正常青年人气、骨导听性脑干反应的比较研究(英文)

A comparative research on auditory brain stem reaction of air conduction and bone conduction in normal young people

背景:由于气、骨导换能器声学特性的不同,两者的检测结果存在差异。目的:探讨和比较气(AC)、骨导(BC)听性脑干反应(ABR)测试结果的差异,为骨导听性脑干反应的临床应用提供参考依据。设计:进行自身和相互对照实验。地点和对象:实验地点在第一军医大学珠江医院耳鼻咽喉科隔声电屏蔽室内完成,研究对象为一组听力正常青年人(男31耳,女30耳)年龄19～23岁,平均21.7岁。干预:采用美国NicoIetspirit型诱发电位仪进行测试。气、骨导测试所用耳机分别为TDH-39P和RadioearB-71,经校准,符合GB/T4854.1与GB/T4854.3标准。电极阻抗均小于5kΩ,极间电阻≤4kΩ。分别测试双耳短声气、骨导ABR。刺激声强度从100dB(nHL)(机器最大刺激输出)开始,以20dB(nHL)一级依次递减,重复记录两次,接近反应阈时以5dB递减,以能引出可重复波V的最小声强作为ABR阈值。测出ABR反应阈后再进行阈上60dB(nHL)刺激强度下的气、骨导ABR测试,分别记录I,Ⅲ,Ⅴ波潜伏期。将同一耳两种检测数据作自身配对t检验,正常青年男女间测试结果作非配对t检验。主要观察指标:男、女性气、骨导(短声)阈值,气、骨导ABR各波潜伏期及波间期。结果:在阈值及阈上强度下,骨导ABR波形与气导类似,但各波引出率较气导低。听力正常青年男女之气。

BACKGROUND:The detective results of air conduction and bone conduction are dif ferent because of different auditory characteristics of these two transducers.OBJECTIVE:To discuss and compare the difference of auditory brain stem reactio n(ABR) on air conduction(AC) and bone conduction(BC) for providing a gist in cli nical application of bone-conducted auditory brain stem reaction.DESIGN:A self and inter control study was conducted.SETTING and PARTICIPANTS:The research was completed in a sound insulated and e lectric screened room of Department of Otolaryngology,Zhujiang Hospital,First Mi litary Medical University.All subjects were a group of young people with normal hearing(31 male ears and 30 female ears) and an age from 19 to 23 years old(aver age 21.7 years old).INTERVENTIONS:American NicoIet spirit inducing electric potential instrument w as introduced.The earphones for air conduction and bone conduction testing were TDH-39P and Radioear B-71 models, which accorded with GB/T 4851.1 and GB/T 485 4.3 criteria after adjustment.The impedances of electrode were all less than 5 k ?, and the impedance between electrodes was ≤4 k?.Short sound air-conducted and bone-conducted ABR for both ears were tested separately.The strength of sti mulant started from 100 dB(nHL) (the maximum output of the machine) and decrease d in turn by 20 dB(nHL), which was set as one grade, recorded twice.And 5 dB was chosen as one grade when closed to reactive threshold to induce the minimum rep eatable sound strength as ABR threshold.Once ABR reactive threshold obtained, 60 dB(nHL) above threshold stimulant was operated to test air and bone conducted A BR and the latency of I, III, V wave was recorded separately.Two groups of data obtained from same ear were self-paired for t test.The test results among norma l young males and females were gone through unpaired t test.MAIN OUTCOME MEASURES:Threshold of air conduction and bone conduction for shor t sound in both males and females, latency and interval of each wave in air and bone conducted ABR.RESULTS:Under or below threshold, ABR wave of bone conduction was alike to tha t of air conduction, but with lower inducing rate.There was no significance in t he ABR threshold for air and bone conducted short sound with normal auditory bet ween normal young males and females(tAC=0.12, tBC=1.08,P >0.05).The comparison b etween bone conducted short sound ABR and air conducted shout sound ABR suggeste d: the former was higher than the latter(t=19.55,P< 0.01), with distinct positiv e correlation(r=0.7740,P< 0.01); the latencies of I, III, and V wave of the form er were all bigger than that of the latter under 60 dB(nHL) strength(t=10.62,P< 0.01), but there were no significant differences of I-III, III-V and I-V inte rvals between the two(tAC=1.45,tBC=0.68,P >0.05).CONCLUSION:There are certain limitations in the application of bone conducted ABR test.However, it still has merits in clinical application on some patients w ho are not suitable for air conducted ABR test.