蜗性聋的敏感性、特异性和符合率来评估其测试效能。方法：测试听力正常人86耳和耳蜗性聋98耳的DPOAE，其1～6kHz各个频率的幅值与对应频率的电测听纯音听阈相比较，用所得到患耳蜗性聋敏感性和特异性值作受试者作业特征曲线。并计算其面积。其面积值并不因为DPOAE用于区别听力正常与否的取值标准不同而发生变化。用所得到的面积值来判断DPOAE的测试效能。结果：1～6kHz从低到高各个频率对应的受试者特征曲线面积分别为0．677，0．777，0．818，0．890，0．873。结论：DPOAE可以作为测试耳蜗性聋的一种频率特异性的客观方法。     

对侧刺激声影响畸变产物耳声发射临床意义的探讨

观察白噪声对畸变产物耳声发射输入输出函数曲线影响，探讨其临床价值。方法：检测临床患者６１例，包括单纯性耳鸣不伴有听力下降患者３２例；以低频听力下降为主的耳聋患者２７例；蜗后病变２例。     

Analysis of the distortion product otoacoustic emission (DPOAE) and input/output function (I/O) in tinnitus patient with normal hearing

Distortion Product Otoacoustic Emission (DPOAE) has been used as a tool to determine the presence of cochlear pathology. It is well known that the damage of Outer Hair Cells (OHCs) results in reduced auditory sensitivity and generation of tinnitus. At the same time tinnitus arises in normal hearing persons as well. The aim of this study was the assessment of the DPOEA amplitude and the behavior of DP I/O function in tinnitus patients with normal hearing threshold. The group of 48 tinnitus patients (92 ears) with normal hearing threshold and the control group of 30 normal hearing patients (40 ears) were investigated for this study. All subjects have undergone the measurement of DPOAE and DP I/O functions for frequencies: 1000, 2000 and 4000 Hz. In the tinnitus group there were observed the decrease in DPOAE amplitude for some frequencies and the steeper slope of I/O function. This means that the places with localized damage or dysfunction of OHCs on the basilar membrane can be responsible for the origin of tinnitus.     

Diagnostics of the cochlear amplifier by means of distortion product otoacoustic emissions

Distortion product otoacoustic emission (DPOAE) growth functions reflect the active nonlinear cochlear sound processing when using a primary-tone setting which accounts for the different compressions of the two primaries at the DPOAE generation site and hence provide a measure for objectively assessing cochlear sensitivity and compression. DPOAE thresholds can be derived from extrapolated DPOAE input/output (I/O) functions independently of the noise floor and consequently can serve as a unique measure for reading DPOAE measurements. The thus-estimated DPOAE thresholds exhibit a close correspondence to behavior audiometric thresholds and thus can be used for reconstructing an audiogram, i.e., a DPOAE audiogram. The DPOAE I/O functions' slope increases with cochlear hearing loss and thus provides a measure for assessing recruitment. Hence, DPOAE I/O functions can give more information for diagnostic purposes than those of DP grams, transiently evoked OAEs (TEOAEs), or auditory brain stem responses (ABRs). DPOAE audiograms can be applied in pediatric audiology to assess cochlear dysfunction in a couple of minutes. In newborn hearing screening, they are able to detect transitory sound-conductive hearing loss and thus can help to reduce the rate of false-positive TEOAE responses in the early postnatal period. Since DPOAE I/O functions are correlated with loudness functions, DPOAEs offer the possibility of basic hearing aid adjustments, especially in infants and children. Extrapolated DPOAE I/O functions provide a tool for a fast automated frequency-specific and quantitative evaluation of hearing loss.     

单侧耳蜗性聋患者对侧耳耳声发射的表现

目的 :探讨致聋因素在致单耳发病时对对侧耳潜在的影响。方法 :利用OtodynamicILO96耳声发射分析仪 ,对 35例单侧耳蜗性聋患者 (分为 5组 :发病 2个月以内的突发性聋 9例为S1组 ,发病 1年以上的突发性聋 6例为S2 组 ,梅尼埃病 13例分为M1、M2 组 ,不明机理的耳蜗性聋 7例为UNK组 )对侧耳瞬态诱发性耳声发射 (TEOAE)的反应幅值、反应重复率及频带的重复率 ,畸变产物耳声发射 (DPOAE)曲线特点及 1～ 5kHz反应幅值进行分析比较。结果 :S1组、M2 组TEOAE的反应幅值、反应重复性、频带重复性明显低于正常值 ,DPOAE幅值明显降低 ;S2 组、M1组、UNK组TEOAE和DPOAE正常。结论 :在不同致聋因素中 ,有的对单耳产生损伤作用 ,有的对双耳产生损伤作用。     

Changes in input/output function of distortion product otoacoustic emissions during the glycerol test in Ménière's disease

OBJECTIVE: To investigate the manner of change in the input/output (I/O) function of distortion product otoacoustic emissions (DPOAEs) during the glycerol test in patients with Ménière's disease. MATERIAL AND METHODS: The DPOAE I/O functions at three F2 frequencies of 1001, 1501, and 2002 Hz were measured before and after the glycerol test following pure-tone audiometry for 16 ears of 16 patients with unilateral Ménière's disease. Changes in DPOAE I/O function during the glycerol test were analyzed using maximum level of DPOAEs (max. DP level) and the detection threshold of DPOAEs (DP threshold) in the I/O function as parameters. RESULTS: Significant changes in I/O function during the glycerol test were observed for at least one of three F2 frequencies in all 8 ears and 6 of 8 ears with and without positive test results, respectively, regardless of change in pure-tone thresholds at 1000 and 2000 Hz. A total of 12 ears exhibited two findings of significant change in parameters indicating improvement of cochlear function, increase in max. DP level and lowering of DP threshold, and 2 ears exhibited decrease in max. DP level, a finding indicative of deterioration of cochlear function. Neither of the two parameters exhibited significant change simultaneously, except in one I/O function. Moreover, there appeared to be no clear relationship between the parameter exhibiting significant change and F2 frequencies or changes in pure-tone threshold. CONCLUSION: Subtle changes in cochlear function during the glycerol test can be detected with higher sensitivity by measurement of the DPOAE I/O function than by conventional audiometry. However, multiple parameters should be used in analysis of change in the I/O function since it is difficult to predict how the I/O function will change prior to the glycerol test. Furthermore, the high sensitivity of DPOAEs in detecting change in cochlear function may provide useful information on inner ear status in Ménière's disease.     

Interpreting auditory brainstem evoked responses and distortion product otoacoustic emissions in diabetic patients with normal hearing

ObjectiveHearing impairment is a reported late complication of diabetes mellitus (DM). Previous studies have suggested that microangiopathic complications may cause cochlear nerve function deterioration. We evaluated the auditory brainstem evoked responses (ABRs) and distortion product otoacoustic emission (DPOAE) results according to the presence of DM in subjects with normal hearing.MethodsA cross-sectional comparative study was conducted from January 2016 to January 2018. Auditory function tests including ABR and DPOAE were performed for outpatients complaining of unilateral tinnitus. All of analyses were conducted in ears without tinnitus on contralateral side of tinnitus ears. We included subjects showing hearing thresholds within 25 dB at 0.5, 1k, 2k, and 4k on pure tone audiometry. 45 ears in patients with type 2 diabetes mellitus and 85 ears in non-diabetic patients were finally enrolled in our study.ResultsDiabetic subjects showed significantly more prolonged absolute peak latencies (I, III, V) and inter-peak latencies (I–V, III–V) than non-diabetic subjects. However, there was no significant difference in the inter-peak latency (I–III) between these two groups. Diabetic subjects also showed significantly lower amplitudes at f2 frequencies of 1001, 1200, 1587, 4004, 5042, and 6348 Hz than non-diabetic subjects. Additionally, the prevalence of a DPOAE response, defined as 3 dB above the noise floor, was significantly lower in diabetic subjects than that in non-diabetic subjects.ConclusionDiabetic patients with normal hearing can still have abnormal ABR and DPOAE results due to diabetic neuroangiopathy. ABR and DPOAE assessments can help in detecting subclinical auditory dysfunction, which precedes the manifestation of hearing impairment in diabetic patients.     

畸变产物耳声发射对耳蜗性聋和耳蜗后性聋的鉴别诊断意义

目的 探讨畸变产物耳声发射（DPOAE）鉴别诊断耳蜗性聋和耳蜗后性聋的意义。方法 采用ILO96耳动态分析仪对49例耳蜗性聋和4例耳蜗后性聋进行DPOAE测试。结果 耳蜗性聋组的DPOAE图显示出DPOAE幅值随纯音听阈的升高有不同程度的下降,并显示出很好的频率特异性,当纯音听阈＞50dBHL时,DPOAE消失。耳蜗后性聋组的DPOAE图显示出的DPOAE幅值变化不明显,仍在正常范围,与纯音听阈长吭程度缺乏相对应关系。结论 DPOAE是一种有效的辅助性鉴别诊断耳蜗性聋和耳蜗后性聋的方法。     

听力正常耳鸣患者的畸变产物耳声发射测试

目的探讨畸变产物耳声发射(DPOAE)对听力正常耳鸣患者的检测意义. 方法采用ILO96耳动态分析仪对26例(46耳)听力正常耳鸣患者进行DPOAE检测. 结果在听力正常耳鸣患者中,DPOAE正常率为63.04%(29/46耳),DPOAE异常率为36.96%(17/46耳).在DPOAE异常的17耳中,耳鸣频率与DPOAE反应幅值下降频率范围基本对应的有9耳(52.94%),有8耳(47.06%)不完全对应,但较接近. 结论对听力正常耳鸣患者进行DPOAE检测可以早期发现耳蜗存在的轻微损伤,对指导临床治疗,防止耳蜗病变进一步发展具有临床意义.