多频听性稳态反应(ASSR)在听觉诊断中的应用

Relevant Problems about the application of ASSR in the auditory diagnosis

目的了解多频听性稳态反应(ASSR)在实际应用中的优劣势,准确度,研究其与听力测试金标准纯音听阈测试(PTA)之间的相关性,为临床听力诊断提供客观依据。方法选择10名听力正常志愿者(20耳),首先在标准隔声室内进行纯音听阈测试,确定500、1000、2000、4000Hz各频率阈值;然后在屏蔽室进行镇静状态下ASSR阈值测试,获得相应各频率阈值,将两个测试所得的结果进行统计分析比对。结果ASSR阈值比纯音听阈阈值高,各频率差值为500Hz为32.78±7.16dBHL、1000Hz 42.45±6.32dBHL、2000Hz 45.92±2.32dBHL、4000Hz 45.02±4.25dBHL。两者之间有很好的线性相关关系。在500、1000、2000、4000Hz上的相关系数分别为0.634,0.712,0.533,0.541。结论在临床的实际应用中可以使用ASSR评估听力阈值,其阈值比纯音听力阈值高,各频率差值不同。受到测试环境、仪器设置,测试人群等多重因素,各个实验室需要自行找出校正值,利用之一差值找出实际听力阈值,以供临床需要。

Objective To study the multiple auditory steady state response （ ASSR ） in practical application of the advantages and disadvantages, accuracy, to research its correlation between listening test gold standard as the pure tone andiometry （ PTA ） , and to provide an objective basis for clinical diagnosis. Methods In the standard sound insulation room, 10 normal hearing volunteers （20 ears） tested by pure tone andiometry to determine the frequency threshold in 500, 1000, 2000, 4000Hz. And then, in a shielding room, the Volunteers tested by the ASSR threshold testing method with a calm status to obtain corresponding frequency threshold. After doing two different tests, we compare test results by statistical analysis. Results ASSR threshold were Higher than pure tone audiome- try threshold, the mean difference of each frequency were （ 32.78 ＋ 7. 16 ） dBHL （ 500Hz）, were （42.45 ~ 6. 32 ） dBHL （ 1000Hz）, were （45.92 ~2. 32） dBHL （2000Hz） , were （45.02 ~4. 25） dBHL （4000Hz） . The correlation between ASSR threshold and PTA thresholds is significant. Correlation coefficients were 0. 634, 0. 712, 0. 533, 0. 541 among 500, 1000, 2000, 4000Hz. Conclusion： In clinical practical application, we can use the ASSR threshold evaluating for hearing threshold, as the response thresholds is higher than the threshold of pure tone hearing thresholds. Due to multiple factors of testing environment, testing instrument settings and testing populations, each laboratory needs to find out corrected values, using of the difference to identify the actual hearing threshold for clini- cal needs.