不同原因内耳损伤下畸变产物耳声发射的改变

目的研究不同原因内耳损伤下畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)改变的特点.方法对耳科正常人、噪声暴露工人和应用顺铂化疗的妇科肿瘤患者进行DPOAE(0.5～16 kHz)、常频纯音测听(0.5～8 kHz)及扩展高频测听(9～16 kHz)检查.对DPOAE幅值与纯音听阈进行比较分析.结果在噪声性和顺铂耳毒性损伤下,常频DPOAE表现为3～6 kHz幅值降低,早于对应常频纯音听阈变化.扩展高频DPOAE幅值均有下降,但频率区域不同,噪声组只在11.2 kHz处下降明显,其他频率变化不大,尤其是12.5 kHz、14 kHz、16 kHz三个频率几无变化;药物组除16 kHz外各频率均幅值下降.结论常频DPOAE比常频纯音测听和扩展高频DPOAE敏感,因此,在噪声、顺铂等引起的耳蜗性听力损害的早期监测中,优于常频纯音测听和扩展高频DPOAE.     

畸变产物耳声发射幅值与纯音听阈相关性的研究

目的：探讨畸变产物耳声发射（distortion product otoacoustic emissions,DPOAE）与常规纯音测听及扩展高频测听的关系。方法：对耳科正常人进行0．5－16kHz DPOAE、常规纯音测听及扩展高频测听检查，比较DPOAE和常规纯音测听、扩展高频测听结果的相关性。结果：0．5-3kHz DPOAE幅值与扩展高频区（10－12．5kHz）的纯音听阈相关；4－6kHz DPOAE幅值与相应频率及11．2kHz的纯音听阈相关；11．2kHz DPOAE幅值与4KHz纯音听阈明显相关。结论：DPOAE可能不全来源于对应频率区及较高频率区耳蜗外毛细胞，其产生部位和机制尚需深入研究。     

Ⅱ型糖尿病患者听力损害的临床研究

目的 观察Ⅱ型糖尿病对扩展高频测听及畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)的影响.方法 选择自觉听力正常32例和异常的糖尿病患者28例及正常对照组30例进行扩展高频测听及DPOAE的检测,对其结果进行对照比较.结果 同一年龄段糖尿病组扩展高频测听阈值较对照组升高,17～40岁患者12kHz及以上频率阈值增高有显著意义(P＜0.05),41～55岁年龄组10～14kHz频率阈值增高有显著意义(P＜0.05),糖尿病患者的DPOAE幅值在1000～8000Hz出现下降,其中在2000,4000,8000Hz均有统计学意义.结论 DPOAE和扩展高频测听可以在早期检测出糖尿病患者的听力损害,临床上可作为Ⅱ型糖尿病患者耳蜗功能早期变化的有效监测手段.     

不同听力检测方法对早期发现噪声性隐性听力损失的意义

目的探讨扩展高频纯音测听、畸变产物耳声发射(DPOAE)及噪声下言语识别能力测试对早期发现噪声性隐性听力损失的意义。方法选取20例常频纯音听阈正常、有噪声接触史的工人(接噪组,年龄20~41岁)与20例无噪声接触史、常频听阈正常的青年人(对照组,年龄19~35岁),分别行扩展高频纯音测听、扩展高频DPOAE及噪声下言语识别能力测试(汉化版噪声下BKB语句测试),记录并比较两组各项测试结果。结果接噪组扩展高频纯音听阈检出率低于对照组,在16 kHz差异有统计学意义(P<0.05),在18、20 kHz差异有显著统计学意义(P<0.01);接噪组8~20 kHz扩展高频纯音听阈平均值高于对照组,在9、18 kHz差异有统计学意义(P<0.05),在14 kHz差异有显著统计学意义(P<0.01);接噪组扩展高频DPOAE的信噪比及幅值均较对照组降低,在10 kHz差异有统计学意义(P<0.05),在8、9 kHz差异均有显著统计学意义(P<0.01);噪声下言语识别能力测试显示接噪组信噪比损失平均值为4.6±2.19 dB,高于对照组(3.00±2.08 dB)(P<0.01)。结论接噪组相较对照组,扩展高频纯音听阈值升高或引不出,扩展高频DPOAE信噪比及幅值降低,噪声下言语识别能力显著下降,以上三种检测方法对早期发现噪声性隐性听力损失有一定的参考价值。     

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

目的 分析纯音听阈正常的耳鸣患者扩展高频畸变产物耳声发射(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68例(104耳)为实验组，对照组为纯音听阈正常无耳鸣症状的志愿者40例(40耳)。两组均用Neuro-Audio耳声发射仪进行常规频率(1～6 kHz)畸变产物耳声发射(DPOAE)测试、EHF DPOAE(8～12 kHz)测试。结果 对照组常规频率DPOAE的平均检出率为97.2%,EHF DPOAE的检出率为88.7%;实验组常规频率DPOAE的检出率为72.2%,EHF DPOAE的检出率为51.2%。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中振幅值明显低于对照组EHF DPOAE的振幅值(P<0.001);实验组EHF DPOAE的平均信噪比值明显低于对照组EHF DPOAE的平均信噪比值(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...     

耳鸣患者的畸变产物耳声发射测试

目的探讨耳鸣患者畸变产物耳声发射（DPOAE）的临床特征，了解畸变耳声发射检测在耳鸣患者中的临床应用价值。方法对42例耳鸣患者进行DPOAE测试及纯音听阈检测，并进行对比。结果耳鸣伴听力下降患者的畸变产物耳声发射在相关频率幅值下降或未引出，二者有相关性；耳鸣伴听力正常患者畸变产物耳声发射均出现高频段幅值下降或缺失。结论对纯音听阈正常的耳鸣患者DPOAE可用于发现早期耳蜗病变，对听力损失者可有助于客观预估听力损失程度。     

畸变产物耳声发射在军事噪声致爆震性聋早期监测中的作用

目的探讨畸变产物耳声发射(DPOAE)在军事噪声致爆震性聋早期监测中的作用。方法将听力正常的炮兵某部男性官兵88例(176耳)随机分成两组,每组44例(88耳),实验组参加火炮实弹射击训练,对照组未参加火炮实弹射击训练。对照组及实验组训练前后进行纯音测听及DPOAE测试,对两组结果进行比较分析。结果实验组训练后80耳中耳传导功能无障碍,其中13耳纯音听阈示感音神经性听力损失,DPOAE检查亦异常;67耳纯音听阈正常,其中15耳DPOAE幅值在4kHz处降低。与训练前、对照组比较,实验组训练后2、4及8kHz纯音听阈升高(P<0.05或P<0.01),以4kHz处升高最为明显;实验组训练后2、3、4、6及8kHzDPOAE幅值降低(P<0.05或P<0.01),其中以4kHz处降低最为明显。结论畸变产物耳声发射在军事噪声致爆震性聋早期监测中有一定应用价值,可对其防护、诊断和治疗提供指导和帮助。     

驾驶人员畸变产物耳声发射检测与纯音听力测试相关性

目的 探讨畸变产物耳声发射(DPOAE)在检测驾驶人员听力损失的可行性和运用价值.方法 选择纯音听力测试听阈提高的驾驶人员作为检查组30例(60耳);正常体检人员作为对照组20例(40耳),分别进行纯音听力测试和DPOAE测试,比较两组结果.结果 检查组纯音听力测试2、4、8 kHz频率明显提高,与对照组比较差异有统计...     

噪声暴露工人畸变产物耳声发射和扩展高频测听的研究

目的 :分析畸变产物耳声发射 (DPOAE)和常频纯音测听、扩展高频测听的关系 ,借以探讨DPOAE的产生机制以及在噪声性听力损伤的监测和早期诊断中的应用价值。方法 :对 4 2例耳科正常人 (对照组 )和 2 0例噪声暴露工人 (实验组 )进行 0 .5～ 16 .0kHzDPOAE、常频纯音测听及扩展高频测听的检测 ,比较对照组和实验组DPOAE和常频纯音测听、扩展高频测听的结果。结果 :实验组纯音听阈在 6 .0kHz处和扩展高频区下降明显 ,与对照组比较 ,差异有显著性意义 (P <0 .0 5 ) ;DPOAE幅值在 4 .0、6 .0和 11.2kHz处下降明显 ,与对照组比较 ,差异均有显著性意义 (P <0 .0 5 ) ;而在 12 .5、14 .0、16 .0kHz 3个频率处两组差异无显著性意义 (P >0 .0 5 )。结论 :常频DPOAE检查可用于噪声性聋的早期诊断和监测。DPOAE可能来源于对应频率区及较高频率区耳蜗外毛细胞 ,其产生部位和机制尚待深入研究     

阻塞性睡眠呼吸暂停低通气综合征患者的早期听觉损害评估手段探讨

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的早期听觉损害评估方法。方法对31例(62耳)OSAHS患者和20例(40耳)对照组,分别检测常频(0.125～8 kHz)纯音气骨导和扩展高频(8～16 kHz)气导听阈、瞬态诱发性耳声发射(TEOAE)及畸变产物耳声发射(DPOAE)。结果①常频纯音听阈两组间无显著差异,而扩展高频听阈OSAHS组明显高于对照组(t=3.045～3.779,P=0.000～0.003);②TEOAE检出率OSAHS组为37.1%,而对照组为92.5%,组间差异显著,χ2=30.82,P=0.000;③在各个频率点DPOAE检出率和振幅,OSAHS组明显低于对照组(检出率χ2=22.94～34.31,P=0.000～0.000;振幅t=-2.740～-9.980,P=0.000～0.008)。结论对于OSAHS患者建议用耳声发射、扩展高频测听进行早期听觉损害评估。     

应用畸变产物耳声发射和扩展高频测听对顺铂耳毒性的临床研究

目的：应用0．5—16kHz畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)和扩展高频测听对顺铂耳毒性进行临床研究。方法:对24例应用顺铂进行初次化疗的妇科肿瘤病人于化疗前后分别进行0．5—16kHz DPOAE、常频纯音测听及扩展高频测听检查，比较DPOAE和常频纯音测听、扩展高频测听的结果。结果：顺铂化疗后扩展高频区纯音听阈升高，DPOAE在3kHz、4kHz处及扩展高频区下降明显。结论：常频DPOAE较常频纯音测听更敏感，和扩展高频测听检查一样均可用于顺铂耳毒性的监测。扩展高频DPOAE可能比常频DPOAE更敏感。DPOAE与纯音听闻可能并非一一对应关系。病人对顺铂的易感性可能随着年龄的增加逐渐减低。     

Presbycusis among older Chinese people in Taipei, Taiwan: a community-based study

The purpose of this study was to estimate the prevalence and severity of presbycusis in older Chinese people in Taipei, Taiwan. Pure-tone audiometry and a questionnaire were administered to a randomly-recruited cohort of people > 65 years old (n=1221) from a community in Taipei. The study cohort showed pure-tone thresholds worsening, especially at frequencies >2 kHz, with increasing age. The mean pure-tone average at speech frequencies (0.5, 1, and 2 kHz) of the better ear of subjects stratified by five-year age groups ranged from 34.9 dB hearing level (HL) to 46.4 dB HL. The pure-tone average at speech frequency in women was slightly higher than that in men in all age groups. The prevalence of presbycusis (M3 > or = 55 dBHL) was 1.6% (65-69 years), 3.2% (70-74 years), 7.5% (75-79 years), and 14.9% (> or =80 years). Persistent tinnitus was present in 13.9% of subjects, and 18.8% of subjects had a history of vertigo. Of subjects with a clinically evident hearing impairment (M3 > or = 55 dB HL), 18.4% used hearing aids. These data provide estimates of the prevalence and severity of presbycusis in community-dwelling older persons in Taiwan.     

Effects of cigarette smoking on distortion product otoacoustic emissions

This study measured distortion product otoacoustic emissions (DPOAEs) and DPOAE input/output (I/O) curves to assess the effects of smoking on cochlear function. Twenty-four healthy adults, 12 smokers and 12 nonsmokers in the 20-30 years age range were selected based on self-reported histories of five to eight years of smoking or no smoking, respectively. All subjects received tympanometric screening to rule out middle ear pathology. Conventional (0.25-8 kHz) and ultra high frequency (UHF; 10-20 kHz) audiometry showed normal or age-appropriate thresholds across both groups. DPOAE results showed small, but significant, decline in DPOAE levels without concomitant changes in noise floors in smokers as compared to nonsmokers. I/O detection thresholds were also significantly elevated at high frequencies in smokers as compared to their nonsmoking counterparts. These findings indicate that smokers are at greater risk for cochlear damage than nonsmokers, and that DPOAE amplitudes and I/O detection thresholds may identify early changes in cochlear function in smokers.     

Changes in otoacoustic emissions and high-frequency hearing thresholds in children and adolescents

With the aim of characterizing the loss of high frequency hearing sensitivity in children, hearing thresholds and otoacoustic emissions were measured in a group of 126 normal hearing children and adolescents aged from 6 to 25 years. The subjects were divided into four 5-year age groups. Hearing thresholds over a range of 125 Hz-12.5 kHz were similar in all age groups, the average hearing threshold at 16 kHz was significantly elevated in the oldest age group. The response values of transiently evoked otoacoustic emissions (TEOAEs) significantly declined with age; the decline was negatively correlated with the hearing loss at 16 kHz. Significantly larger TEOAE responses and average distortion-product otoacoustic emission (DPOAE) values at 6.3 kHz were present in the youngest group in comparison with the other three older groups. Spontaneous otoacoustic emissions (SOAEs) were present in 70.8% of the children (in either one or both ears) with the greatest prevalence in the 11-20-year-old subjects. In the 21-25-year-old group, the hearing loss at 16 kHz was significantly smaller in ears with SOAEs than in ears without SOAEs. The results demonstrate that the increase in the high frequency hearing threshold at 16 kHz, which starts at ages over 20 years, is correlated with a decrease in the TEOAE responses at middle frequencies.     

High-frequency audiometry. Age and sex variations

286 normal subject representing both sexes and seven age groups from 10 to greater than or equal to 70 years were tested with both conventional pure tone audiometry and high frequency audiometry (4--20 kHz) using a previously described free field system. The subjects were selected according to very strict criteria. Results from conventional audiometry are similar to other findings in presbycusis studies, though sex difference was seen for the oldest age groups, but only at the frequencies 4 and 5 kHz where the male population showed a significantly poorer hearing. The same sex difference was observed by high frequency audiometry at 4 and 8 kHz. From 10--20 kHz no sex difference was present. At the high frequencies there is an abrupt decrease in hearing sensitivity already from youth. Hitherto, no international standard for zero dB hearing level exists for frequencies above 8 kHz. It is questioned whether a general standard is meaningful at all and that normative data for various age groups should instead be used as a reference level.     

相关疾病对老年人听力的影响

目的探讨高血压、高血脂、糖尿病对老年人听力的影响,以期对预防和系统治疗老年性聋提供帮助。方法选取184例年龄≥65岁的老年人,除外有中耳疾病、强噪声暴露史及60岁以前有听力损失主诉等。根据所患疾病将受试者分为高血压病组（组1）,糖尿病组（组2）,高血脂组（组3）,高血压＋高血脂组（组4）,高血压＋糖尿病组（组5）,糖尿病＋高血脂组（组6）,高血压＋糖尿病＋高血脂组（组7）及对照组（正常组）。每组均进行双耳常频和扩展高频的纯音昕阈测试,并计算扩展高频各频率的检出率。结果患有高血压、高血脂、糖尿病老年人的常频听力均下降,且几种疾病并存时昕力下降更为明显;其中,高血脂对听力的影响最大（p〈0．05）;患高血压、高血脂、糖尿病的老年人在10、0、12、5和16．0kHz扩展高频听力下降明显（P〈0．05）;除组5、组6在18．0kHz及组4、组5在20kHz的检出率较对照组高以外,其他组较对照组低,统计学上有显著性差异（P〈0．05）。结论高血压、高血脂、糖尿病均可导致老年人常频及扩展高频听力下降,高血脂对听力的影响尤为显著。