听神经病病损部位分析

目的：探讨一组以言语听力下降为主的听力损失的命名、临床特点、病损部位。方法：分析１１例低频或以低频为主的感音神经性听力损失患者的临床症状、纯音测听、声导抗测试、听性脑干反应、耳蜗电图、畸变产物耳声发射～ＣＴ和（或）ＭＲＩ资料。结果：本组病例具有下列矛盾现象；主诉进行性听力闰退，尤其听不清语言，纯音听阈呈上升型听力图，听性脑干反应引不同或明显异常，甚经４０００Ｈｚ纯音听琢怕主观阈严重镫骨肌反引不出；

Analyse of the site of lesion in auditory neuropathy

Objective:To analyze the clinic signs,the site of lesion and terminology of a kind of hearing loss which is characterized by speech hearing loss.Method:The data of 11 patients were collected and analyzed including the clinic symptoms,pure tone audiometry,acoustic impedance audiometry,auditory brainstem response (ABR), electrocochleogram(ECochG),distortion product otoacoustic emission (DPOAE),CT/MRI.Result:All these cases had following contradictory phenomena:Pure tone audiograms were low frequency hearing loss;ABRs were absent or seriously abnormal,and ABR response threshold was worse than pure tone threshold and click subjective threshold;ECochG could be recorded in some patients;The stapes muscle reflex was absent;DPOAEs were normal or near normal,the average amplitude of lowfrequency was higher than normal hearing group,but the average amplitude of high frequency was lower than normal hearing group;The imaging examination did not show any abnomality.Conclusion:All data of this group show that the sites of lesion in most patients may be in lower brainstem,but the sites of lesion in some patients may be in the spiral ganglion of cochlea. The research of this disease should be continued.