摘要
目的探讨听神经病的听力学基本特点。方法回顾性分析14例28耳听神经病患者临床病史、纯音测听(puretone audiometry)、镫骨肌反射(stapedial muscle reflex)、听性脑干反应(auditory brainstem response)、40Hz相关电位(40Hz audi-tory event related potential)、畸变耳声发射(distortion product otoacoustic emission)及瞬态耳声发射(transient-evoked otoacoustic emission)等听力学相关资料。结果纯音测听示患者中24耳以轻至中度低频感音性聋为主(听力图上升型),2耳为中重度全频听力下降(听力图平坦型),2耳为低、高频听力下降(听力图鞍型)。声导抗鼓室图全部正常,镫骨肌反射消失,全部病例可引出畸变耳声发射及瞬态耳声发射,听性脑干反应各波不能引出,40Hz相关电位检查只有1例未引出,其余均引出。14例患者中有13例能闻其声,不能辨其语。结论异常听性脑干反应、正常畸变耳声发射及瞬态耳声发射、纯音听阈升高(以低频为主)的感音神经性聋、镫骨肌声反射未引出、听性脑干反应阈值与纯音听阈不符均是听神经病的主要特征,应与一般感音神经性聋和中枢性聋相鉴别。
Objective To explore the audiological characteristics of auditory neuropathy(AN). Methods The history,pure tone audiometry,stapedial muscle reflex,auditory brainstem response(ABR),40 Hz auditory event related potential,distortion product otoacoustic emission(DPOAE)and transient-evoked otoacoustic emission(TEOAE)in 28 ears diagnosed as auditory neuropathy were retrospectively analyzed. Results Of 28 ears,24 ears showed mild-to-moderate bilateral sensorineural hearing loss at low frequencies(a elevated shape),two ears had moderate-to-severe bilateral sensorineural hearing loss at overall frequencies(a flat shape),two ears had moderate bilateral sensorineural hearing loss at low and high frequencies(a saddle-like shape).The tympanograms were normal.Twenty-eight ears lost stapedial muscle reflex.Auditory brainstem response cannot be recorded.DPOAE and TEOAE were evoked in all patients.Thirteen patients can hear the voice but not clear. Conclusion Abnormal ABR,normal DPOAE and TEOAE,sensorineural hearing loss with increase of low-frequency pure tone threshold,loss of stapedial muscle reflex and unparallel pure tone threshold to ABR threshold are the important features of AN.It is necessary to differentiate AN from the common sensorineural hearing loss and central nerve hearing loss.
出处
《山西医科大学学报》
CAS
2009年第4期372-376,共5页
Journal of Shanxi Medical University
关键词
听神经病
耳声发射
听性脑干反应
听力损失
auditory neuropathy
otoacoustic emission
auditory brainstem response
hearing loss
