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.     

正常人扩展高频测听结果报告

目的研究正常人扩展高频听敏度,观察扩展高频听力随年龄增加的细微变化.方法用意大利Amplaid-460型听力计,频率范围8～18kHz.测试正常人128人、256耳,17～50岁,男92人,女36人,其中17～29岁90人,30～50岁38人,125Hz～8kHz纯音各频率听阈≤20dBHL,声导抗测听正常.以5岁为一年龄段分5组进行分析.结果1.正常年轻人(17～29岁)高频听阈总的趋势是随频率提高,听阈逐渐增加,出现率逐渐下降,在14kHz以上频率更为显著;2.正常人17～19岁、20～24岁、25～29岁、30～34岁、35岁以上各年龄组间12、14、16、18kHz听阈相比差异有显著性(P＜0.05),随年龄增加听阈逐渐提高,高频听阈出现率逐渐下降,随频率增加各年龄组差距逐渐明显,14kHz以上频率最为明显.结论人耳的老化是一个逐渐的过程,随年龄增加听阈提高.频率越高受影响越明显.扩展高频纯音测听结果可反映耳蜗亚临床病理状态,有利于早期发现听觉感受器病变,可用于临床监测耳毒性听力损失和早期诊断梅尼埃病等.     

Preoperative speech and pure-tone audiometry in four types of patients with acoustic neuroma

PURPOSE: The goal of this study was to compare pure-tone and speech audiometry in 4 groups of patients with confirmed unilateral acoustic neuroma in which auditory brainstem responses and transient-evoked otoacoustic emissions were either both normal, abnormal, or one of the tests was abnormal.Material and methods: This study was realized during a preoperative assessment of 65 patients (29 men, 36 women) from 25 to 78 years of age suffering from unilateral acoustic neuroma. The assessment, preceded by tympanometry, included recordings of auditory brainstem responses, transient-evoked otoacoustic emissions, pure-tone audiometry, speech recognition thresholds, and speech discrimination. RESULTS: Some discrepancies between objective and behavioral test results were noticed. Subjects with no otoacoustic emissions but present auditory brainstem responses did not show any significant difference in their speech scores as compared with subjects with both auditory brainstem responses and otoacoustic emissions. CONCLUSIONS: In summary, this study showed that comparable audiometric findings in acoustic neuroma patients can be found regardless of the presence of transient otoacoustic emissions (TEOAEs). TEOAEs are a good screening tool and have been used, like auditory brainstem-evoked responses, as a predictive measure before hearing preservation procedures but cannot predict the audiogram or give information about speech perception. The findings confirm that even if auditory brainstem responses are an extremely useful diagnostic tool for identifying acoustic neuroma, this test provides only giving pieces of information regarding auditory abilities. Also, the pure-tone audiogram gives useful information but has to be used in conjunction with speech audiometry to get an accurate picture of the patient's true auditory abilities.     

Pure‐tone and speech audiometry in patients with Menière's disease

The aim of this study was to reinvestigate many of the claims in the literature about hearing loss in patients with Menière's disease. We carried this out on a well‐defined group of patients under well‐controlled circumstances. Thus, we were able to find support for some claims and none for many others. As part of a diagnostic protocol, pure‐tone and speech audiometry was performed on 111 patients with Menière's disease according to the ‘Definition Menière Groningen’. This was a prospective clinical cohort study. Affected ears of patients suffering from Menière's disease show reduced hearing, both in pure‐tone and in speech audiometry. A classification method was devised to determine audiogram shape in an objective manner. The results of this method indicate that affected ears more frequently show ‘low’ or ‘low + high’ hearing losses (P = 0.006). The shape of the hearing loss does not depend on the duration of the affection of the disease. In combination with the fact that the average hearing loss does not correlate with the duration of the disease, this leads to the conclusion that, if a classification of the hearing loss in Menière's disease is possible, such a classification cannot be connected to the duration. This conclusion is further supported by the fact that no relationship is found between the duration of the disease and the classification of the hearing loss over the 3 months before hospital admission, as given by the patients in a questionnaire. A relationship between the (objective) audiometric data and the (subjective) classification of the hearing loss by the patient seems to be present, but is not very strong. Correlations between pure‐tone and speech audiometry are present as in non‐Menière ears (r = 0.899, P < 0.001), and no indications are found of reduced speech discrimination relative to the expectation based on pure‐tone loss. The audiogram shape does not appear to play any additional role in speech discrimination (in addition to the influence of the average pure‐tone loss).     

Impedance audiometry with 3-probe frequency]

The 3-probe frequency (226, 678, 1000Hz) admittance (Y), susceptance (B) and conductance (G) tympanograms were recorded from 28 normal-hearing adults with a GSI 33 Version 2 Middle-Ear analyzer, and the 3-frequency ipsilateral acoustic-reflex thresholds were measured too. In all subjects, there were normal values of tympanometric indices, such as peak compliances, peak pressures, gradients and ear canal volumes, and of ipsilateral acoustic-reflex thresholds at a 226-Hz probe tone. From 226 to 1000Hz, Y, B and G increased in magnitude while the corresponding admittance-,susceptance- and conductance-tympanogram peak pressures (PY, PB, PG) shifted towards positive evidently. In comparison with 226 Hz, the 678-Hz static admittance (Y') and static susceptance (B') values were large but had no significant differences as compared with those of 1000 Hz. The relation among Y, B and G, among PY, PB and PG, and between Y' and B' changed as a function of probe frequency from 226 to 1000 Hz. The average reflex thresholds of 25 adults (30 ears) were 83 dB HL at 226-Hz probe frequency, 91 dB at 678 Hz, and 88 dB at 1000 Hz, using a 1000-Hz tonal activator. There were significant differences among the 3 values (all P less than 0.01). The ipsilateral acoustic reflexes from 3 adults (4 ears) were present at 226-and 678-Hz probe tones, but not at 1000 Hz.     

Ototoxicity monitoring with ultra-high frequency audiometry in peritoneal dialysis patients treated with vancomycin or gentamicin

Ototoxicity affects the higher frequencies first and extends to the lower frequencies during continuation of the ototoxic treatment. Peritonitis due to continuous ambulatory peritoneal dialysis (CAPD) regularly demands ototoxic antibiotic treatment, e.g. with gentamicin and vancomycin. In this study ultra-high frequency audiometry (10-20 kHz), 'normal' audiometry (0.125-8 kHz) and registration of blood concentrations of the antibiotics were used to assess ototoxic hearing loss during treatment of CAPD patients with peritonitis.     

慢性肾功能不全血液透析患者的高频纯音听阈检测

目的:探讨慢性肾功能不全血液透析患者的高频听阈的变化特点。方法:将慢性肾功能不全行血液 透析的患者(透析组)与正常人(对照组)的高频听阈的变化特点进行比较。结果:透析组与对照组高频听阈的平 均阈值均随年龄的增加而增加,然高频阈值的检出率则随年龄和测听频率的增加而下降;但透析组阈值增加的程 度明显高于对照组。结论:透析组患者的听力损害以高频下降为主,其高频阈值亦较对照组高,差异有统计学意 义。     

Hyperbaric oxygenation with corticoid in experimental acoustic trauma

Among possible therapies after acute acoustic trauma, hyperbaric oxygenation (HBO) combined with corticoid was found effective in several animal studies. Such evidence was obtained for moderate 20–25 dB losses. The aim of this study was to further assess this therapy for noise-induced hearing losses greater than previously examined. Sixty-five ears from thirty-six adult guinea pigs were used. Acoustically evoked responses from intracranial electrodes chronically implanted bilaterally into the ventral cochlear nucleus were used to assess acoustic sensitivity alterations. Trauma sound was a third-octave noise-band around 8 kHz presented bilaterally at 115 dB SPL for 45 min. One control group received no treatment, one group was treated with HBO only and another with corticoid only both starting within one day post-trauma, two groups were treated with both HBO and corticoid starting for one group within one day post-trauma, and for the second group at 6 days post-trauma. Acoustic thresholds were measured between the 6th and the 16th days after acoustic trauma. Animals treated with HBO alone or corticoid alone did not differ from controls. Combined HBO and corticoid therapy provided significant protection from noise-induced loss of auditory thresholds, especially when started one day post-exposure. Hearing loss reduction induced by HBO combined with corticoid was of similar magnitude (about 10–15 dB) as in previous studies although the induced hearing loss was considerably greater (about 40 dB instead of 20–25 dB).     

82例耳鸣患者半倍频程频率纯音测听的特征及意义

目的 :观察常规倍频程纯音测听听阈无异常的耳鸣患者的半倍频程频率测试结果并探讨其特征及临床意义。方法 :应用纯音听力计对 82例 (14 0耳 )倍频程纯音测听听阈无异常的耳鸣组患者和 30例 (6 0耳 )正常对照组进行半倍频程频率测试。结果 :耳鸣组 14 0耳中 ,发现 37.14 %存在听力下降 ;主要为高频下降 ;大多为轻度下降 ;下降的频率与耳鸣频率有高度一致性 ;耳鸣的强度 (dBSL)与听力下降与否无关。结论 :半倍频程频率测试方法可为倍频程纯音测听听阈无异常的耳鸣患者早期听力损害的检出提供直接参考依据 ,对临床早期发现其潜在的耳蜗病变有积极意义     

BSER audiometry in haemodialysis patients

The object of this paper was to study the brain stem evoked response in 20 patients suffering from chronic renal failure and having haemodialysis, and to evaluate the effects of this treatment. A further 5 successful renal transplant patients were investigated to analyse the evolution of the brain stem conduction when the metabolic abnormality is removed. In the first group, the responses were minimally abnormal in 30% of cases before the dialysis. The dialysis session showed an improvement of the brain stem conduction. This variation was temporary and, 24 hours following the dialysis treatment, the patients showed the pathological values observed before the dialysis. The results of the successful transplanted patients were consistent with the data obtained in the dialysis group. Before transplantation the nerve impulse conduction was found to be abnormal in 3 subjects. These abnormalities disappeared completely after successful transplantation. These results support the view of those who favour the use of evoked potentials to follow the status of the central nervous system in uraemic patients.     

Predictive value of high frequency audiometry in otosclerosis]

A study was carried out to evaluate the value of high-frequency audiometry in stapes surgery in cases of otosclerosis. The hearing function was measured pre- and postoperatively by means of conventional and high-frequency audiometry (Demlar 20k). The operative findings of the gradation of otosclerosis were compared with the pre and postoperative audiometrical measurements. The results of this study point out that a clear relation exists between the preoperative high tone audiogram and the gradation of otosclerosis. In conclusion, we state that high-frequency audiometry can predict the state of stapes fixation in otosclerosis and that can be important in stapes surgery.