Diplacusis, hearing threshold and otoacoustic emissions in an episode of sudden, unilateral cochlear hearing loss

Limited data are available on the relationship between diplacusis and otoacoustic emissions and sudden hearing threshold changes, and the detail of the mechanism underlying diplacusis is not well understood. Data are presented here from an intensively studied single episode of sudden, non-conductive, mild hearing loss with associated binaural diplacusis, probably due to a viral infection. Treatment with steroids was administered for 1 week. This paper examines the relationships between the hearing loss, diplacusis and otoacoustic emissions during recovery on a day-by-day basis. The hearing thresholds were elevated by up to 20 dB at 4kHz and upwards, and there was an interaural pitch difference up to 12% at 4 and 8 kHz. There was also a frequency-specific change in transient evoked otoacoustic emission (TEOAE) and distortion-product otoacoustic emission (DPOAE) level. DPOAE level was reduced by up to 20 dB. with the greatest change seen when a stimulus with a wide stimulus frequency ratio was used. Frequency shifts in the 2f2-fi DPOAE fine structure corresponded to changes in the diplacusis. Complete recovery to previous levels was observed for TEOAE, DPOAE and hearing threshold. The diplacusis recovered to within normal limits after 4 weeks. The frequency shift seen in the DPOAE fine structure did not quite resolve, suggesting a very slight permanent change. The time-courses of TEOAE. diplacusis and hearing threshold were significantly different: most notably, the hearing threshold was stable over a period when the diplacusis deteriorated. This suggests that the cochlear mechanisms involved in diplacusis, hearing threshold and OAE may not be identical.     

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。     

Fine structure of distortion product otoacoustic emissions: its dependence on age and hearing threshold and clinical implications

Distortion product otoacoustic emissions (DPOAE) are routinely used in audiological diagnostics. When the stimulus frequencies f1 and f2 are varied in small steps, distinct non-monotonicities (peaks and valleys) in DPOAE level versus frequency functions can be observed. This so-called DPOAE fine structure (FS) is supposed to be the result of physiological interferences between two different cochlear sources which generate the DPOAE signal. Although FS can complicate interpretations with respect to cochlear functional status at the primary source near f2, its presence might also be relevant in clinical audiological diagnostics. It is therefore of interest to determine FS prevalence and its dependence on age, frequency and hearing threshold. First, it was screened for FS using two tone stimulation (L1/L2 = 55/45 dB SPL, f2/f1 = 1.22) and frequency steps of 40 Hz in the frequency range of 1.8-4.2 kHz. DPOAE (2f1 - f2) were then recorded in 1/3 octave-bands centered around f2 = 2, 3 and 4 kHz with a frequency resolution of 12.5, 20 and 25 Hz, respectively, both with and without a third stimulus (L3 = 45 dB SPL, f3 = 2f1 - f2 + 25 Hz) which was supposed to act as a suppressor of FS. Results of measurements in 102 human individuals from a mixed patient population are reported. Prevalence of DPOAE and FS in a specific frequency range, (i.e. 2, 3, or 4 kHz) was classified into five categories: I) distinct FS within the respective frequency range, II) "single dip" in DP-gram, III) "flat" DP-gram well above noise floor but no distinct FS, IV) DPOAE near noise floor with "irregular responses", and V) no DPOAE measurable. The prevalence of the categories was set in relation to the subject's age and the audiometric threshold at the corresponding center frequency. The estimated probability for a FS (category I and II) was 50-80% if hearing threshold was better than 10 dB HL at the corresponding center frequency. FS prevalence strongly decreased with increasing hearing loss (P < 0.0001). There was no statistically significant age effect (P = 0.088). In more than 50% of the subjects with a behavioral hearing threshold of 10 dB HL or better, a distinct FS near the according frequency was detected, given the presented measurement conditions. While further research is directed at optimal suppression of the second cochlear source of DPOAE and thereby of FS in order to obtain information about the cochlear status near f2 only, the evaluation of FS itself may be clinically useful for monitoring subtle cochlear changes, e.g. during exposure to ototoxic substances or noise.     

Occupational hearing loss: screening with distortion-product otoacoustic emissions

Hearing assessment of applicants for occupational hearing loss compensation can be a time-consuming process. An accurate screening procedure that is sensitive to occupational hearing loss may have application in many situations. The present study developed distortion-product otoacoustic emission (DPOAE) screening criteria to identify subjects likely to meet the Hong Kong requirements for occupational hearing loss compensation, namely a bilateral sensorineural loss ≥ 40 dB HL (average of 1000, 2000 and 3000 Hz). The screening criteria of 1500 and/ or 2000 Hz, with a signal-to-noise ratio of >0 or 3 dB, yielded high sensitivity and specificity. DPOAE measures therefore have the potential to accurately indicate possible occupational hearing loss. However, DPOAEs should be used as a screening tool only, as conventional pure-tone audiometry remains the more comprehensive measure of hearing sensitivity.     

Comparison of characteristics observed in tinnitus patients with unilateral vs bilateral symptoms,with both normal hearing threshold and distortion-product otoacoustic emissions

Conclusion: Tinnitus characteristics in normal-hearing patients differ between the groups with unilateral and bilateral complaints.

Objectives: The study was to determine the differences between tinnitus characteristics observed in patients with unilateral vs bilateral symptoms and normal hearing threshold, as well as normal results of distortion-product otoacoustic emissions (DPOAEs).

Method: The patients answered questions concerning tinnitus duration, laterality, character, accompanying symptoms, and circumstances of onset. The results of tympanometry, auditory brainstem responses, tinnitus likeness spectrum, minimum masking level (MML), and uncomfortable loudness level were evaluated. Records of 380 tinnitus sufferers were examined. Patients with abnormal audiograms and/or DPOAEs were excluded. The remaining 66 participants were divided into groups with unilateral and bilateral tinnitus.

Results: Unilateral tinnitus in normal-hearing patients was diagnosed twice more frequently than bilateral. Tinnitus pitch was higher in the group with bilateral tinnitus (p?p?p?p?p?相似文献   

The relationship between auditory threshold and evoked otoacoustic emissions

The aim of this study was to compare transiently evoked otoacoustic emissions (TEOAE) and distortion product otoacoustic emissions (DPOAE) in normal hearing ears (n = 44) and ears with cochlear hearing loss (HL) to obtain defined data on qualitative and quantitative correlations. In addition, we wanted to determine the reliability with which a clinical examiner could predict a typical, idealized audiometric configuration from TEOAE measurements. In the hearing-impaired subjects (n = 149), a 50% reduction of OAE incidence was caused by a mean HL of 10.5 dB for TEOAE compared to 27 dB SPL for DPOAE. A 90% incidence reduction was found at a mean threshold elevation of 33 dB for TEOAE and 51 dB for DPOAE. Correlation between TEOAE amplitudes and HL was in general rather low (r = –0.1 to –0.5), while DPOAE amplitudes showed a slightly better correlation with HL (r = –0.3 to –0.6). In general, efforts to derive an audiogram from evoked OAE have been more promising for DPOAE than for TEOAE. However, our studies showed that approximately 40% of the ears with HL could be categorized correctly into one of five typical audiometric patterns from TEOAE measurements. Additionally, a cochlear HL in or near the medium frequency range was much more likely to cause a reduction in TEOAE than an isolated low- or high-frequency lesion. Accordingly, TEOAE were often preserved in ears with isolated HL in the high or low frequencies. Received: 7 May 1998 / Accepted: 25 September 1998     

Comparison of transient evoked otoacoustic emissions and distortion product otoacoustic emissions when screening hearing in preschool children in a community setting

OBJECTIVE: The first purpose of this study was to compare transient evoked otoacoustic emissions (TEOAE) with distortion product otoacoustic emissions (DPOAE) to determine if they resulted in equivalent signal-to-noise ratios (SNRs) when used for hearing screening in a preschool population in a community setting. The second purpose was to determine if the OAE methods would result in equivalent pass/refer rates. The third purpose was to determine the agreement between the pass/refer rates from a tympanometric screening and the pass/refer rates from each OAE method. METHODS: Thirty-three preschool children ages 4 months to 4 years, 4 months were tested using DPOAE and TEOAE. The frequencies 800-4000Hz were compared. The tympanometric gradient was obtained from a tympanogram done on each ear. A multivariate statistic was used to compare the emission SNR from both methods. A chi(2) statistic was used to compare the pass/refer rates from both methods. The agreement between the pass/refer rates from the OAE screens and from the tympanometric gradient were compared. RESULTS: TEOAE and DPOAE SNRs were significantly different in the low frequency however, there were no significant differences found in the high frequencies. There were no significant pass/refer differences found between the methods at any frequency. When comparing the agreement between the OAE methods with the tympanometry, both methods produced nearly equivalent agreement with tympanometric gradient. However, the overall correspondence between OAE findings and tympanometry was not perfect. CONCLUSIONS: Both methods are effective and especially equivalent in the high frequencies and can be recommended for use in a preschool population in the field. Tympanometric gradient disagreed with both OAE screening results about 25% of the time. Finally, our study also found that higher refer rates can be expected when young (<3 years) preschool children are included in the screen.     

Hearing loss in vestibular schwannomas: analysis of cochlear function by means of distortion-product otoacoustic emissions

Objective

We investigated cochlear function in a group of patients affected by vestibular schwannoma (VS), by means of recording distortion-product otoacoustic emissions (DPOAEs).

Methods

Between January 1996 and January 2007, we observed 183 patients affected by unilateral VS. DPOAEs, compared to the corresponding hearing thresholds, were subjectively classified into three categories: “compatible” with hearing function, “cochlear” and “retro-cochlear”. We also related the responses to some clinical variables (tumor size, intracanalicular tumor and radiologic appearance of the internal auditory canal). Statistical analysis was performed.

Results

In 137 cases (74.9%), DPOAEs were as expected based on audiometry responses, while in 11 patients (6%) a “cochlear” DP-gram was recorded and in 35 patients (19.1%) DPOAEs evidenced a “retro-cochlear” pattern. In eight cases we detected acoustic responses despite a profound hearing loss. No statistically significant data merged from the comparison between “cochlear” and “retro-cochlear” responses and the clinical variables.

Conclusion

Our results confirm that sensorineural hearing loss due to VS can be of sensory and/or neural origin. DPOAEs still remain just a complementary auditory test; nevertheless, in case of severe or profound unilateral hearing loss, recorded acoustic responses may be suspicious for the presence of a vestibular schwannoma.     

The prognostic value of the otoacoustic emission test in low frequency sudden hearing loss

Low frequency sudden hearing loss (LFSHL) is a frequent finding in the otological practice. Several prognostic indicators have been suggested concerning the prediction of the outcome of sudden hearing loss, but so far there are no proven factors to establish the prognosis. The aim of this study was to assess whether OAEs could be considered as a reliable prognostic test in LFSHL. The study group consisted of 20 patients presenting with a unilateral LFSHL. Each patient was submitted to spontaneous otoacoustic emissions (SOAEs), transient otoacoustic emissions (TEOAEs) and distortion products (DPOAEs) recording and then treated with glycerol administrated intravenously in 3-h intervals for 4 days. Pure tone audiometry (PTA) threshold was evaluated again 1 h after the last administration of glycerol. After osmotic therapy 12 patients (60%) showed a significant PTA improvement with a mean improvement of 11 dB; modifications were significant at the Students t test for paired data (P<0.0001). The relationship between the pretherapy presence or absence of SOAEs, TEOAEs and DPOAEs and PTA modification was not significant at the exact Fishers test. In conclusion, even if our study supports that OAEs could be an indicator of the inner ear functional state, they cannot be utilized as a prognostic test in LFSHL in relation to the efficacy of osmotic therapy. Among the other parameters evaluated, only the precocity of therapy seems to be related to prognosis in LFSHL.This revised version was published online in June 2004 with corrections to the names of the authors.     

听力正常人畸变产物耳声发射的基本特性

利用动态分析仪ＩＬＰＯ－９２，对４８例听力正常人在４组不同原始刺激强度下进行畸变产物耳声发射检查，结果发现平均ＤＰＯＡＥｓ图呈双叶型轮廓：在１．５ｋＨｚ和５ｋＨｚ附近。     

单侧突发性聋患者对侧耳耳声发射分析

目的研究突发性聋患者单耳发病时对侧耳的耳蜗功能状态。方法利用Capella耳声发射仪对单侧突发性聋患者的对侧耳50例(50耳,病例组)及正常人30例(60耳,对照组)分别进行瞬态声诱发耳声发射(TEOAE)及畸变产物耳声发射(DPOAE)检测,记录和分析TEOAE的通过率及各频率DPOAE的检出率、幅值。结果①TEOAE通过率对照组为100%,病例组为75%,两组比较差异有统计学意义(χ2=20.84,P<0.01);②DPOAE检出率在0.5、0.75、1.0、3.0、4.0 kHz频点上,病例组低于对照组(P<0.05或P<0.01);③与对照组相比,病例组各频率DPOAE的幅值均降低,差异有统计学意义(P<0.05或P<0.01)。结论部分突发性聋患者的对侧耳已出现早期耳蜗功能受累,利用耳声发射分析方法可在听力损失出现之前早期发现此类病变。     

Evaluation of otoacoustic emissions in high-risk infants by using an easy and rapid objective auditory screening method

Summary Ninety-five ears of 53 infants at high risk for hearing impairment were examined using brainstemevoked response audiometry (BERA), stapedial reflex audiometry (SRA) and click-evoked otoacoustic emissions (EOAEs). By taking BERA as a reference, the results obtained were compared in order to evaluate the significance of EOAEs for auditory screening. EOAEs were present in more than 90% of the ears when the BERA threshold was below 30 dB. In this group of infants, the stapedial reflex was positive in about 80% of the ears examined. In contrast, EOAEs were never observed with BERA thresholds exceeding 40 dB. In several cases with BERA thresholds above 30 dB, elevated SRA values could also be recorded. A further advantage of EOAEs and SRA was a recording time of less than 3 min. Since the non-invasive recording of EOAEs was fast and easy to perform and the results obtained were reproducible, we conclude that click-evoked otoacoustic emissions are a reliable technique for demonstrating normal cochlear function.     

遗传性无综合征耳聋一家系畸变产物耳声发射测试

目的　探索遗传性进行性无综合征耳聋患者的听功能改变特点。方法　一个常染色体显性遗传进行性无综合征耳聋家系 5 2名成员及听力正常组 15名 ,进行了纯音测试及畸变产物耳声发射 (distortionproductotoacousticemissions,DPOAE)测试。结果　无综合征耳聋家系中 34名成员纯音测试为感音神经性聋 ,其中纯音听阈均值 (puretoneaverage ,PTA)≥ 40dB的 15例 (2 9耳 )DPOAE反应缺失 ,PTA≤ 35dB伴高频下降的 12例 (2 3耳 )DPOAE高频或高、中频振幅下降或缺失 ;2 1名 (42耳 )纯音听阈正常成员中 ,有 12例 (15耳 )DPOAE高频或高、中频振幅下降或缺失。结论　DPOAE能鉴别出耳蜗亚临床的病理改变 ,对该病的早期诊断 ,遗传咨询有指导意义。     

Bilateral sudden sensorineural hearing loss caused by alcohol abuse and heroin sniffing

Objective. Acute or chronic heroin abuse has been associated with various central neurologic pathologies and, occasionally, with peripheral nervous system damage. The effect of heroin on hearing has not been adequately documented, although several cases with sudden hearing loss owed to heroin abuse have been reported. We present a young male with bilateral sudden sensorineural hearing loss, following heroin sniffing and alcohol consumption. Methods. Our patient underwent a detailed clinical and audiological evaluation, including auditory brainstem responses and otoacoustic emission. Routine laboratory blood tests and imaging studies were performed. Results. The patient was treated with corticosteroids and magnesium, resulting in complete restoration of hearing after one month. Conclusion. Sudden hearing loss owed to heroin abuse is usually curable, following adequate treatment.     

Quantitative analysis of cochlear active mechanisms in tinnitus subjects with normal hearing sensitivity: multiparametric recording of evoked otoacoustic emissions and contralateral suppression

Objective

Aim of this study was to investigate the possible role played by outer hair cells and cochlear efferent system functionality when tinnitus develops in normal hearing ears. A multiparametric approach was used, entailing recording and analysis of a set of otoacoustic emissions (OAEs): distortion product (DPOAEs), transient evoked (TEOAEs) and efferent-mediated TEOAE suppression in the presence of contralateral acoustic stimulation (CAS).

Methods

Fifty-four subjects with normal hearing sensitivity participated in the study. Twenty-three suffered from chronic subjective tinnitus whereas thirty-one did not have tinnitus and acted as control subjects. DPOAEs were measured with eliciting tones of frequency ratio 1.22 and intensity 65 and 55 dB SPL in the frequency range 0.5–8 kHz. TEOAEs were recorded with the ‘linear’ protocol using clicks at 60 dB peak SPL both in the absence and in the presence of CAS at two different intensities. DPOAE amplitude, TEOAE amplitude, and TEOAE suppression were analysed as relevant parameters.

Results

Significantly reduced DPOAE amplitude in the frequency range 1.5–8 kHz, lower TEOAE amplitude, and slightly decreased TEOAE suppression were measured in tinnitus subjects compared to non-tinnitus controls. In particular, 74% of tinnitus subjects exhibited abnormal DPOAEs, 13% had abnormal TEOAEs, whereas abnormal TEOAE suppression was found in 9% of patients.

Conclusion

Overall, the present work revealed the presence of abnormal OAEs, in particular at higher frequencies, in tinnitus subjects with normal hearing sensitivity. A minor (i.e., sub-clinical) outer hair cell dysfunction, particularly in high-frequency cochlear regions, might thus be assumed in normal hearing tinnitus subjects. In order to better put in light the possible role played by outer hair cells in low-frequency cochlear regions, or by the cochlear efferent system, additional analyses would be needed.     

自觉听力正常耳鸣患者纯音听力及畸变产物耳声发射临床分析

目的分析自觉听力正常耳鸣患者的纯音听力特征,并探讨自觉听力正常耳鸣患者畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)测定值与纯音听阈值之间的相关性及其意义。方法 2010—2011年在我科就诊的以耳鸣为第一主诉但无明显自觉听力障碍患者114例(190耳),对所有入组患者进行纯音测听及DPOAE检测。分析DPOAE测定值与纯音听阈值之间的相关性,并结合其发病的可能危险因素进行相关分析。结果自觉听力正常的耳鸣患者中,听力异常可达76.84%(146/190)。纯音测听表现为:高频下降型46.31%(88/190);低频下降型14.73%(28/190);正常23.15%(44/190);其它类型15.78%(30/190)。其危险因素主要为:噪声接触,疲劳和/或精神压力、其他基础疾病等。所有频率(f0)的DPOAE幅值与各频率纯音听阈间存在负相关,且有明显的频率对应关系。结论自觉听力正常的耳鸣患者存在一定程度的听力损失,尤其以高频听力下降为多见。DPOAE测定值与其纯音听阈之间呈明显的负相关关系,且DPOAE测试频率与纯音听阈频率间存在明显的对应关系,DPOAE检测作为一种客观指标,可以在一定程度上反映自觉听力正常耳鸣患者的听力损失程度,有一定的临床应用价值。     

瞬态诱发耳声发射检测职业性听力损伤的可行性研究

目的 :探讨瞬态诱发耳声发射 (TEOAE)检测职业性听力损伤的可行性及临床应用价值。方法 :选择 90例 (180耳 )噪声暴露工人为实验总组 ,按噪声暴露时间长短又分为 1、2、3组 ;另选 11例 (2 2耳 )正常听力青年人作为对照组 ,行纯音听阈和TEOAE测试。结果 :各实验组纯音听阈值明显高于对照组 ,TEOAE总重复率、幅值和信噪比及各频段重复率、幅值和信噪比明显低于对照组 (P <0 .0 5或P <0 .0 1)。实验 1、2、3组间比较 ,随着噪声接触时间的增加 ,各频率点纯音听阈提高 ,TEOAE总重复率、幅值和信噪比及各频段重复率、幅值和信噪比变小 ,在 2 .5 0～ 3.5 0kHz和 3.5 0～ 4 .5 0kHz频段最明显。结论 :用TEOAE检测职业性听力损伤是可行的 ,有临床应用价值 ,最敏感频段为 2 .5 0～ 3.5 0kHz和 3.5 0～ 4 .5 0kHz频段。     

Newborn hearing screening project using transient evoked otoacoustic emissions: Western Sicily experience

OBJECTIVE: To study the incidence of congenital sensorineural hearing loss in all newborns introducing a screen test with a protocol no expensive, with a good "screen sensitivity" that could let an earlier identification of hearing impairment beginning early intervention by 2 months of age and increasing the probability of having language development within the normal range of development. METHODS: The study was conducted in Sciacca hospital from the beginning of 2003 to our days and was carried out with transient evoked otoacoustic emission using the criteria for PASS or RETEST and considering eventual prenatal and perinatal risk factors. All the newborns were divided into four groups each one with its personal secondary step program. RESULTS: In the years 2003-2004 the number of the newborns in Sciacca hospital was: 538 for 2003, 653 for 2004 with a total of 1191; all these infants were divided in three groups: resident in Sciacca, resident in the Sciacca borderlands and resident out of the district of Sciacca. The coverage (percentage of the target population who undergo the screen) was of 90% in the 2003 (483 newborns) and of 90% in the 2004 (585 newborns) with two cases of congenital sensorineural hearing loss identified. The incidence of sensorineural hearing loss, in the District of Sciacca, was estimated to be 2.07/1000 in 2003 and 1.70/1000 in 2004. CONCLUSIONS: The higher incidence of sensorineural hearing loss in our study is due to a high prevalence of consanguineous marriage in Sicily that was shown to be linked with hearing impairment. The "sensitivity value" was 95% at the first step but became 99% after the second step with a few number of false positive (0.74%). All the infants with a diagnosis of sensorineural hearing loss began a rehabilitation program before the age of 5 months and they have a good speech development and speech intelligibility.     

Distortion-product otoacoustic emission: early detection in deferoxamine induced ototoxicity

OBJECTIVE: Deferoxamine therapy in lifelong transfusion-dependent anaemias, as beta-thalassemia major, is associated with an increased risk of ototoxic changes. With increasing survival rates, prevention and/or early detection of ototoxicity are important for providing management options. The predictive value of pure-tone audiometry in early detection of ototoxicity has been questioned, particularly in the higher frequencies. Otoacoustic emissions appear to be more sensitive to cochlear insult than the conventional pure-tone audiometry. The aim of our study was to compare the efficacy of otoacoustic emissions (distortion-product otoacoustic emissions) with that of pure-tone audiometry as method of audiological monitoring. METHODS: Baseline audiometric (0.25-8kHz) and otoacoustic emission testing (distortion-product otoacoustic emissions) was conducted in a group of patients with beta-thalassemia major, 60 of whom met the criteria for inclusion in the study. Comparisons were performed between baseline measurements and those recorded after 20 months. Distortion-product otoacoustic emissions were obtained as DP-grams. The DP-gram amplitude was determined for each child. RESULTS: Threshold changes from baseline were found to be statistically significant from 4 to 8kHz in 68.4% of the subjects (P<0.01). Distortion-product otoacoustic emissions demonstrated a significant threshold shift and a decreased amplitude in the frequencies >3kHz (P<0.05). Furthermore, DP-gram amplitude also reduced significantly at 3kHz (P<0.05) without any similar change in pure-tone audiometry. CONCLUSIONS: As ototoxicity screening tool DP-gram was extremely sensitive and superior to pure-tone audiometry. Their use is recommended for regular monitoring of cochlear function, aiming in prevention of permanent damage.     

耳声发射正常的听觉障碍类型

目的：分析总结临床中耳声发射正常的听觉障碍类型。方法：对83例听觉障碍患者行纯音听阈、阻抗、听性脑干反应（ABR）、40Hz AERP、自发性耳声发射（SOAE）、瞬态耳声发射（TEOAE）、畸变产物耳声发射（DPOAE）测试及CT和（或）MRI扫描。结果：耳声发射（OAE）正常的听觉障碍包括：①听神经病68例;②听神经瘤2例;③皮层聋或中枢性聋3例;④听觉过敏2例;⑤功能性聋2例;⑥伪聋6例。结论：耳声发射检测在蜗后性聋、中枢性聋、非器质性聋和其他一些特殊类型听觉障碍的诊断和鉴别诊断中具有重要临床意义。