感音神经性聋成人不同刺激声ASSR反应阈与纯音听阈的相关性分析

目的探讨调制声听性稳态反应(ASSR)、 CE-Chirp ASSR用于评估感音神经性聋成人客观听力的价值。方法对78例(131耳)感音神经性聋成人同时进行纯音听阈和调制声ASSR、 CE-Chirp ASSR测试,比较0.5~4 kHz各频率纯音听阈与调制声ASSR、CE-Chirp ASSR反应阈的相关性及差值。结果 0.5、1、2、4 kHz CE-Chirp ASSR反应阈与纯音听阈的相关系数(分别为0.77、0.73、0.80、0.88)均高于调制声ASSR反应阈与纯音听阈的相关系数(分别为0.64、0.61、0.78、0.84),调制声ASSR、CE-Chirp ASSR反应阈与纯音听阈均具有显著相关性(圴为P<0.01);0.5~4 kHz CE-Chirp ASSR反应阈和纯音听阈的差值(分别为8.09±4.74、10.76±5.86、7.44±7.95、6.11±9.14 dB)均明显小于调制声ASSR反应阈和纯音听阈间的差值(分别为14.31±6.38、13.85±6.25、17.17±6.29、13.58±4.35 dB),差异均有统计学意义(均为P<0.05)。结论 CE-Chirp ASSR快捷可靠,较调制声ASSR能更好地评估感音神经性聋成人的听力。     

不同听力损失耳听觉稳态诱发反应阈值与纯音听阈的比较

目的研究不同听力损失耳的听觉稳态诱发反应(auditory steady-state evoked response,ASSR)与纯音听阈的关系,为客观的听力评估提供指导。方法对67例(103耳)不同听力损失耳分别行ASSR与纯音测听检查,比较ASSR分别在0.5、1、24、kHz频率处的反应阈值与纯音听阈的相关性及差值。结果ASSR的反应阈与纯音听阈在0.5、1、24、kHz频率处的相关系数分别为0.84、0.83、0.89、0.91,呈极显著相关(P<0.01);ASSR的反应阈与纯音听阈在0.5、1、2、4 kHz频率处的差值在轻度耳聋组分别为(11.2±3.5)dBHL、(12.9±3.7)dBHL、(13.6±4.1)dBHL、(13.4±4.5)dBHL;在中度耳聋组分别为(3.4±4.6)dBHL,(4.9±4.3)dBHL,(6.8±5.7)dBHL,(7.1±5.6)dBHL;在重度耳聋组分别为(1.5±3.1)dBHL,(3.4±2.1)dBHL,(2.9±2.3)dBHL,(1.2±2.6)dBHL;其中轻度耳聋组的ASSR的反应阈与纯音听阈的平均差值与重度耳聋组的平均差值有统计学意义(P<0.01)。结论ASSR反应阈与纯音听阈有显著相关性,随着听力损失的加重,ASSR反应阈愈接近纯音听阈,ASSR可作为不同听力损失者客观的听力评估。     

成人频率特异性chirp听性稳态反应与纯音听阈测试的相关性研究

目的采用chirp信号作为声刺激进行听性稳态反应(auditory steady-state response,ASSR)测试,观察chirp-ASSR反应阈值与纯音听阈的相关性,探讨chirp-ASSR客观听力检测在成人临床听力评估中的价值。方法研究对象包括正常成人组(年龄20～60岁,共计151耳)和感音神经性听力损失组(年龄22～82岁,共计83耳)。在500Hz、1000Hz、2000Hz和4000Hz处进行Chirp-ASSR和纯音听阈测试,并对结果进行统计学分析。结果 0.5～4kHz频率听力正常组Chirp-ASSR反应阈与纯音听阈的相关系数r分别为0.19、0.43、0.58、068;0.5-4.0kHz频率感音神经性听力障碍者的相关系数r分别为0.68、0.84、0.87、0.84;校正后0.5～4kHz各听力组预估听力阈值与纯音听阈的差值较校正前明显缩小。结论在0.5～4.0kHz频率,Chirp-ASSR反应阈与纯音听阈之间存在明显的相关性,在听力损失组中两者的相关性更加显著,而在500Hz处两者的相关性较其它频率低。Chirp-ASSR在客观听力评价中有较好的准确率。     

听性稳态反应对噪声性聋客观评估的价值

目的 研究噪声性聋患者的听性稳态反应(ASSR)阈与纯音听阈的关系,为客观评估噪声性聋及伪聋提供依据.方法 对40例(80耳)噪声性聋患者及20例(40耳)正常人分别进行ASSR与纯音听阈测试,分别比较0.25、0.5、1、2、3、4、6 kHz各频率ASSR反应阈与纯音听阈的差值及相关性.结果 正常组在0.25、0.5 kHz的ASSR反应阈与纯音听阈相比差异无统计学意义(P＞0.05),在1、2、3、4、6 kHz的ASSR反应阈高于纯音听阈,二者相比差异有统计学意义(P＜0.05).噪声性聋组除2 kHz外其余各频率ASSR的反应阈与纯音听阈相比差异无统计学意义(P＞0.05),其ASSR反应阈与纯音听阈在0.25、0.5、1、2、3、4、6 kHz处的相关系数分别为0.55、0.62、0.55、0.49、0.54、0.73、0.73.结论 噪声性聋患者ASSR反应阈与纯音听阈显著相关,且随着听力损失的加重,ASSR反应阈越接近纯音听阈;ASSR可作为噪声性聋及伪聋患者的客观听力评估方法之一.     

成人感音神经性聋听觉稳态诱发反应阈值与纯音听阈值比较

目的：测定成人感音神经性聋患者听觉稳态诱发反应（ASSR）和纯音听阈值,为临床诊断提供客观依据。方法：选成人感音神经性聋患者33例（65耳）,行ASSR阈值纯音听测试。结果：ASSR、纯音听阈值对比有统计学意义,听阈有显著相关性,0．5、1．0、2．0、4．0kHz频区间相关系数分别为：0．769、0．772、0．743、0．756。ASSR阈值较行为阈值高,ASSR阈值与纯音听阈间差值多在3．0～10．0dB HL之间。在0．5、1．0、2．0、4．0kHz频区间分剐为：4．77、8．83、6．49、3．67dB HL,随频率增高,两者的差异有缩小趋势。结论：成人感音神经性聋患者ASSR阈值与纯音听阈间对比有统计学意义,通过测试ASSR阈值可推断出被检查者纯音听阈的阈值。     

听性稳态反应和短声诱发的听性脑干反应在客观听阈评估中的作用

目的探讨听性稳态反应(auditory steady-state responses,ASSR)和短声诱发听性脑干反应(ABR)在感音神经性聋人群客观听阈评估中的作用及其在耳聋鉴定中的价值。方法对感音神经性聋组(35耳)及正常组(22耳)分别进行纯音听阈、ABR及ASSR测试,并记录0.5、1、2及4kHz ASSR反应阈(dBHL)、纯音听阈(dBHL)及ABR反应阈(dBnHL)。结果正常组在0.5、1、2、4kHz的ASSR反应阈与纯音听阈相比差异无统计学意义(P>0.05),ABR反应阈与各频率纯音听阈差异有显著统计学意义(P<0.05);耳聋组各频率ASSR反应阈与纯音听阈差异无统计学意义(P>0.05),ABR反应阈与0.5kHz纯音听阈差异有统计学意义(P<0.05),与1、2、4kHz纯音听阈差异无统计学意义(P>0.05)。结论ASSR与ABR联合测试是临床工作中用于客观听阈评估的有效方法。     

感音神经性聋患者窄带CE-Chirp ASSR测试结果初步分析

目的探讨感音神经性听力损失患者CE-Chirp声诱发听性稳态反应(auditory steady state response,CE-Chirp ASSR)与纯音听阈各频率反应阈值的相关性。方法选取中、重度听力损失患者18例(30耳)为受试者,听性稳态反应调制频率为90 Hz,分别测试窄带CE-chirp ASSR和纯音听阈500、1000、2000和4000 Hz的反应阈值,并进行相关性分析。结果 0.5-4.0 kHz频率CE-Chirp ASSR反应阈与纯音听阈的的相关系数r分别为0.671、0.704、0.563、0.687(P<0.01)。结论 CE-Chirp ASSR反应阈与纯音听阈有显著相关性,在客观听力评估中有较好的准确性。     

多频稳态诱发电位评估中度感音神经性聋儿童的应用

目的探讨多频稳态听觉诱发电位评估儿童中度感音神经性聋的可靠性。方法所有患者经纯音测听（PTA）检查筛选出中度感音神经性聋30例5～6岁儿童（共40耳），然后口服10％水合氯醛镇静睡眠后，行多频稳态听觉诱发电位（ASSR）检测，其阈值与纯音听阂阈值进行比较，分析不同频率处听力阈值分布情况及其相关性。结果分别比较语言频率ASSR阂值与纯音听闽阈值，结果显示，0．5kHz处相关性较差，其差值为2-18dB，而在4kHz处相关性最好。结论可以应用多频稳态听觉诱发电位评估中度感音神经性聋儿童的听力阈值，但需要注意0．5kHz处的相关性差异。     

感音神经性聋儿童听性稳态反应与行为听阈相关性分析

目的：分析感音神经性聋儿童听性稳态反应（auditory steady－state response,ASSR）与行为听阈的相关性。方法63例（126耳）重度或极重度感音神经性听力损失儿童,年龄0．5～6岁,按年龄分为 A 组（0．5～1．0岁,21例）,B 组（1．1～3．0岁,21例）,C 组（3．1～6．0岁,21例）;分别进行 ASSR 及小儿行为听阈测试,A 组采用行为观察测听（BOA）,B 组采用视觉强化测听（VRA）,C 组采用游戏测听（PA）,采用 SPSS17．0统计软件分析二种检查结果的相关性。结果①ASSR 反应阈与行为听阈在0．5、1、2和4 kHz 处的相关系数分别为0．75、0．76、0．76、0．83,呈极显著相关（P ＜0．01）。②小儿行为听阈值通常比 ASSR 反应阈值低,随着频率的增高,两者间差距缩小。③A 组（相关系数0．70）各频率 ABR 反应阈与行为听阈相关性均较 B（相关系数0．78）、C（相关系数0．83）组低。结论0．5～6．0岁感音神经性聋儿童 ASSR 与行为听阈值均有良好的相关性,ASSR 可预测感音神经性聋儿言语频率的客观听阈,为低龄儿童及难以检测行为听力的患儿验配助听器提供参考。     

儿童分泌性中耳炎患者骨导听觉稳态诱发反应的测试

目的研究听觉稳态诱发反应(ASSR)对儿童传导性聋及骨导客观听阈评估的准确性。方法对26例(32耳)儿童分泌性中耳炎患者进行气、骨导ASSR及纯音测听,并将ASSR反应阈和纯音听阈进行比较。结果气、骨导ASSR反应阈和纯音听阈之间具有较好的相关性,ASSR气、骨导反应阈均高于纯音气、骨导听阈,ASSR骨导反应阈可以预测相应的纯音骨导听阈。ASSR对儿童传导性聋评估的准确性和纯音测听相似。结论 ASSR可用作儿童传导性聋患者客观听阈的评估。     

Auditory steady-state responses for children with severe to profound hearing loss

OBJECTIVE: To investigate the clinical usefulness of the dichotic single-frequency auditory steady-state response (ASSR) for estimation of behavioral thresholds in children with severe to profound congenital sensorineural hearing loss. DESIGN: A comparative experimental research design was selected to compare behavioral and ASSR thresholds for the sample. Behavioral pure-tone audiometry served as the criterion standard. SETTING: Hearing Clinic, Department of Communication Pathology, University of Pretoria, Pretoria, South Africa. PATIENTS: A referred sample of 10 patients (20 ears), 5 girls and 5 boys aged 10 to 15 years (mean age, 13 years 4 months), with severe to profound sensorineural hearing impairment. MAIN OUTCOME MEASURES: The difference, and correlation, between 160 pure-tone behavioral and ASSR thresholds at 0.5, 1, 2, and 4 kHz. RESULTS: Mean differences between ASSR and behavioral thresholds were 6 dB for 0.5 kHz and 4 dB for 1, 2, and 4 kHz, with standard deviations varying between 8 and 12 dB. No significant differences (P<.05) were observed between ASSR and behavioral thresholds, except at 0.5 kHz, and Pearson correlation coefficients varied between 0.58 and 0.74 across the evaluated frequencies, with best correlation at 1 kHz and worst at 0.5 kHz. CONCLUSIONS: The ASSR thresholds provided reliable estimations of behavioral thresholds for children with severe to profound hearing loss and indicated an increased sensitivity for more profound hearing loss.     

60例军校男女学员ASSR测试研究

目的旨在观察正常年轻人多频稳态诱发电位（ASSR）测试的正常值特点。方法对60例第一军医大学学员行ASSR、ABR和电测听测试，比较男．女及左、右耳测试值的差异。结果ASSR0．5kHz、1kHz、2kHz、4kHz测试值均数与纯音听闻均数各频率的差值分别为13．86dBHL、14．63dBHL、13．06dBHL．15．28dBHL；ASSR0．5kHz、1kHz、2kHz、4KHz测试值均数与ABRV波反应阈的差值分别为6．14dBHL、5．37dBHL、6．94dBHL、4．72dBHL；男、女学员ASSR测试值比较无显著性差异（P〉0．05）。结论ASSR正常值不受性别．耳别的影响；用ASSR测试值来推断预估纯音听阈．ABRV波反应阈要综合考虑各频率的差值。     

正常儿童多频稳态诱发电位与纯音测听测试的相关性

目的：测定正常儿童多频稳态听觉诱发反应（multiple auditory steady-state responses,ASSR）阈值及纯音听阈,探讨两者的相关性。方法：对30例（60耳）正常5～10岁儿童分别行ASSR与纯音测听测试。结果：不同频率ASSR测试值均数与纯音听阈均数差值为11～16.50dB HL;各频率ASSR测试值与纯音听阈均数间差异均有统计学意义（P＜0.05）,在0.25?kHz及0.5?kHz组差异尤为明显（P＜0.01）。除0.25?kHz及0.5?kHz外,其他频率ASSR测试值与纯音听阈相关系数均有统计学意义（P＜0.05）,且随着测试频率的增加,两者的相关关系有增强趋势。结论：正常5～10岁儿童中、高频率ASSR测试值与纯音听阈有良好的相关性,可应用ASSR预测被检查者纯音听阈。     

Comparison of pure tone audiometry and auditory steady-state responses in subjects with normal hearing and hearing loss

The objective of this study is to compare pure tone audiometry and auditory steady-state response (ASSR) thresholds in normal hearing (NH) subjects and subjects with hearing loss. This study involved 23 NH adults and 38 adults with hearing loss (HI). After detection of behavioral thresholds (BHT) with pure tone audiometry, each subject was tested for ASSR responses in the same day. Only one ear was tested for each subject. The mean pure tone average was 9 ± 4 dB for NH group and 57 ± 14 for HI group. There was a very strong correlation between BHT and ASSR measurements in HI group. However, the correlation was weaker in the NH group. The mean differences of pure tone average of four frequencies (0.5, 1, 2, and 4 kHz) and ASSR threshold average of same frequencies were 13 ± 6 dB in NH group and 7 ± 5 dB in HI group and the difference was significant (P = 0.01). It was found that 86% of threshold difference values were less than 20 dB in NH group and 92% of threshold difference values were less than 20 dB in HI group. In conclusion, ASSR thresholds can be used to predict the configuration of pure tone audiometry. Results are more accurate in HI group than NH group. Although ASSR can be used in cochlear implant decision-making process, findings do not permit the utilization of the test for medico-legal reasons.     

Auditory steady state response in pediatric audiology

The main issue regarding pediatric audiology diagnosis is determining procedures to configure reliable results which can be used to predict frequency-specific hearing thresholds.AimTo investigate the correlation between auditory steady-state response (ASSR) with other tests in children with sensorineural hearing loss.MethodsProspective cross-sectional contemporary cohort study. Twenty-three children (ages 1 to 7; mean, 3 years old) were submitted to ASSR, behavioral audiometry, click audiometry brain stem response (ABR), tone burst ABR, and predicting hearing level from the acoustic reflex.Resultsthe correlation between behavioral thresholds and ASSR was (0.70- 0.93), for the ABR tone burst it was (0.73 -0.93), for the ABR click it was (0.83-0.89) only at 2k and 4 kHz. The match between the ASSR and the hearing threshold prediction rule was considered moderate.Conclusionthere was a significant correlation between the ASSR and audiometry, as well as between ABR click (2k and 4 kHz) and for the ABR tone burst. The acoustic reflex can be used to add information to diagnosis in children.     

Auditory steady-state responses for estimating moderate hearing loss

The auditory steady-state response (ASSR) has gained popularity as an alternative technique for objective audiometry but its use in less severe degrees of hearing loss has been questioned. The aim of this study was to investigate the usefulness of the ASSR in estimating moderate degrees of hearing loss. Seven subjects (12 ears) with moderate sensorineural hearing loss between 15 and 18 years of age were enrolled in the study. Forty-eight behavioural and ASSR thresholds were obtained across the frequencies of 0.5, 1, 2, and 4 kHz. ASSR thresholds were determined using a dichotic multiple frequency recording technique. Mean threshold differences varied between 2 and 8 dB (±7–10 dB SD) across frequencies. The highest difference and variability was recorded at 0.5 kHz. The frequencies 1–4 kHz also revealed significantly better correlations (0.74–0.88) compared to 0.5 kHz (0.31). Comparing correlation coefficients for behavioural thresholds less than 60 and 60 dB and higher revealed a significant difference. Eighty-six percent of ASSR thresholds corresponded within 5 dB of moderate to severe behavioural thresholds compared to only 29% for mild to moderate thresholds in this study. The results confirm that the ASSR can reliably estimate behavioural thresholds of 60 dB and higher, but due to increased variability, caution is recommended when estimating behavioural thresholds of less than 60 dB, especially at 0.5 kHz.