【作者】 郎小娥；

【导师】 王斌全； 王建明；

【作者基本信息】 山西医科大学 ， 耳鼻咽喉科学， 2004， 硕士

【摘要】 目的： 探讨外伤性听觉损害听力学表现，为临床客观公正定量、定性与定位诊断提供听力学重要依据。方法： 就我院收治的外伤后主诉听觉障碍者92例113耳，分别进行纯音听阈（PTHT）、声导抗（AI）、40 Hz AERP（40 Hz听觉事件相关电位）、ABR（听性脑干反应）与DPOAE（畸变产物耳声发射）测试，并分别绘制出纯音听阈图与DPOAE听力图。结果： 92例患者113耳行纯音听阈测试、声导抗、40 Hz AERP、ABR与DPOAE检测，发现器质性聋98耳，占86.73%，其中夸大性聋者38耳，夸大程度＜20dBnHL6耳，20～40dBnHL27耳，＞40dBnHL5耳；非器质性聋13耳，占11.50%，诈聋2耳，占1.77%；98耳器质性听力损失者中，25耳为传导性耳聋，29耳为感音神经性耳聋，44耳为混合性耳聋。外伤后听觉障碍组与正常对照组各频率点DPOAE检出率相比，有显著差异性；两组各频率DPOAE幅值相比也具有显著差异性，且DPOAE幅值与纯音听力图比较有良好的一致性。结论：纯音测听为主观测听，声导抗是检测中耳及听反射弧的客观测听，ABR是判断外伤性听觉损害的敏感指标，可及时发现听通路损害，DPOAE具有良好的频率特性，可检测耳蜗毛细胞功能状况。多种测试方法联合使用可相互取长补短，结果互相印证，可成为听力损失定性与定量诊断的听力学检测手段。更多还原

【Abstract】 Objective：To study the expression of auditory using in clinical audiometry on post-traumatic hearing loss. Methods：92 posttraumatic patients (113 ears) complained hearing loss were treated by our hospital. They were examined by test of pure tone hearing threshold (PTHT), test of acoustic immittance (AI), test of 40Hz auditory event related potentials (40 Hz AERP)， test of auditory brainstem response(ABR) and test of distortion product otoacoustic emission(DPOAE). Then the pure tone audiogram and DPOAE audiogram were drawn. Results：92 patients (113 ears) were examined by PTHT, AI ， 40 Hz AERP，ABR and DPOAE. It was found that organic deafness was confirmed on 98 ears (86.73%), of which exaggerated hearing loss was 38 ears; nonorganic deafness was confirmed on 13 ears (11.50%)； stimulated deafness was 2 ears(1.77%). 98 organic deafness ears were diagnosed, of which conductive hearing loss was 25ears; sensorineural hearing loss was 29 ears, and mixed hearing loss was 44 ears. Compared the detected DPOAE rate and DPOAE amplitude at different frequencies between the post-traumatic hearing loss group and the normal contrast group. We found that there was a statistical significant difference. Moreover, DPOAE amplitudes were consistent with the pure tone audiogram. Conclusion：The pure tone audiometry is subjective audiometry. Acoustic immittance is objective audiometry of middle ear or hearing reflex arc. ABR is very sensitive to identify post-traumatic hearing loss, and can detect the injure of hearing system immediately. DPOAE has good frequent specificity. So it can respond the function state of the cochlea outer hair cells. Make up the multiple audiometry into a test battery. The test battery was valuable in evaluation of post-traumatic hearing loss, and can be used extensively as a tool to detect hearing loss.更多还原