耳声发射与纯音听阈之间关系的研究

The relations between otoacoustic emissions and pure tone threshold

目的：通过对耳声发射（OAE）与纯音听阈之间关系的分析,明确OAE通过率与纯音听阈之间的关系。方法：对172例10岁以上听力正常人群或者感音神经性听力损失患者进行纯音听阈测试、瞬态声诱发性耳声发射（TEOAE）和畸变产物耳声发射（DPOAE）测试。按年龄将研究对象分为≤30岁组、〉30~40岁组、〉40~50岁组、〉50岁组,对比不同年龄组OAE通过率之间的差异。分析平均听阈与TEOAE的通过率、2kHz听阈与f2为2kHz时DPOAE通过率、4kHz听阈与f2为4kHz时DPOAE通过率之间的关系。结果：TEOAE主要反映2kHz及以下频率的听力情况。TEOAE及2kHz DPOAE的通过率在各年龄组间不存在差异,4kHz DPOAE〉50岁组的通过率小于其余各年龄组。OAE的通过率随听力损失程度的增加而减小。当TEOAE、2kHz及4kHz DPOAE通过时,分别有70%、81%、79%的测试耳听阈≤25dB HL,94%、96%、93%的测试耳听阈≤40dB HL,当TEOAE、2 kHz及4 kHz DPOAE未通过时,分别有93%、84%、87%的测试耳听阈〉25dB HL,71%、58%、68%的测试耳听阈〉40dB HL。结论：TEOAE主要反映2kHz及以下频率的听力损失,同时测TEOAE和DPOAE能对患者0.5、1.0、2.0、4.0kHz的听力情况有比较全面的评估,临床上结合使用可互补了解更多频率的信息。OAE通过或未通过不宜简单解释成听力正常或不正常,当OAE通过时,不代表患者没有听力损失,14%~24%的患者可能存在40dB HL以下的轻度听力损失;当OAE未通过时,患者不一定有听力损失,但很可能存在轻度及轻度以上的听力损失,并最有可能是中度及中度以上的听力损失,需要进一步确诊。

Objective ： To investigate the relationship between passing rate of otoacoustic emission （OAE） and pure tone thresholds. Method .. OAE including both transient evoked otoacoustic emission （TEOAE） and distortion products otoacoustic emission （DPOAE） as well as pure tone thresholds were measured in subjects with normal hearing and sensory hearing loss. The passing rates of OAE were calculated in subjects with different age groups and different pure tone thresholds. Result..TEOAE can identify hearing loss at frequencies of 2 kHz and below. For TEOAE and 2 kHz DPOAE, passing rate has no difference between different age groups. For 4 kHz DPOAE, the passing rate in age over 50 years group is lower than other groups. The passing rate decreased as the pure tone threshold increased. When TEOAE and DPOAE suggest ＂ pass＂, 70~, 81%, 79~ subjects had pure tone threshold lower than 25 dB HL and 94% ,96~/oo ,93~ lower than 40 dB HL respectively. When they suggest ＂re- fer＂, 93 % ,84% ,87 % subjects had pure tone threshold higher than 25 dB HL and 71%, 58%, 68% higher than 40 dB HL respectively. Conclusion.. TEOAE is sensitive to hearing loss at middle and low frequencies but not at high frequencies. Measuring both TEOAE and DPOAE might provide more information of hearing loss at 0.5, 1.0,2.0 and 4.0 kHz. It is worth noting that even OAE suggest ＂pass＂ or ＂refer＂, because there is still exist the possibility of hearing loss.