短时纯音暴露对正常人畸变产物耳声发射幅值及频谱时间序列的影响

探讨在耳蜗功能早期轻微损害时畸变产物耳声发射（ＤＰＯＡＥ）幅值及频谱时间序列的特征,促进ＤＰＯＡＥ的临床应用。方法：用 １３０ｄＢ ＳＰＬ的 ４ ｋＨｚ纯音对 １５例听力正常人（３０耳）进行 ３ ｍｉｎ的短时暴露,造成听力暂时性阈移后,用ＩＬＯ－９０耳声发射仪记录、分析暂时性阈移（ＴＴＳ）时ＤＰＯＡＥ的幅值、时间序列的特征,并与纯音暴露前进行对比。结果：正常人经过短时纯音暴露后,０．５,１,２ ｋＨｚ纯音和宽带噪声的声反射阈升高,纯音暴露前后０．５、１、２ ｋＨｚ与ＢＢＮ之间的平均反射阈差值分别为（９．７８±６．９８）,（８．０４±５．５８）,（１３．０±５．５８） ｄＢ ＨＬ和（８．８２±６．２３）,（５．７５±４．４２）,（９．０５±２．２７）ｄＢ ＨＬ,声反射阈差值缩小。纯音暴露前后６ ｋＨｚＤＰＯＡＥ幅值分别为（６．００±３．４５）和（１．７２±１. ２３） ｄＢ ＳＰＬ,降低４．２８ ｄＢ ＳＰＬ,时间序列变异系数为（５．１８±１．６３）％,时间序列曲线稳定性降低,ＤＰＯＡＥ幅值与时间序列结合发现８０％的人ＤＰＯＡＥ处于异常范围。结论：ＤＰＯＡＥ的幅值与时间序列结合分析有诊断耳蜗功能早期轻微受损的临床价值。     

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     

正常青年人自发性耳声发射的测试及意义

目的：探讨自发性耳声发射（ＳＯＡＥ）与耳蜗功能间的关系。方法：对５０例正常青年人进行了ＳＯＡＥ检查。结果：５０例（１００耳）中ＳＯＡＥ检出率为４０％（４０耳）,性别、左右耳差异无显著性（Ｐ〉０．０５）;有ＳＯＡＥ的４０耳中振幅范围为－２７．５￣９．７ｄＢＳＰＬ,频率范围为２６９￣５６６０Ｈｚ,无性别差异,ＳＯＥＡ与纯音测听听阈间差异无显著性（Ｐ〉０．０５）。结论：ＳＯＡＥ的出现意味着有好的耳蜗功能     

畸变产物耳声发射对侧抑制效应的研究

利用ＩＬＯ９２耳动态分析仪，测试２３例（４６耳）正常青年人的畸变产物耳声发射（ＤＰＯＡＥ）和对侧窄带噪声（ＮＢＮ）的影响。结果：（１）对侧ＮＢＮ对ＤＰＯＡＥ的抑制非常明显，随ＮＢＮ强度增加ＤＰＯＡＥ幅值下降增加，二者呈显著负相关（Ｆ２为１～６ｋＨｚ，γ为－０．４９～－０．２４，均Ｐ〈０．０５，斜率０．２６～０．０８ｄＢ／１０ｄＢ）。（２）在Ｆ２为中频（１．２ｋＨｚ）且为中等强度（４５～６５ｄＢＳＰ     

选择注意对畸变产物耳声发射的影响

为研究高级中枢对耳蜗微机制的调控作用，对正常人１６例（３２耳）进行有和无视觉选择任务条件下的畸变学产物耳声发射（ＤＰＯＡＥ）测试，结果显示视觉任务了出现时ＤＰＯＡＥ幅值下降，Ｆ２为１，２ｋＨｚ处的ＤＰＯＡＥ幅值下降达显著性水平（Ｐ〈０．０５）。讨论了调控作用的可能机制，认为研究高级中枢和橄榄耳蜗传出神经系统对耳蜗功能的影响将有十分重要的生理和病理意义。     

钻井工人畸变产物耳声发射的检测

目的：了解畸变产物耳声发射（ＤＰＯＡＥ）在监测噪声性聋方面的应用价值。方法：检测１０２例（１９５耳）钻井工人ＤＰＯＡＥ的幅值和引出率。结果：钻井工人ＤＰＯＡＥ的幅值和引出率均较对照组明显下降;随着接触噪声工龄的延长,ＤＰＯＡＥ的引出率逐渐下降;纯音测听正常的接触噪声者与正常人相比,ＤＰＯＡＥ的幅值及引出率亦明显降低;ＤＰＯＡＥ高频段引出率与相应频段的纯音听阈存在着负相关。结论：ＤＰＯＡＥ能较好地反     

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     

畸变产物耳声发射临床应用价值的探讨

研究了７３例（１３９耳）纯音听阈正常耳及各种感音神经性聋耳的ＤＰＯＡＥ，发现ＤＰＯＡＥ对耳蜗功能异常的改变早于纯音测听，并可精确地反映耳蜗毛细胞在相关频率上的功能状态；ＤＰＯＡＥ幅值及引出率随纯音听阈的提高而下降，当纯音听阈＞５０ｄＢ（ＨＬ）时，ＤＰＯＡＥ幅值明显降低或缺失；蜗后病变耳ＤＰＯＡＥ正常，当蜗后病变累及耳蜗时，ＤＰＯＡＥ幅值可异常，其异常程度与纯音听阈不平行。认为ＤＰＯＡＥ有广泛临床应用价值。     

短时纯音暴露对正常人畸变产物耳声发射幅值及频谱时间序 …

目的：探讨在耳蜗功能早期以微损害时畸变产物耳声发射（ＤＰＯＡＥ）幅值及频谱邓列的特征，促进ＤＰＯＡＥ的临床。方法：用１３０ｄＢＳＰＬ的４ｋＨｚ纯音对１５例听力正常人（３０耳）进行３ｍｉｎ的短时暴露，造成听力暂时性阈移后，用ＩＬＯ－９０耳声发射仪记录，分析暂时性阈移（ＴＴＳ）时ＤＰＯＡＥ的幅值，时间序列的特征，并与纯音暴露前进行对比。结果：正常人经过短时纯音暴露后，０．５，１．２ｋＨｚ纯音和宽带噪声     

不同类型及强度的对侧声刺激对畸变产物耳声发射的影响

目的 观察不同类型及强度的对侧声刺激对ＤＰＯＡＥ的影响。方法 以三种不同类型（白噪声，窄带噪声，纯音）及八种强度（阈上０－３５ｄＢ范围内，每档５ｄＢ）的对侧声刺激测试１２例正常人（２４耳）在有，无对侧声刺激出现时的ＤＰＯＡＥ幅值变化。结果（１）三种类型的对侧声刺激均能使ＤＰＯＡＥ幅值下降，白噪声抑制作用最大，窄带噪声次之，纯音抑制作用最小。（２）随对侧声刺激强度增加，抑制现象增加两垧显著相关。（     

自发性耳声发射与耳蜗传出调控的关系探讨

OBJECTIVE: To study the relationship between spontaneous otoacoustic emissions(SOAE) and efferent control of cochlea and their clinical significance. METHODS: SOAE, transient evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE) and contralateral white noise (60 dB SPL) suppression of TEOAE and DPOAE experiments were conducted in 312 ears of 95 patients with retrocochlear impairment and/or MOCS dysfunction and 64 normal young adults. RESULTS: MOCS dysfunction was shown in 126 ears of 65 patients (130 ears) with auditory neuropathy, 2 ears of 2 patients with unilateral acoustic neuroma, 4 ears of 2 patients with hyperacusis, 14 ears of 26 patients(48 ears) with normal hearing level in unilateral or bilateral tinnitus. Stronger EOAE could be recorded in total 146 ears with MOCS dysfunction at any pure tone hearing level. SOAE could be recorded in 126 of 146 ears (86.3%) with MOCS dysfunction and 44 of 128 ears (34.3%) with normal hearing. SOAE of ears with MOCS dysfunction was mainly at frequencies from 0.693 to 3.055 kHz and SOAE of normal ears was at frequencies from 1.135 to 2.746 kHz. Average value of maximum amplitude of SOAE spectrum (-3.4 +/- 6.4) dB SPL was significantly greater than that in normal ears (-6.8 +/- 7.8) dB SPL (P < 0.01). The major frequency range of SOAE (0.693-3.055 kHz) in MOCS dysfunction ears was essentially consistent with that of efferent suppression in normal ears (0.7-3 kHz). CONCLUSION: The modulation of the cochlear active mechanisms by MOCS mainly presents in the low- and mid-frequency regions, these frequencies correspond to the frequency range of SOAE. Stronger SOAE indicates pathophysiological significance. There is a clear clinical relationship between SOAE and the efferent modulation of the cochlea.     

畸变产物耳声发射选择注意效应测试对糖尿病人听力的评价

为观察畸变产物耳声发射选择注意效应的临床应用价值对１９例控制良性的糖尿病人进行ＤＰＯＡＥ温度，并以１９例正常人作对照。结果示，正常人在对侧声刺激与视觉任务同时出现时，相对幅值增加，ＣＡＳ与视觉任务有协同作用。２例糖尿病人的ＤＰＯＡＥ在３ｋＨｚ以上频率区消失，４例的对侧抑制效应，选择注意效应及协同效应显著减弱，ＤＰＯＡＥ相对幅值显著小于正常人；３例的相对幅值均为正值，ＣＡＳ或视觉任务不但不抑制，反而     

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。     

Sound-Evoked Olivocochlear Activation in Unanesthetized Mice

Genetic tools available for the mouse make it a powerful model to study the modulation of cochlear function by descending control systems. Suppression of distortion product otoacoustic emission (DPOAE) amplitude by contralateral acoustic stimulation (CAS) provides a robust tool for noninvasively monitoring the strength of descending modulation, yet investigations in mice have been performed infrequently and only under anesthesia, a condition likely to reduce olivocochlear activation. Here, we characterize the contralateral olivocochlear reflex in the alert, unanesthetized mouse. Head-fixed mice were restrained between two closed acoustic systems, while an artifact rejection protocol minimized contamination from self-generated sounds and movements. In mice anesthetized with pentobarbital, ketamine or urethane, CAS at 80 dB SPL evoked, on average, a <1-dB change in DPOAE amplitude. In contrast, the mean CAS-induced DPOAE suppression in unanesthetized mice was nearly 8 dB. Experiments in mice with targeted deletion of the α9 subunit of the nicotinic acetylcholine receptor confirmed the contribution of the medial olivocochlear efferents to this phenomenon. These findings demonstrate the utility of the CAS assay in the unanesthetized mouse and highlight the adverse effects of anesthesia when probing the functional status of descending control pathways within the auditory system.     

Contralateral suppression of linear and nonlinear transient evoked otoacoustic emissions in neonates at risk for hearing loss

To investigate the transient evoked otoacoustic emissions (TEOAE) contralateral suppression in neonates at risk for hearing loss, 55 neonates at risk for hearing loss (risk group) and 72 full-term neonates not at such risk (control group) were bilaterally tested. In all neonates, the TEOAE were recorded in two stimulation modes (linear and nonlinear clicks), with and without contralateral acoustic stimulation. Findings revealed significant contralateral suppression of otoacoustic emissions in both groups, but the amount of TEOAE contralateral suppression was reduced for at risk group (p=0.001), supporting the hypothesis that medial olivocochlear bundle function is reduced in neonates at risk for hearing loss. The combination of contralateral acoustic stimulation and TEOAE enables easy and noninvasive study of auditory efferent function. However it should be emphasized that the reduction in TEOAE contralateral suppression in the risk group, statistically identified as a group effect, might not be detectable in individual cases. Further studies are needed in order to determine whether the lower amount of TEOAE contralateral suppression in neonates at risk for hearing loss represents a risk for developing auditory processing disorders. LEARNING OUTCOMES: The reader will be introduced to the study using auditory efferent pathway activation by contralateral acoustic stimulation (CAS), resulting in the TEOAE suppression effect. The characteristics of TEOAE suppression in the neonatal population, in which it provides evidence of the reduced medial olivocochlear system function in those at risk for hearing loss, will also be addressed.     

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。     

Medial olivocochlear functioning and speech perception in noise in older adults

The purposes of this study were to: (1) compare medial olivocochlear system (MOCS) functioning and speech perception in noise in young and older adults and (2) to quantify the correlation between MOCS functioning and speech perception in noise. Measurements were taken in 20 young (mean 26.3 +/- 2.1 years) and 20 older adults (mean 55.2 +/- 2.8 years). Contralateral distortion product otoacoustic emission (DPOAE) suppression was measured to assess MOCS functioning. Speech perception in noise was evaluated using the Hearing in Noise Test in noise-ipsilateral, noise-front and noise-contralateral test conditions. The results revealed that the older group had a significantly lower high-frequency (3-8 kHz) contralateral DPOAE suppression, and performed more poorly in the noise-ipsilateral condition than the younger group. However, there was no correlation between contralateral DPOAE suppression and speech perception in noise. This study suggests that poor speech perception performance in noise experienced by older adults might be due to a decline in medial olivocochlear functioning, among other factors.     

耳声发射在低频感音神经性聋诊断中的应用

报告利用耳动态分析仪ＩＬＯ－９２，对５４例低频感音神经性聋患者进行了畸变产物耳声发射，瞬态诱发性耳声发射和自发性耳声发射测试。发现突聋和梅尼埃病人的ＴＥＯＡＥ检出率为４８％，ＤＰＯＡＥ的检出率为９１％，且有２例记录到ＳＯＡＥ波。而在不是原因听力下降组中，ＯＡＥ的检出率为１００％，且可记录到ＳＯＡＥ。