外伤后听力损失的评估

Evaluation of Post-traumatic Hearing Loss

目的 :探讨如何准确评估外伤后听力下降的方法。方法 :对 30例外伤后主诉听力下降的受试人进行询问病史 ,耳镜检查 ,瞬态诱发耳声发射 ,声导抗 ,听觉脑干诱发电位 ,言语测听和纯音测听 ,用客观检测结果来验证纯音测听的准确性。如果两者不一致 ,要对受试者进行劝说 ,求得受试者的配合 ,得到其真实纯音听阈。结果 :30例中 18例配合所有检查。 9例在纯音测听中夸大听力下降的程度 ,经过耐心劝说 ,最终获得真实的听阈。 3例存在精神创伤 ,虽经听力师努力 ,未能配合检查。结论 :纯音测听是听力评估的基本方法 ,瞬态诱发耳声发射 ,声导抗 ,听觉脑干诱发电位 ,言语识别阈可以验证纯音听阈的准确性。

Objective:To find the correct method for evaluating post-traumatic hearing loss.Method:Thirty cases were examined by taking case history,otoscopy,TEOAE,immitance testing,ABR,speech audiometry, and pure tone audiometry.Pure tone threshold should be consistent with the other testing results.If inconsistent appeared,patient might exaggerate his hearing loss,pure tone should be repeated until the accurate threshold was obtained.Result:Eighteen post-traumatic hearing loss cases were well cooperative,and their real thresholds were easily obtained,9 cases exaggerated their hearing loss,but their real thresholds were obtained under the persuasion of audiologist.There were still 3 cases who were not cooperative during the evaluation of hearing loss due to psychological problem.Conclusion:Pure tone thresholds should be consistent with the results of TEOAE,immitance testing,ABR,and speech audiometry.