短纯音ABR和NB CE-Chirp ASSR在陡降型听力损失中的应用

Application of Tb-ABRs and NB CE-Chirp ASSRs in Assessment of Sloping Sensorineural Hearing Loss

目的研究陡降型感音神经性聋短纯音听性脑干反应(Tb-ABR)、NBCE-Chirp声诱发的多频听觉稳态反应(NBCE-ChirpASSR)、短声听性脑干反应(click-ABR)与纯音测听(PTA)之间的关系,以评估陡降型感音神经性聋最佳的客观测听方法。方法对43例(62耳)经PTA诊断为陡降型感音神经性聋的成人和20名(40耳)听力正常的健康受试者,分别行Tb-ABR、NBCE-ChirpASSR及click-ABR,记录研究组和对照组三种客观检查的反应阈值,同时就所得阈值与PTA进行相关性分析。结果健康对照组中,0.5、1、2和4kHzTb-ABR与PTA的相关系数r分别为0.628、0.783、0.808和0.853;NBCE-ChirpASSR与PTA的r值分别为0.653、0.793、0.882和0.903;click-ABR阈值与2.0k和4.0kHzPTA平均阈值的r值为0.762;高频陡降组,2.0和4.0kHzTb-ABR阈值与PTA的r值分别为0.925和0.940,2.0和4.0kHzNBCE-ChirpASSR与PTA的r值分别为0.942和0.958,不同听力损失程度Tb-ABR和NBCE-ChirpASSR阈值与PTA的相关性基本一致。陡降型ABC三组click-ABR与2.0k和4.0kHzPTA平均阈值的r值分别为0.443、0.314和0.299。结论Tb-ABR和NBCE-ChirpASSR评估陡降型感音神经性聋优于click-ABR。

Objective To study the relationship between Tb-ABRs,NB CE-Chirp ASSRs,click-ABRs and PTA in adults with sloping high-frequency sensorineural hearing loss,so as to identify the best objective assessment approach for sloping high-frequency sensorineural hearing loss.Method Tb-ABRs,NB CE-Chirp ASSRs and click-ABRs were recorded in 43 adults(62 ears)diagnosed with sloping high-frequency sensorineural hearing loss by PTA and in 20 healthy subjects(40 ears)with normal hearing.Correlation between thresholds obtained by Tb-ABRs,NB CE-Chirp AS-SRs,click-ABRs and PTA was analyzed.Result In the healthy control group,the correlation coefficient(r)were 0.628,0.783,0.808 and 0.853 for 0.5,1,2 and 4 kHz between Tb-ABR thresholds and PTA,and 0.653,0.793,0.882 and 0.903 between NB CE-Chirp ASSR thresholds and PTA,respectively.The correlation coefficient(r)was 0.762 between click ABR thresholds and PTA at 2 and 4 kHz.In patients with sloping high-frequency sensorineural hearing loss,the correla-tion coefficient(r)was 0.925 and 0.940 for 2.and 4 kHz between Tb-ABR thresholds and PTA and 0.942 and 0.958 be-tween NB CE-Chirp ASSR thresholds and PTA,respectively,although the correlation coefficients between click-ABR and PTA at 2 and 4 kHz were only 0.443,0.314 and 0.299,respectively,for the three hearing loss subtypes.Conclusion Tb-ABRs and NB CE-Chirp ASSRs are superior to click-ABRs in assessing sloping high-frequency sensorineural hearing loss.