畸变产物耳声发射测试在听力正常的耳鸣者中的应用价值

Clinical value of distortion product otoacoustic emission in tinnitus patients with normal hearing

目的探讨畸变产物耳声发射(DPOAE)测试在听力正常的耳鸣患者中的临床应用价值。方法对82名(164耳)听力正常且无耳鸣的健康者(对照组)进行DPOAE测试。同时对84例(109耳)听力正常的耳鸣患者(耳鸣组)进行DPOAE测试,并给予改善内耳循环、补充营养等治疗20d后再次进行DPOAE测试。结果耳鸣组中,DPOAE测试在0.50、0.75、1.00、1.50、2.00、3.00、4.00、6.00、8.00kHz各频率点的检出率均显著低于对照组(P值均<0.05)。耳鸣组治疗后DPOAE的检出率为43.1%,与治疗前(56.9%)的差异无统计学意义(P>0.05),治疗后在各频率点的DPOAE反应幅值呈提高趋势,尤其在高频(3.00、4.00、6.00、8.00kHz)的差异有统计学意义(P值均<0.05)。结论听力正常的耳鸣发生可能与耳蜗外毛细胞的早期损伤导致的超高频听力损失有关,DPOAE检测可以作为耳蜗早期改变及外周性耳鸣的一种客观检测方法。

Objective To investigate the clinical value of distortion product otoacoustic emission（DPOAE） application in normal hearing patients with tinnitus.Methods A total of 82 healthy volunteers（164 ears） without tinnitus or hearing loss were enrolled as control group and tested with DPOAE.Meanwhile,84 normal hearing patients（109 ears） with tinnitus were tested with DPOAE before and after 20-days treatment including circulation improvement and supplemental nutrition for inner ear.Results At the frequency of 0.5,0.75,1.00,1.50,2.00,3.00,4.00,6.00 and 8.00 kHz,the detection rate of DPOAE in tinnitus group was significantly lower than that in control group（all P0.05）.In tinnitus group,the difference of DPOAE detection rates before and after treatment had no statistical significance（56.9% vs.43.1%,P0.05）;the wave height in every frequency was increased after treatment,especially in high frequency（3.00,4.00,6.00 and 8.00 kHz,all P0.05）.Conclusion Tinnitus with normal hearing is likely to be related to hearing loss of super high frequency caused by early impairment of outer hair cells in cochlea.DPOAE examination can be used as an objective assessment for early change of cochlea and periphery tinnitus.