听神经病在纯音听阈测听和声导抗检查中的特征性表现

目的 探讨听神经病在纯音听阈测听及声导抗检查中的临床听力学特点及诊断要点.方法 回顾性分析中山大学附属第三医院耳鼻喉科收治的17例(32耳)听神经病确诊患者在纯音听阈测听、声导抗检查中的听力学特点.结果 17例患者中15例为双侧发病,呈左右对称性听力曲线;26耳以轻至中度低频感音性聋为主(听力图上升型);病程<5年的听力损失主要为轻度、中度听力障碍(17/32耳),病程>5年的听力损失主要为重度、极重度听力障碍.16例(31耳)声导抗为"A"型鼓室图,15例(30耳)同侧及交叉镫骨肌声反射均未引出,2例(2耳)镫骨肌声反射阈值升高.结论 听神经病在纯音听阔测听及声导抗检查中主要表现为:(1)为双侧对称性、渐进性听力下降;(2)早期为低频上升型听力图,后期为全频听力下降;(3)呈"A"型鼓室图,镫骨肌声反射阈值升高或引不出;(4)患耳无响度重振现象.

Clinical features of auditory neuropathy under pure tone audiometry and acoustic immitance examination

Objective To analyze the clinical characteristics of auditory neuropathy under pure tone audiometry and acoustic immitance examination.Methods Seventeen patients (32 ears) diagnosed as having auditory neuropathy were examined for audiology features by pure tone audiometry and acoustic immitance.Results Bilateral and symmetrical hearing loss was found in 15 patients and low-frequency sensorineural hearing loss was noted in 26 ears.Seventeen ears with a course of disease less than 5 years presented light or moderate dysaudia,and those with more than 5 years presented grave loss of aural comprehension.16 patients (31 ears) in the acoustic immitance examination showed type A tympanogram,and absence of stapedius muscle reflex was found in 15 patients (30 ears).The threshold of acoustic stapedius reflex increased in 2 patients (2 ears).Conclusion Auditory neuropathy primarily presents bilateral and symmetrical hearing loss,low-frequency hearing loss at the initial stage and total-frequency hearing loss finally,absence of stapedius muscle reflex and type A tympanogram,and absence of loudness recruitment phenomenon.