200例主观性耳鸣患者听力损失临床分析

目的:对耳鸣患者的听力损失进行分析,为进一步探讨耳鸣的发病原因、检查方法提供临床依据。方法:对以主观性耳鸣为主诉的200例患者进行耳科专科检查、声导抗检测、常频纯音听阈测听和高频扩展听阈测听检查。结果:200例耳鸣患者中,单侧耳鸣123例(61.5%),双侧耳鸣77例(38.5%);46例(23.0%)听力正常。单侧耳鸣中,患侧与对侧听阈比较0.125～8kHz差异有统计学意义(P<0.05),10kHz及其以上频率差异无统计学意义(P>0.05)。常频听力正常组与听力异常组比较各频率阈值差异均具有统计学意义(均P<0.05),听力异常组扩展高频检出率低于听力正常组。结论:耳鸣可以存在听力正常的人群中,扩展高频测听能否为耳鸣患者提供早期听力损失的依据,尚需对更多的临床资料进一步研究。     

煤矿井下噪声暴露工人扩展高频测听

目的 探讨扩展高频纯音听阈在听力监测及早期发现噪声性听力损害中的价值.方法 对73名(142耳)耳科正常者(对照组)和78名(154耳)煤矿井下噪声暴露工人(实验组,其中常频纯音听阈正常组45名90耳,常频纯音听阈异常组33名64耳),行常频纯音测听、扩展高频纯音(0.5～16kHz)测听,将两组结果进行比较.结果实验组纯音听阈在4.0、6.0 kHz及扩展高频区与对照组比较明显升高,扩展高频未检出率逐渐增加,差异有显著意义(P＜0.05);常频纯音听阈正常的实验组与对照组比较,其扩展高频听阈升高,未检出率在14 kHz开始升高,差异有显著意义(P＜0.05);常频听阈异常的实验组与对照组比较,扩展高频听阈升高,未检出率在11.2 kHz开始增加,差异均有显著意义(P＜0.01).结论 扩展高频测听可用于噪声性聋的早期诊断和听力监测.     

扩展高频测听对代谢综合征患者听觉功能早期损害的测试

目的探讨代谢综合征（MS）患者听觉功能早期损害的听力学特征,为研究和防治耳聋提供临床资料。方法选择20-50岁纯音听阈正常的健康者120例（240耳）作为对照组,同等年龄、纯音听阈正常并确诊为MS的患者130例（260耳）作为实验组,每耳在同一测试条件下行扩展高频测听。所得结果进行组间比较。结果同一年龄段实验组扩展高频测听阈值较对照组升高,20-40岁患者12kHz及以上频率阈值增高有显著意义（P〈0.05）。41-50岁年龄组10-14kHz频率阈值增高有显著意义（P〈0.05）,16kHz频率检出率下降有显著意义（P〈0.05）。结论MS是致聋的病因之一,也是加重老年性聋的因素,扩展高频测听可以在早期检测出MS患者的听力损害。     

正常人扩展高频测听阈值的研究

目的探讨不同年龄正常人扩展高频测听阈值以标准零级为听力计0dB时的变化特点。方法对131名正常人(21～印岁)按10岁为一组分组，分别测定扩展高频听阈值。听力评价应用ORBITER922—2听力计(Madsen，丹麦)，频率范围0．125～20kHz。结果①各年龄组扩展高频听阈的平均阈值随测听频率和年龄的增加而增加；②各年龄组阈值的检出率随测听频率以及年龄的增加呈下降趋势。结论①正常人的高频测听阈值与年龄及测听频率呈正相关。②高频听阈左右耳及性别间无显著性差异。     

高频测听及耳声发射对老年性听力损失早期诊断的研究

目的探讨扩展高频听阈及畸变产物耳声发射（DPOAE）幅值与年龄的关系及其对老年性听力损失早期诊断的意义。方法应用扩展高频测听和畸变产物耳声发射对100例常频听力正常者（20～70岁,分5个年龄段）进行听力测试。结果在扩展高频测听中,随测试频率增高,各年龄段听阈逐渐增加,不同测试频率随年龄增加听阈增高,听阈检出率逐渐下降,经SPSS软件分析,在9～11．2kHz,41岁以下组间无显著性差异,但与41岁及以上组有显著性差异（P〈0．01）;12．5～16kHz,20～30岁组与其他各组均有显著差异,51～60岁组与61～70岁组无显著差异。在DPOAE测试中,各频率随年龄增长DPOAE幅值下降,尤其在高频区,不同年龄段DPOAE幅值有显著差异。结论扩展高频测听与畸变产物耳声发射幅值可以作为对老年性听力损失早期诊断的依据,均可以用于老年性听力损失的早期筛查和诊断。     

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...     

自觉听力正常的后循环缺血患者纯音听阈与耳声发射结果分析

目的：探讨自觉听力正常的后循环缺血（posterior circulation ischemia ,PCI）患者的纯音测听和耳声发射的结果及临床意义。方法选择经临床确诊为PCI且自觉听力正常的患者40例（80耳）作为实验组,健康成年人30例（60耳）作为对照组,两组均行纯音测听、瞬态诱发耳声发射（TEOAE）和畸变产物耳声发射（DPOAE）检查,对结果进行统计学分析。结果 PCI组125～8000 Hz各频率气导听阈与对照组比较差异无统计学意义（ P＞0．05）;PCI组的TEOAE检出率（47．5％,38／80）低于对照组（95．0％,57／60）,差异有统计学意义（P＜0．01）;PCI组DPOAE各频率检出率、幅值均低于健康对照组（P＜0．05）,尤以高频区明显（P＜0．01）。结论后循环缺血可以影响耳蜗的血液供应,导致常规纯音测听难以发现的耳蜗功能损害,尤以高频区明显。     

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。     

扩展高频听力测试在糖尿病患者早期听损伤监测中的应用

目的　探讨扩展高频听力测试在糖尿病患者早期听损伤监测中的应用价值。方法　以50名（100耳）听力正常者为对照组,糖尿病患者65例（130耳）进行常规频率纯音测听,依据常频段测听结果,将糖尿病组分为听力正常组30例（60耳）和听力异常组35例（70耳）。各组分别进行扩展高频听力测试,将测试结果进行比较。结果　糖尿病组扩展高频听力阈值均高于对照组,引出率低于对照组,差异有统计学意义。糖尿病听力正常组扩展高频听力测试引出率从16 kHz开始下降,糖尿病听力异常组扩展高频听力测试引出率从12.5 kHz开始下降,差异有统计学意义（t 正常=9.03,t 异常=8.59,P 均<0.05）。年龄是影响扩展高频测试结果的重要因素。结论　扩展高频测试可用于糖尿病患者早期听损伤监测。     

京剧器乐的听力损伤（附55例调查报告）

本文对从事京剧打击乐的55人（110耳）进行了听力调查及动态观察。利用图表进行对比分析，发现110耳中高频听力损伤89耳，占81％；语频听力损伤32耳，占29.1%；其中伴有高频耳鸣78耳，占70．9％。动态观察30人（60耳），均为永久性听阈阈移。高频听力损伤最早出现的频率是4kHz，并见典型“V”谷，符合噪声性聋的诊断。     

Frequency resolution in children

The auditory frequency resolving ability of preschool children, school-aged children, and adults was assessed in a standard forced-choice masking experiment. Thresholds for pure-tone signals at 500 Hz, 2000 Hz, and 4000 Hz were obtained in two masking conditions. In one condition, the masker was a 4000-Hz-wide band of noise centered at the signal frequency; in the other, there was a notch in the noise spectrum, approximately one-half octave wide and 50 dB deep, centered at the signal frequency. Frequency resolving ability was inferred from the difference in signal threshold between the two masking conditions. The adaptive forced-choice psychophysical procedure was embedded in a video game in order to obtain rigorous psychophysical data within the attentional limits of young children. This procedure produced data from children as young as 3 years old that were qualitatively indistinguishable from adult data. However, the threshold estimates from the children were more variable from run to run than were the estimates obtained from adults. The mean data from this experiment suggest that frequency resolving ability improves at all frequencies with increasing age.     

Frequency mapping in cochlear implants

OBJECTIVE: To understand the short-term ("acute") effects of parametric variations to the frequency-to-electrode mapping on phoneme identification by Nucleus-22 cochlear implant listeners. METHODS: Phoneme recognition was measured in five Nucleus-22 cochlear implant listeners using custom four-channel continuous interleaved sampler (CIS) processors. For the four-channel processors, speech signals were band-pass filtered into four broad frequency bands. The temporal envelope in each band was extracted by half-wave rectification and low-pass filtering at 160 Hz. The extracted envelope was then transformed to electric currents by a power function with an exponent of 0.2. The resulting electric currents were delivered to four electrode pairs (18,22), (13,17), (8,12), (3,7). The effect of frequency-to-electrode mapping was investigated by systematically varying the parameters of band-pass filters while fixing the electrode locations. Experiment 1 measured phoneme recognition as a function of the slope of band-pass filters. The slope of band-pass filters varied from 48 dB/octave to 6 dB/octave; the corner frequencies of band-pass filters were not varied. Experiment 2 measured phoneme recognition as a function of the distribution of band-pass filters across a fixed overall frequency range. The frequency divisions of a fixed overall frequency range were systematically varied from a logarithmic to a linear distribution. Experiment 3 measured phoneme recognition as a function of the bandwidth of the band-pass filters. The bandwidth of each filter varied from 0.2 to 2 octaves; the center frequencies for each band were not varied. No practice or feedback was provided for subjects in all experiments. RESULTS: The slope of the band-pass filters had little effect on both vowel and consonant recognition. A slight performance drop was observed for only the shallowest slope condition (6 dB/octave). In contrast, the distribution of the band-pass filters had a strong effect on vowel recognition but a weak effect on consonant recognition. Best performance was achieved when a logarithmic or near-logarithmic frequency distribution was used to divide the overall frequency range. The bandwidth of the band-pass filters had a moderate effect on both vowel and consonant recognition. Vowel scores dropped significantly when the bandwidth of filters was too broad, whereas consonant scores dropped significantly when a narrower bandwidth was used. CONCLUSION: Under "acute" testing conditions, phoneme recognition with a four-channel CIS strategy seems to be only mildly affected by the slope of the band-pass filters, but can be significantly affected by the distribution of filters as well as the bandwidth of the filters. Optimal or near-optimal performance can be achieved with a logarithmic frequency distribution. Vowels are more susceptible to broad bandwidths, whereas consonants are more susceptible to narrow bandwidths.     

移频助听技术与移频助听器

自从助听器诞生以来．助听技术一直在不断完善、改进和更新。虽然这些技术的确改善了听障人士配戴助听器的舒适度．但仍然不能解决重度和重度以上听障病人听清并理解语言及在所有听觉环境下都能理解语言的问题。     

Frequency representation in the rat cochlea

In order to determine the place-frequency map of the rat cochlea, iontophoretic HRP-injections were made into the cochlear nucleus at electrophysiologically characterized positions. Distribution of retrograde HRP transport in cochlear spiral ganglion cells was analysed by means of a three dimensional reconstruction of the cochlea. The map was established for frequencies between 1.2 and 54 kHz, corresponding to positions between 96.5 to 2% of basilar membrane length (base = 0%). At apex of the cochlea the slope of the place-frequency map was below 0.25 mm/octave. The slope increased to a value of 2.1 mm/octave at 34% basilar membrane length, and remained almost constant towards the cochlear base. The close relationship between frequency range of highest sensitivity and maximum receptor- and innervation-density in the rat cochlea is discussed.     

Extended High Frequency Audiometry in Pre-school Children

Since adequate and reliable earphones are now available and standards have been established, clinical audiometry can be performed at extended high frequencies (EHFs). In the present study, 47 preschool children (aged 4–7 years) were examined with EHFs (8-16 kHz) using the new Sennheiser HDA 200 earphone. The hearing thresholds correspond to those of other studies; the median thresholds and range increase with increasing frequency. The medians and quartiles were: 10 kHz: 25 (5–35) dB(SPL), 11.2 kHz: 35 (20–40) dB(SPL), 14 kHz 40 (30–50) dB(SPL) and 16 kHz: 50 (40–60) dB(SPL). The hearing thresholds could be more reliably determined in the older children (< 5 years) and were 5 dB better than in the younger ones (< 5 years). Thresholds in the 10-12.5 kHz range correspond to those of adults but are more sensitive by 5–12 dB in the 14–16 kHz range.     

Frequency selectivity in patients with acoustic neuroma

Frequency selectivity was compared in subjects with hearing loss due to acoustic neuroma and cochlear pathology, and normal listeners. A particular interest was the role of probe tone parameters on the shape of the tuning curve. Psychophysical tuning curves (PTCs) were measured for each of two equal energy 2000-Hz probe tones (10 dB SL/300 msec and 17 dB SL/60 msec), using simultaneous 1/3-octave narrowband noise maskers centered at 1, 1.25, 1.6, 2.5, 3.15, and 4 kHz. The results showed that the critical masker levels obtained for impaired listeners were significantly greater than those from normal subjects. The slope of the low-frequency limb of the PTC was steeper for normal compared to hearing-impaired listeners but there was no difference due to site of lesion. In all three groups, the critical masker levels obtained with the short probe were significantly greater than those for the long probe, negating the hypothesis that equal energy probes would yield the same outcomes. Tuning in listeners with hearing loss was highly correlated with audiometric threshold but not with tumor size, width of the internal auditory canal, or tumor location within the cerebellopontine angle. The main conclusion was that cochlear and retrocochlear hearing loss are similar with respect to their effect on frequency selectivity.     

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.     

Frequency shaping and multiband compression in hearing aids

Compression and noncompression amplification were compared for a range of conditions. The noncompression conditions included flat-frequency response and “LDL frequency response,” with and without peak clipping. The compression conditions included a single-band compression system and two combinations of a two-channel compression system. The LDL frequency response was obtained by finding the LDL for each subject using one-third octave bands of noise and then determining that frequency response which would amplify each one-third octave band of speech to just below the LDL for that band. A low-frequency roll off below 300 Hz was used to reduce upward spread of masking. Four hearing-impaired persons served as subjects. Four replications of the Nonsense Syllable Test were administered in quiet and in noise for each experimental condition. The highest scores were obtained, on the average, for the condition of noncompression, no peak clipping, with the LDL frequency response. There were, however, large individual differences in relative performance on different conditions, indicating the importance of individualized determination of optimum amplification characteristics.