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     

畸变产物耳声发射幅值与超高频纯音听阈的关系

目的 探讨畸变产物耳声发射（ｄｉｓｔｏｒｔｉｏｎ ｐｒｏｄｕｃｌｓ ｏｔｏａｃｏｕｓｔｉｃ ｅｍｍｉｓｓｉｏｎ,ＤＰＯＡＥ）与超高频纯音听阈用于早期耳蜗性听力损害的听力监测的可能性。方法 ＤＰＯＡＥ以配对初始音诱发,两音强度均为７０ｄＢ ＳＰＬ,频率比为１：１．２,频率范围０．５￣８ｋＨｚ。测定常规频率（１２５Ｈｚ￣８ｋＨｚ）及超高频率（９￣２０ｋＨｚ）的纯音听阈。比较正常听阈组与不正常听阈值的Ｄ     

听力正常人畸变产物耳声发射的幅值分析

近 2 0年来 ,国内外学者对耳声发射的研究越来越深入 ,尤其是畸变产物耳声发射 (ＤＰＯＡＥ) ,由于其具备稳定性好等优点 ,在临床上的使用价值更显突出。本文旨在研究畸变产物耳声发射幅值的特点。1　资料与方法1.1　临床资料　随机选取志愿者 45人 84耳。入选标准为 :无耳聋、耳鸣、耳闷堵及眩晕病史 ;无耳毒性药物使用史及噪声暴露史 ;纯音听阈小于 2 0ｄＢＨＬ ,鼓室导抗图正常 ,镫骨肌反射正常。排除标准为 :检测畸变产物耳声发射的幅值在任何一频率上与本底噪声的差值小于 3ｄＢ。根据这一标准 ,15耳被排除 ,参加统计的共 42人 ,69耳 ;…     

短时纯音暴露对畸变产物耳声发射的影响

畸变产物耳声发射（ＤＰＯＡＥ）测试所采用的参数可以对测试结果有明显影响，为研究改变ＤＰＯＡＥ测试参数对反映耳蜗功能变化是否有影响，使１０只大白兔（１６耳）接触短时（３分钟）、中等强度（８２ｄＢ ＳＰＬ）的纯音暴露后发现，以等强原始音（Ｌ１＝Ｌ２）诱发的ＤＰＯＡＥ的幅度变化小于以差强原始音（Ｌ２＝Ｌ１－１２ｄＢ）诱发的ＤＰＯＡＥ（相差１０．１１ｄＢ），而其恢复过程也短于后者（相差１００．７１秒）。这     

听力正常人畸变产物耳声发射的基本特征及频谱变化过程分析

为研究DPOAE尤其是DPOAE频谱变化过程的基本特征,根据0.125—8kH_z倍频纯音听阈和鼓室导抗图选择听力正常年轻人19例38耳进行DPOAE的测试.测试的内容包括DP-图、I/O曲线、潜伏期和DPOAE频谱变化过程.结果:DPOAE在正常人均能检出,幅值有明显的个体差异性,DP-图呈双峰伏,峰值分别为9.11±5.28dB SPL和7.72±6.85 dB SPL,位于1.5、6kHz处;3kHz处最小,为5.56±5.84dB SPL,DPOAE幅值随刺激强度的升高而升高,检出阈和潜伏期随频率的升高分别降低和缩短;多数人频谱变化过程曲线平坦,变异系数为253±1.89%,部分耳(7耳)变化过程曲线异常波动,占18.5%;提示频谱变化过程分析可能有反映耳蜗功能的亚临床病变的意义.     

短时纯音暴露对畸变产物耳声发射的影响

畸变产物耳声发射（ＤＰＯＡＥ）测试中所采用的参数可以对测试结果有明显影响，为研究改变ＤＰＯＡＥ测试参数对反映耳蜗功能变化是否有影响，使１０只大白兔（１６耳）接触短时（３分钟）、中等强度（８２ｄＢＳＰＬ）的纯音暴露后发现，以等强原始音（Ｌ１＝Ｌ２）诱发的ＤＰＯＡＥ的幅度变化小于以差强原始音（Ｌ２＝Ｌ１－１２ｄＢ）诱发的ＤＰＯＡＥ（相差１０．１１ｄＢ），而其恢复过程也短于后者（相差１００．７１秒）。这种差别可能提示在ＤＰＯＡＥ的产生过程中有多个生理机制发挥作用，而变化测试参数则可以选择性地突出表现其中某一个机制     

畸变产物耳声发射与纯音听阈间测试频率的相关性研究

目的探讨畸变产物耳声发射(DPOAE)测值与纯音听阈值之间的相关性，阐明DPOAE测试频率(f0)与纯音听阈测试频率之间的对应关系。方法选正常听力人20倒(40耳)，蜗性聋病人100例(179耳)进行纯音听阈和DPOAE测试。用相关分析的统计方法计算出DPOAE测值与纯音听阈值之间的相关系数。结果DPOAE测值与纯音听阈值之间有负相关关系。f0为0．5、0．75、1．0．1．5、2．0、3．0、4．0、6．0、8．0kHz时的DPOAE测值与测试频率分别为1．0、1．0、1．0、2．0．3．0、3．0、4．0、6．0、8．0kHz时的纯音听阈值之间有相对最大的负相关系数。f0为0．5、0.75、1．0、1．5、2．0、3．0、4．0、6．0、8．0kHz时所对应的量相关纯音听阈测试频率分别为0．75、1．0、1．5、2．0、2．5、3．5、5．0、6．0、8．0kHz。结论DPOAE测值与纯音听阈值之间有负相关关系，且DPOAE测试频率与纯音听阈测试频率间存在一定的对应关系。     

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。     

畸变产物耳声发射幅值与纯音听阈相关性的研究

目的：探讨畸变产物耳声发射（distortion product otoacoustic emissions,DPOAE）与常规纯音测听及扩展高频测听的关系。方法：对耳科正常人进行0．5－16kHz DPOAE、常规纯音测听及扩展高频测听检查，比较DPOAE和常规纯音测听、扩展高频测听结果的相关性。结果：0．5-3kHz DPOAE幅值与扩展高频区（10－12．5kHz）的纯音听阈相关；4－6kHz DPOAE幅值与相应频率及11．2kHz的纯音听阈相关；11．2kHz DPOAE幅值与4KHz纯音听阈明显相关。结论：DPOAE可能不全来源于对应频率区及较高频率区耳蜗外毛细胞，其产生部位和机制尚需深入研究。     

纯音听阈正常老年人畸变产物耳声发射特征

目的探讨纯音听阈正常老年人畸变产物耳声发射(DPOAE)特征。方法对纯音听阈正常的青年对照组39例和老年组30例分别行DPOAE检测,比较两组500～8 000Hz各频率DPOAE的检出率和幅值差异。结果老年组DPOAE检出率在3kHz及以下频率与青年组无明显差异(P>0.05),在4、6、8kHz处均明显低于青年组(P<0.05);老年组DPOAE检出率随频率增加而降低,0.5～3kHz DPOAE检出率高于4～8kHz,其中8kHz检出率最低,其次是6kHz和4kHz;老年组与青年组DPOAE幅值的频率特点基本一致,在中低频率幅值较高,在4kHz及以上频率明显降低;老年组各频率DPOAE幅值均低于青年组(P<0.05),差值平均约5.4dB,6、8kHz差值更大,分别为6.75及9dB。结论纯音听阈正常的老年人在4kHz及以上频率DPOAE幅值明显下降,说明该频率段外毛细胞功能减弱,且该现象青年时已开始显现,非老年人特有。     

Racial and gender effects on pure-tone thresholds and distortion-product otoacoustic emissions (DPOAEs) in normal-hearing young adults

This study examined racial and gender effects on behavioral thresholds and distortion-product otoacoustic emissions (DPOAEs) in the same subjects. Pure-tone behavioral thresholds and DPOAEs were measured in 60 young normal-hearing adult subjects (20 Caucasian, 20 Asian, 20 African-American, with ten females and ten males in each group). Behavioral thresholds were measured from 1000 through 16 000 Hz using Békèsy tracking. A DPOAE frequency sweep was measured with primary stimulus levels of L₁/L₂=60/45 dB SPL, and an f₂/f₁ of 1.2 at discrete f₂ frequencies between 2000 through 12 000 Hz for each subject. Significant racial and gender differences in behavioral thresholds were found at 14 000 and 16 000 Hz, with the African Americans and females having the best hearing sensitivity. Based on the current results, similar findings for DPOAE frequency sweeps can be expected amongst different racial groups given that no significant differences were identified between the groups. To further define the effects of race and gender on auditory measures, future studies should include larger numbers of subjects, measurement of body size and middle ear reflectance, and examine emission generators.     

The effect of impulse noise on distortion product otoacoustic emissions

The aim of this study was the evaluation of distortion product otoacoustic emissions (DPOAEs) before and after noise exposure from shooting, and the comparison of DPOAEs with pure-tone audiometry. Thirteen young male police officers were exposed to impulse noise from shooting, without using earplugs. Standard pure-tone audiometry, tympanometry, and DPOAEs were performed before exposure and at one hour post- and 24 hour post-exposure. In the one hour post-exposure testing mean pure-tone thresholds were elevated in the 1–8 kHz frequency zone and DPOAE levels were reduced at several frequencies. DPOAEs were more affected at 3 kHz or lower, whereas pure-tone thresholds were more affected at higher frequencies. After the final examination, non-significant partial shifts at high frequencies on both tests remained. Pure-tone audiometry was overall more sensitive, but DPOAEs provided additional information about the cochlear status of certain ears. These data suggest that besides behavioral testing, DPOAEs may play a role as a fast, objective, and easy to perform test for monitoring subjects exposed to impulse noise.     

Accuracy of distortion-product otoacoustic emissions-based ototoxicity monitoring using various primary frequency step-sizes

Abstract

Objective: A cisplatin ototoxicity monitoring protocol was recently proposed using distortion-product otoacoustic emissions (DPOAEs) measured in 1/48th octave steps over the highest obtainable quarter octave (). This protocol can take up to 40 minutes to complete in both ears among seriously ill patients in a potentially noisy test environment. The goal of the current study was to contrast the diagnostic accuracy of ototoxicity monitoring protocols based on changes in DPOAE levels at wider, more rapidly tested, primary frequency step sizes. Design: Measure DPOAE levels in 1/48th octave steps over the highest half-octave of obtainable DPOAEs prior to treatment and at each ototoxicity monitoring session during the course of treatment with cisplatin. Study sample: Nineteen cancer patients being treated with cisplatin at the Portland Veterans Affairs Medical Center were observed over 56 monitoring appointments. Hearing thresholds in the sensitive region for ototoxicity (SRO) were measured concurrently with DPOAE levels. Results: DPOAE levels measured in 1/24th octave steps provided comparable accuracy, and half the testing time, to the 1/48th octave step protocol previously described. Conclusions: DPOAE level shifts measured in 1/24th octave steps may provide a basis for rapid ototoxicity monitoring among adult cancer patients treated with cisplatin.     

椎基底动脉短暂缺血性眩晕患者畸变产物耳声发射的频谱时间序列分析

为探讨畸变产物耳声发射（DPOAE）对椎基底动脉短暂缺血性眩晕（VBTIV）患者进行定位诊断的可能性，利用ILO－92耳声发射仪对21例VBTIV患者进行了纳音听阈、声反射阈及DPOAE测试。结果示，21例VBTIV患者纯音听阈、声反射阈均无明显改变；而DPOAE的平均幅值下降，变异系数增大，DPOAE的平均幅值与变异系数结合发现VBTIV患者中36．8％属于异常。提示部分VBTIV患者存在用常规听力学测试方法难以发现的耳蜗功能损害，DPOAE的频谱时间序列分析有可能为证实并鉴别VBTIV是属于中枢性还是周围性提供依据。     

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。     

Topodiagnostic assessment of occupational noise-induced hearing loss using distortion-product otoacoustic emissions compared to the short increment sensitivity index test

Because the efforts needed to produce an “automatic audiogram” by means of distortion-product otoacoustic emissions (DPOAE) are still experimental, their capacity to produce objective topodiagnostic information must still be defined. In the present study results of the short increment sensitivity index testing (SISI) test in 97 patients with noise-induced hearing loss (NIHL) were compared with those of a DP-gram. Pure tone, speech and impedance audiometry, SISI tests and DPOAE measurements were performed on all patients. SISI was measured in both ears of 93 patients and unilaterally in 4 patients. SISI was also determined at two frequencies in 46 patients. Six measurements were rejected because of conductive hearing losses in adjacent frequencies. In all, 230 measurements could be compared. After classifying topodiagnostic results of the SISI test and DP-gram into cochlear, inconclusive and retrocochlear lesions, statistically significant correlations were found and differences were noted in only 18% of cases. Findings demonstrated the superiority of DPOAE to the SISI test in obtaining topodiagnostic information about inner ear disease. Received: 24 March 1998 / Accepted: 29 July 1998     

Modification of otoacoustic emissions following ear-level exposure to MP3 player music

The purpose of this study was to examine if a pre-determined exposure level and duration of MP3 player music would result in significant changes in cochlear function when measured with audiometric and physiological methods. Distortion-product otoacoustic emissions (DPOAEs), synchronized spontaneous otoacoustic emissions (SSOAEs), and hearing thresholds were measured in 20 normal-hearing adults before and after a 30-minute MP3 player music exposure. DPOAEs were acquired with 65/45 dB SPL primary tones (f₂=0.842–7.996 kHz) with a frequency resolution of 8 points/octave. A probe microphone system recorded ear-canal music levels and was used to equalize levels at approximately 85 dBC across individuals during the music presentation. Comparison of pre- and post-exposure measurements revealed no significant differences in hearing thresholds, but DPOAE levels in half-octave bands centered from 1.4–6.0 kHz were significantly reduced following the music exposure. Post-exposure shifts in SSOAE frequency and level were highly variable in individuals identified with SSOAEs. The results for the exposure conditions explored in this study indicate that changes in otoacoustic emissions may precede the development of music-induced hearing threshold shifts.     

次声波对豚鼠畸变产物耳声发射幅度的影响

目的观察强次声波暴露后豚鼠畸变产物耳声发射(DPOAE)的变化情况.方法将15只豚鼠置于频率8Hz、强度为135dB SPL的次声声场中连续暴露90分钟.分别于强次声波暴露前及暴露后即刻(2h内)、2天和5天做畸变产物耳声发射测试.结果强次声波暴露后豚鼠DPOAE的幅度值在各个频率段与暴露前相比均有明显的降低(p＜0.01),随着时间的推移,各个频率的幅度虽有一定的恢复,但仍明显低于暴露前水平(p＜0.01).结论强次声波可导致豚鼠耳蜗外毛细胞功能明显减退.