阻塞性睡眠呼吸暂停低通气综合征手术前后耳声发射的观察

Peri-uvulopalatopharyng oplasty otoacoustic emissions in patients with obstructive sleep apnea-hypopnea syndrome

目的 观察阻塞性睡眠呼吸暂停低通气综合征 (obstructivesleepapnea hypopneasyndrome,OSAHS)患者的耳蜗功能变化。方法 应用耳声发射仪观察 2 8例OSAHS患者行悬雍垂腭咽成形术前后的诱发性瞬态耳声反射 (transientlyevokedotoacousticemissions,TEOAE)和畸变产物耳声发射 (distortion productotoacousticemissions ,DPOAE)变化。结果 TEOAE检出率 6 4 3% ,频谱能量分布主要在 0 5～ 2kHz;DPOAE各频率的反应幅值在 0 5～ 8kHz处均显著下降 ,各频率的检出率约 4 6 4 %～89 3%。术后TEOAE和DPOAE检出率提高 ,0 5～ 8kHz的DPOAE反应幅值依次为 (2 2 5 0± 16 70 )、(5 83± 2 6 9)、(0 6 9± 3 83)、(- 2 5 0± 2 4 5 )、(4 95± 2 6 5 )、(4 4 8± 3 0 7)dBSPL ,在 1、2、4、6、8kHz处有显著性增加。结论 反复发作的OSAHS能够影响耳蜗功能 ,悬雍垂腭咽成形术能改善耳蜗功能。

Objective To study the cochlear function of patients with obsructive sleep apnea-hypopnea syndrome (OSAHS). Methods Transiently evoked otoacoustic emissions (TEOAEs) and Distortion-product otoacoustic emissions(DPOAEs) of 28 patients with OSAHS were measured one week before uvulopalatopharyngoplasty (UPPP) and six months after UPPP. Results In these patients the prevalence of TEOAEs was 64.3%,its spectral energy was mainly distributed between 0.5-2 kHz,the amplitudes of DPOAEs between 0.5-8 kHz were reduced significantly,the prevalences of DPOAEs at 0.5-8 kHz were between 46.4%-89.3%. After UPPP,the prevalences of TEOAEs and DPOAEs were increased,the amplitudes of DPOAEs were in turn (22.50±16.70) dB SPL,(5.83±2.69)dB SPL,(0.69±3.83)dB SPL,(-2.50±2.45)dB SPL,(4.95±2.65)dB SPL,(4.48±3.07)dB SPL from 0.5 kHz to 8 kHz,the amplitudes of DPOAEs were significantly increased at 1 kHz,2 kHz,4 kHz,6 kHz,8 kHz. Conclusion OSAHS can affect the cochlear function of the patients with OSAHS,UPPP can improve the cochlear function.