文章摘要
李霞,王建明*.听神经病的临床听力学特征分析[J].山西医科大学学报,2009,40(4):372~376
听神经病的临床听力学特征分析
Study on audiological characteristics in patients with auditory neuropathy
  
DOI:
中文关键词: 听神经病  〓耳声发射  〓听性脑干反应  〓听力损失
英文关键词: auditory neuropathy  〓otoacoustic emission  〓auditory brainstem response  〓hearing loss
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作者单位
李霞,王建明* 山西医科大学第一临床医学院耳鼻咽喉科太原030001*通讯作者E mail:wangjianmingmm@163.com 
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中文摘要:
      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(pure tone audiometry)、镫骨肌反射(stapedial muscle reflex)、听性脑干反应(auditory brainstem response)、40 Hz相关电位(40 Hz auditory 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,40 Hz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。
英文摘要:
      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.
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