不同原因内耳损伤下畸变产物耳声发射的改变

The change of distortion product otoacoustic emissions under different causes of Inner ear damage

目的研究不同原因内耳损伤下畸变产物耳声发射(distortionproductotoacousticemissions,DPOAE)改变的特点。方法对耳科正常人、噪声暴露工人和应用顺铂化疗的妇科肿瘤患者进行DPOAE(0郾5～16kHz)、常频纯音测听(0郾5～8kHz)及扩展高频测听(9～16kHz)检查。对DPOAE幅值与纯音听阈进行比较分析。结果在噪声性和顺铂耳毒性损伤下,常频DPOAE表现为3～6kHz幅值降低,早于对应常频纯音听阈变化。扩展高频DPOAE幅值均有下降,但频率区域不同,噪声组只在11郾2kHz处下降明显,其他频率变化不大,尤其是12郾5kHz、14kHz、16kHz三个频率几无变化;药物组除16kHz外各频率均幅值下降。结论常频DPOAE比常频纯音测听和扩展高频DPOAE敏感,因此,在噪声、顺铂等引起的耳蜗性听力损害的早期监测中,优于常频纯音测听和扩展高频DPOAE。

Objective To investigate the manifestations of distortion product otoacoustic emissions(DPOAE)under different causes of inner ear damage. Methods DPOAE, conventional pure tone audiometry(PTA) and expanded high frequency audiometry(EHFA) were examined in adults with normal hearing,noise exposure workers and gynecologic cancer patients with first time cisplatin administration. DPOAE amplitudes, conventional pure tone hearing thresholds and expanded high frequency hearing thresholds were analysed. Results In different insult conditions, some conventional DPOAE amplitudes were decreased, earlier than the changes of conventional pure tone hearing thresholds in corresponding. Expanded high frequency DPOAE amplitudes were decreased, but the changed frequencies were varied. Conclusions Conventional DPOAE was more sensitive than conventional PTA and expanded high frequency DPOAE. Conventional DPOAE was a potential implement to early diagnose and detect noise-induced deafness and ototoxicity of cisplatin.