骨导给声掩蔽在双耳中度慢性中耳炎患者纯音测听中的应用

Application of bone-guided acoustic masking in pure tone audiometry in patients with moderate chronic otitis media

目的探讨骨导振子给声掩蔽在双耳中度慢性中耳炎患者纯音测听中的可行性。方法用围耳式耳机掩蔽测试气骨导听阈出现掩蔽困难,但改用插入式耳机掩蔽测试可部分解决此困难者为本实验受试者,男性23例、女性20例。对受试者分别用骨导耳机给声掩蔽和插入式耳机给声掩蔽对其骨导阈值进行测试,对2种给声掩蔽方式测出的骨导阈值进行对比、分析。结果用骨导耳机给声掩蔽可直接测出单侧骨导听阈者38例(38耳),可直接测出双侧骨导听阈者5例(10耳)。与插入式耳机给声掩蔽方式相比,骨导耳机给声掩蔽测出的骨导阈值在0. 5～2 k Hz处,差异无统计学意义;在0. 25 k Hz处用后者骨导阈值大于前者,在4 k Hz处则后者小于前者,差异均有统计学意义(P <0. 05)。结论骨导耳机给声掩蔽在纯音测听骨导掩蔽测试中与插入式耳机结果大部分相似,可测出单侧骨导听阈并甄别侧别,部分受试者可测出双侧骨导听阈,解决部分掩蔽难题,有实用价值,值得临床应用。

Objective To discuss the feasibility of bone conduction acoustic masking in pure lone audiometer in patients with moderate bilateral chronic otitis media. Methods The experimental subjects included 23 males and 20 females whose air-bone conduction masking was difficult by headphone but insert earphone could partly solve the difficulty. The bone conduction pure tone hearing threshold was tested by using bone conduction earphones and insert earphone for the sound masking. The results of bone conduction threshold between bone conduction earphones masking and insert earphone masking were compared. Results Thirty-eight cases （38 ears） with unilateral bone conduction threshold and 5 cases （10 ears） with bilateral bone conduction threshold could be directly tested by bone conduction earphone masking. Compared with insert earphone masking, the bone conduction thresholds by bone conduction earphone masking was not significant at 0.5 - 2 kHz （ P 〈 0.05 ）. The bone conduction threshold of the latter was greater than that of the former at 0.25 kHz and the latter was less than that of the former at 4 kHz, with significant difference（ P 〈 0.05 ）. Conclusions Bone conduction earphone and insert earphone are similar in bone conduction masking. Unilateral bone conduction threshold can be measured and ear side can be screened. Partial bilateral bone conduction threshold can be measured and part of the masking problems could be solved. It might have practical value and worth in clinic.