畸变产物耳声发射在飞行员早期听力损失诊断中的应用

目的 了解噪声对飞行员畸变产物耳声发射的影响,以便及早发现听力损失,为空军卫生勤务保障提供参考.方法 采用纯音听力计和耳声发射测试仪,对30名低年龄段飞行员、7名高年龄段飞行员及30名健康青年分别进行纯音听阈和畸变产物耳声发射检查.结果 飞行员听力损失主要在3 ～8 kHz,可以出现单耳高频听力损失.随着年龄增加,逐渐出现双耳高频听力损失.低年龄段飞行员和健康青年两组受试者0.5～8 kHz平均纯音听阈差异无统计学意义.低年龄段飞行员1 kHz和6 kHz畸变产物耳声发射幅值低于健康青年,两组差异具有统计学意义（t=2.11,P＜0.05;t =2.41,P＜0.05）.低年龄段飞行人员2、3、4、8 kHz畸变产物耳声发射幅值与健康青年类似,两组差异无统计学意义.低年龄段军事飞行员高频纯音听阈异常率（13.3％）和健康青年（6.7％）的差别无统计学意义.低年龄段飞行人员高频畸变产物耳声发射异常率（33.3％）高于健康青年（6.7％）,两组差异具有统计学意义（x2 =5.10,P＜0.05）.结论 畸变产物耳声发射受噪声的影响较纯音听阈敏感,畸变产物耳声发射可早期发现飞行员的噪声性听力损失.

Application of distortion product otoacoustic emission to diagnosis of pilots with hearing loss

Objective To study the effect of noise on distortion product otoacoustic emission （DPOAE） in pilots, detect the hearing loss early, and provide the reference for the Air Force health service support. Methods The threshoht of pure tone audiometry and amplitude of DPOAE were examined in 30 low age flying personnel ,7 high age flying personnel and 30 healthy youth with pure tone audiometry and cochlear emission analyzer. Results Hearing loss was mainly at 3 - 8 kHz in pilots, with hearing loss of high frequency occuring in unilateral ear. With increasing age, the high-frequency hearing loss occurred gradually in bilateral ears. The average levels of pure tone threshold in the 0. 5-8 kHz in the low age flying personnel and healthy youth were not significantly different （ P 〉 0.05 ）. The low age flying personnel had lower DPOAE amplitude in the 1 kHz and 6 kHz than the healthy youth, with significant difference between them （ t = 2.11, P 〈 0.05 and t = 2.41, P 〈 0.05 ）. The low age flying personnel had a similar DPOAE amplitude in the 2, 3, 4, 8 kHz to that of healthy youth, with no significant difference between them （P 〉 0.05）. The both abnormal rates of high frequency pure tone audiometry in the low age flying personnel （13.3%） and in the healthy youth （6.7%） were not significantly different （X2 = 0.16, P 〉 0.05）. The low age flying personnel had a higher abnormal rate of high frequency DPOAE （33.3%） than the healthy youth （6.7%）, with significant tifference between them （X2 = 5. 10, P 〈 0.05 ）. Conclusions The effect of noise on DPOAE amplitude in the flying personnel is greater than pure tone threshold, and the DPOAE test can detect early the flying personnel with noise-induced hearing loss.