重度聋的声诱发短潜伏期负反应

目的 探讨重度聋患者在检查听性脑干反应(auditory brainstem response,ABR)时出现的声诱发短潜伏期负反应(acoustically evokled short latency negative response,ASNR)的特点及来源。方法 回顾分析1999—2002年测试的5622例患者的ABR结果。结果 5622例病例中有重度聋436人，74人引出ASNR，占重度聋人数的17％。50％的ASNR出现在0-5岁，0-10岁占75．7％。结论 ASNR可能与前庭系统有关系。     

声诱发的短潜伏期负反应与前庭诱发的肌源性电位关系初步研究

目的研究声诱发的短潜伏期负反应(acoustically evoked short latency negative response,ASNR)的特点,并初步证实该电位的前庭源性,即与前庭诱发的肌源性电位(vestibular evoked myogenic potentials,VEMP)同源。方法分别检测28例健康成人、16例前庭疾病和1例全聋患者的VEMP和ASNR,比较ASNR与VEMP之间的关系。结果ASNR正常引出率为87.5%,潜伏期正常值为3.50±0.25ms;2倍标准差作为正常值的上、下限,ASNR潜伏期的范围为3~4ms,阈值为80~90dB nHL。16例前庭疾病患者均行双侧检查,在VEMP消失的9耳(9例)中,ASNR均未引出;VEMP低振幅的8例(8耳)中,5例(5耳)未引出ASNR,3例(3耳)ASNR正常引出。5例梅尼埃病患者接受甘油试验,1例(2耳)甘油试验前后VEMP与ASNR均正常,2例(4耳)双侧VEMP与ASNR甘油试验前异常,甘油试验后正常,1例(1耳)患侧VEMP正常,甘油试验前后无变化,ASNR由异常变为正常;1例(2耳)VEMP甘油试验前双侧异常,甘油试验后正常,但ASNR均未引出。1例听力正常的前庭神经炎患者,患侧VEMP未引出,ASNR电位也未引出。1例先天性全聋患者人工耳蜗植入前,VEMP、ASNR正常引出;植入后,术侧VEMP振幅降低,ASNR未引出。结论ASNR与VEMP可能均源于球囊。鉴于目前的结果,在不便进行VEMP检测时可用ASNR替代。     

短纯音诱发的听性脑干反应测试中声诱发短潜伏期负反应研究

目的 总结在有听力损失儿童中行短纯音诱发的听性脑干反应(tbABR)测试时记录到的声诱发短潜伏期负反应(acoustically short latency negative response,ASNR)的特点.方法 在有听力损失的0～6岁儿童中应用SmartEP听觉诱发电位仪记录短声和短纯音ABR的反应阈,在记录到ASNR的受试者中分析其反应阈和潜伏期.结果 在所有80受试耳中共7耳(8.75%)在cABR测试中引出ASNR,40耳(50%)在tbABR测试中引出ASNR,其中1 kHz引出率最高(37耳,46.25%),2 kHz次之(25耳,31.25%).引出ASNR者ABR波V反应阈最低65 dB nHL,ASNR反应阈最低80 dB nHL.0.5、1、2和4 kHz短纯音诱发的ASNR潜伏期分别为6～8、5～7、3～5、3～4 ms.随刺激强度的增加,其潜伏期缩短.结论 有听力损失的儿童tbABR测试中可以记录到AS-NR,但不影响以波V反应阈评估听力.     

重度聋者配戴移频与非移频助听器的对比研究

目的　比较移频助听器与非移频助听器在重度以上听力障碍患者听力康复中对声音的感知、辨别能力和语训效果。方法　以助听听阈、清晰度指数 (AI)、Ling′s 6音的感知率和听辨率测试以及听音辨图测试得分为指标比较移频和非移频助听器在声音的感知、辨别、识别方面的差异表现。结果　移频助听听阈较非移频助听听阈明显改善 ,在 2 0 0 0Hz以后的高频区改善尤为明显 (t =2 .45～ 47.46,P <0 .0 1)。移频助听器对清晰度指数较非移频助听器有非常显著的提高 (t=16.89,P <0 .0 1)。非移频助听状态下元音的感知率和听辨率较裸耳有显著提高 (χ2 =7.5～ 78.19,P <0 .0 1) ,但对辅音的感知率和辨别率无明显提高。但移频助听状态下的辅音、元音 i 的感知率和听辨正确率都明显高于非移频助听状态。移频助听的听音辨图测试得分较非移频助听时有明显的改善 (t =16.89,P <0 .0 1)。结论　移频助听器比非移频助听器在重度以上听力障碍患者的听力康复中 ,对声音感知、辨别、识别能力三个方面具有更好的助听效果     

Factors Affecting the Variation of Maximum Speech Intelligibility in Patients With Sensorineural Hearing Loss Other Than Apparent Retrocochlear Lesions

Objectives

To examine the relationship between speech intelligibilities among the similar level of hearing loss and threshold elevation of the auditory brainstem response (ABR).

Methods

The relationship between maximum speech intelligibilities among similar levels of hearing loss and relative threshold elevation of the click-evoked ABR (ABR threshold - pure tone average at 2,000 and 4,000 Hz) was retrospectively reviewed in patients with sensorineural hearing loss (SNHL) other than apparent retrocochlear lesions as auditory neuropathy, vestibular schwannoma and the other brain lesions.

Results

Comparison of the speech intelligibilities in subjects with similar levels of hearing loss found that the variation in maximum speech intelligibility was significantly correlated with the threshold elevation of the ABR.

Conclusion

The present results appear to support the idea that variation in maximum speech intelligibility in patients with similar levels of SNHL may be related to the different degree of dysfunctions of the inner hair cells and/or cochlear nerves in addition to those of outer hair cells.