单侧耳聋配戴助听器后健侧耳DPOAE幅值增高

Hearing Aid in Patients with Unilateral Deafness Caused Increased Amplitude of Distortion Product Otoacoustic Emission(DPOAE) in Normal Ear

目的 通过给单侧聋耳配戴助听器后对健侧耳影响的客观观察，探讨单侧耳聋配戴助听器的必要性。方法 对２７例单侧耳聋对侧耳听阈正常的患者进行患耳配戴助听器前后的耳声发射检测。首诊分别行纯音听阈和健耳ＤＰＯＡＥ检测，根据患侧听力损失程度分中、重度两组，之后为其配戴及调试助听器，并在一个月、三个月及六个月后再行耳声发射检测。对照组１３例单侧耳聋发病时对侧耳听力正常，首诊行双耳纯音听阈测试和对侧耳耳声发射检测，但未配戴助听器。结果 中度耳聋组１９耳健侧ＤＰＯＡＥ幅值较低，仅有４耳尚在正常范围的低值内，另外１５耳低于正常范围。为其配戴助听器后行耳声发射的动态观察，发现ＤＰＯＡＥ幅值较配戴助听器前明显提高，其中三个月后幅值提高最明显。六个月后的平均幅值为 ８．４ｄＢ ＳＰＬ／５００ Ｈｚ、１１．２ ｄＢ ＳＰＩ／１ ｋＨｚ、１０．４ ｄＢ ＳＰＬ／２ｋＨｚ，ｔ检验与配戴助听器前比较有高度显著性差异（Ｐ＜０．０１），ＤＰＯＡＥ Ｉ／Ｏ示非线性机制较好，重度聋组８耳ＤＰＯＡＥ幅值低于正常范围，配戴助听器后５耳ＤＰＯＡＥ幅值提高较小，ｔ检验与配戴助听器前比较有显著差异（Ｐ＜０．０５），另外３耳未见明显改善。对照组１３例分别在首次就诊及半年后?

Objective To investigate the necessity of wearing hearing aid for patients with unilateral hearing loss by detection of DPOAE the normal ear. Methods Otoacoustic emission(OAE) of normal ears and pure tone audiometry of both ears were performed in thirty-seven patients with unilateral deafness. Based on the pure tone threshold in the deaf ear, patients were divided into two groups: moderate deafness(19 cases) and severe deafness(8 cases). Normal ear OAE and pure tone audiometry were tested before and after one, three and six months wearing heating aid respectively. Patients with mild unilateral hearing loss were used as control group. Results The average DPOAE amplitude was 8.4 dB SPL/500 Hz、11.2 dB SP/1 kHz 10.4 dB SPL/2 Hz in 19 normal ears in moderate deafness group. In group of severe deafness, DPOAE amplitude in 8 ears was slightly improved. The average DPOAE in five ears was 7.8 dB SPL/l kHz. The heating of other 3 ears was not improved obviously. In the control group, DPOAE in nine ears can not be recorded. Condusion Fitting hearing aid on deaf ear can improve normal heating on the contralateral ear.