Investigation of hearing loss in patients with acute brucellosis by standard and high-frequency audiometry

This study aimed to determine the effect of acute brucellosis on the auditory system. Forty-two patients with acute brucellosis were evaluated clinically, and with serological and audiological tests, before and after treatment. Hearing threshold averages were calculated at 11 different frequencies (250-8000 Hz) of the auditory airway, and statistical analysis was performed. The average hearing thresholds were > 20 dB, with standard audiometry at 6000-8000 Hz, and < 20 dB at all other frequencies. After treatment, the average auditory threshold decreased to < 20 dB at 6000-8000 Hz (p < 0.0001). Pure-tone hearing thresholds were improved at all frequencies after treatment, with statistically significant differences at all frequencies except 12,000, 14,000 and 16 000 Hz (p < 0.05). There was no permanent hearing loss caused by acute brucellosis, and hearing thresholds were restored after treatment. It was concluded that acute brucellosis affects the auditory system, especially at high frequencies, and that patients with all forms of brucellosis should be evaluated for hearing loss.     

听神经病的纯音听阈检查结果分析

目的 探讨听神经病纯音听阈(PTT)检查的特征。方法 对48例听神经病患者的PTT检查结果进行分析，并与耳蜗性聋进行对照比较。结果 听神经病的PTT图有上升型、峰型、匙型、W型、倒S型、水平型和缓降型。双耳对称的PTT图有38例，不对称的有10例。听神经病的听阈升高程度呈轻、中度。左右耳听阈升高程度基本一致。低频听阈升高或以低频听阈升高为主的PTT图型占93．75％(90／96耳)。结论 双耳对称或基本对称的低频听阈升高或以低频听阈升高为主是听神经病的重要特征。     

一组普通话音位平衡单音节字表的文字编撰

目的编写一组适用于言语识别率测试的音位平衡的单音节测听词表。方法为兼顾测试的可靠性与临床实践中的效率,本课题将简短原则、音位平衡原则、常用字原则、覆盖原则、表间等价性等作为词表编写的主要原则。共设计了30张词表、每张词表包含25个单音节测试项。参照《声学手册》中的汉语音位一维概率分布,计算得到汉语拼音的22个声母(含零声母)、36个韵母、4个声调在30张词表、750个单音节测试项中的分布频次。基于音位平衡原则,通过计算机辅助编程和手动调整,从现代汉语常用字表的一级最常用汉字2500字和常用词表4000词中的单字词表中进行音节编选。结果形成了30张包含声母、韵母、声调在内的音位分配表。选取了489个音节,编撰了30张遵循音位平衡的单音节字表,每张表25字。结论该表文字稿是今后制作汉语音位平衡的单音节语音测试录音材料的基础。     

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 - 4 6 0型听力计 ,频率范围 8～ 18kHz。测试正常人 12 8人、2 5 6耳 ,17～ 5 0岁 ,男 92人 ,女 36人 ,其中17～ 2 9岁 90人 ,30～ 5 0岁 38人 ,12 5Hz～ 8kHz纯音各频率听阈≤ 2 0dBHL ,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～ 2 9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、2 0～ 2 4岁、2 5～ 2 9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 0 5 ) ,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     

老年性痴呆患者的听觉损害

目的　确定老年性痴呆患者 (seniledementiaoftheAlzheimer′sdisease ,AD)有无周围性听功能障碍及其与认知障碍的关系。方法　利用纯音测听、言语识别率、声导抗、听觉脑干反应检测AD患者 43例 ,健康老年人 50例 ,评定受试者测听可信度 ,统计测试结果 ,并将上述结果同受试者简易精神状态量表 (mini mentalscaleofequastionnaire ,MMSE)得分进行对照分析 ,寻找二者之间的关系。结果　受试者两耳间周围听力差异无显著性 ,以右耳听力结果 ( x±s)进行统计。AD组纯音听阈为 (2 6 3± 8 5)dBHL和 (2 9 1± 8 7)dBHL ,言语识别率为 (85 5± 5 5) % ;对照组纯音听阈为 (2 3 2± 1 0 6)dBHL和 (2 6 2± 1 1 8)dBHL ,言语识别率为 (87 6± 6 8) %。虽然AD组周围听功能检查结果低于对照组 ,但无统计学意义 (P >0 0 5)。测听可信度、声导抗和ABR阈值两组间差异无显著性 (P >0 0 5)。结论　老年性痴呆患者纯音听阈和言语识别率与老年聋相似 ,其周围听功能障碍与MMSE认知量表得分无关。     

多频稳态听觉诱发反应测试的临床应用

目的：利用多频稳态诱发反应(MFSSR)测试聋儿的残余听力，比较该方法与听性脑干反应(ABR)之间阳性率的差异来说明这种客观测试法所具有的优点。方法：在睡眠状态下测试了278例聋儿的MFSSR及ABR，分析了MFSSR不同频率阳性反应出现率及阈值分布范围，并与ABR阳性反应出现率进行比较。结果：左右耳MFSSR在0．5kHz、1．0kHz、2．0kHz和4．0kHz的阳性率分别为33．0g％、70．50％、44．96％、19．42％和33．81％、66．91％、41．07％、17．63％，而ABR的阳性率为16．91％和17．27％，MFSSR后3个频率的阳性反应出现率要明显高于ABR。结论：MFSSR作为一种客观测试方法具有频率特性好、刺激强度高、结果由计算机自动判断等特点，是一种有价值的客观测试方法。     

Slow Cortical Evoked Potentials: Interactions of Auditory,Vibro-Tactile and Shock Stimuli

An interaction experiment, in which stimuli of one kind were interposed between stimuli of another variety, was performed on 6 subjects with 8 replications. Cortical vertex potentials evoked by shocks to the median nerve, by vibrotactile stimulation of a finger or by 2400 Hz filtered clicks were averaged by a computer. The inter-stimulus interval was 5 sec. Then stimuli of two different kinds were presented alternately at 2.5 sec intervals. The responses for each kind were averaged separately. The amplitudes, measured from N₁ to P₂, were compared for all combinations of the three modalities.

Cross-modality depression of response occurred (10% level of confidence) for tactile responses with interposed auditory stimuli and (1 % level of confidence) for shock responses with interposed tactile stimuli. A general trend toward depression was clear, with an overall average of 15%, although it was not consistent for all subjects or symmetrical among types of stimuli. This compares with 28% depression when the inter-stimulus interval for identical stimuli was reduced from 5 sec to 2.5 sec.

Resume

Une expérience d'interactions, dans laquelle des stimuli d'un certain mode sensoriel étaient intercalés entre des stimuli d'un mode différent, a été effectuée sur six sujets avec huit répétitions. Un appareil à mémoires magnétiques a calculé les moyennes des potentiels corticaux du vertex, évoqués par des chocs appliqués sur le nerf médian, par une stimulation vibro-tactile d'un doigt ou par des clicks filtrés de 2 400 Hz. L'intervalle entre les stimuli successifs était de 5 secondes. Par la suite, les stimuli de deux modes différents alternaient en intervalles de 2,5 secondes. Les moyennes de réponses pour chacun de ces modes étaient séparemment calculées. Les amplitudes, mesurées de N₁ à P₂, étaient comparées dans toutes les combinaisons des trois modalités.

Une diminution transmodale de réponses se produisait pour les réponses tactiles avec des stimuli auditifs intercalés (significatif à un niveau de 10%) et pour des réponses aux chocs avec des stimuli tactiles intercalés (significatif à un niveau de 1%). Une tendance générate de diminution, ayant une grande moyenne de 15%, se manifestait clairement, bien qu'elle n'aie été soutenue par tous les sujets et ne s'avéraˇt pas symétrique parmi les types de stimuli. Par contre, en réduisant l'intervalle entre les stimuli successifs de 5 à 2,5 secondes, le taux de diminution était de 28%.     

Evoked Response Thresholds for Long and Short Duration Tones

Evoked response thresholds for 45 and 200 msec tones were compared to behavioral thresholds obtained with Békésy audiometry for signals of like duration is seven normal hearing listeners. The purpose of the study was to determine how closely the summed evoked response threshold approximates behavioral threshold at low and high frequencies, and determine if the temporal integration phenomenon can be demonstrated by the evoked response procedure. The results suggest that the behavioral threshold is the more sensitive of the two, but that, in normal listeners, evoked response thresholds approximate behavioral thresholds within 5 dB. This relationship was not frequency dependent being observed at both 500 and 4 000 Hz. Of the evoked response measurements threshold sensitivity was greatest with a stimulus duration of 200 msec. Mean differences of 3 to 6 dB were found when duration was increased from 45 to 200 msec suggesting the occurrence of temporal integration similar to that observed with psychophysical testing procedures.     

A Comparison of Evoked Response Audiometry and Routine Clinical Audiometry

Auditory thresholds were determined by evoked response audiometry (ERA) and by routine clinical audiometry at two frequencies (500 and 2 000 Hz) for 50 adult patients by five audiologists. The differences between ERA results and routine audiometric results in this study suggest caution in the clinical use of data obtained by ERA.     

Association between cytogenetic alteration and the audiometric profile of individuals with Turner syndrome

IntroductionTurner syndrome is a frequent genetic disorder that affects female individuals and covers a large phenotypic variability. Scientific literature suggests an association between hearing loss and Turner syndrome, but it remains a controversial topic.ObjectiveTo associate the cytogenetic alteration with the audiometric profile of individuals with Turner syndrome.MethodsCross-sectional study, with a hospital-based, convenience sample. Patients diagnosed with Turner syndrome were included and those with difficulty understanding the audiometry and/or other associated syndromes were excluded. The participants were studied with pure tone audiometry.ResultsOf the 65 patients included, 36.9% had X chromosome monosomy and 63.0% had other alterations. Regarding the audiometry, 64.6% had normal thresholds and 35.3% had hearing impairment. Of these, 30.4% had hybrid hearing loss, 26.0% alteration at 6 and/or 8 kHz, 17.3% had conductive hearing loss, 13.0% sensorineural loss and 13.0% had mixed hearing loss. We observed that the mild degree was the most frequent one. There was no statistically significant association between the cytogenetic type of Turner syndrome and the presence or absence of hearing loss, or with the type and degree of hearing loss.ConclusionThe cytogenetic alteration in Turner syndrome was not associated with the audiometric profile, which showed variability regarding the type and degree of hearing loss.