绥德同心医院耳鼻喉科整理关于单侧神经性耳鸣患者的耳鸣心理声学测试分析MicrosoftWord文档.docVIP

绥德同心医院耳鼻喉科整理关于单侧神经性耳鸣患者的耳鸣心理声学测试分析 刘敏 姜鸿彦江广理周蔚李广智 1.中山大学附属第一医院耳鼻咽喉科医院（广州 510080） 【摘要】目的 了解神经性耳鸣患者耳鸣的频率、响度和可掩蔽等心理声学特点。 方法 采用心理声学方法对37例耳鸣患者的耳鸣频率、响度、最低掩蔽级（minimum masking level，MML）和掩蔽后效应（residual inhibition，RI）等指标进行测试和分析。 结果 37例患者中有36例耳鸣匹配成功，其中24例为窄带噪声，6例为纯音，白噪声和言语噪声的患者各有3例，1例未匹配成功；除去匹配为白噪声、言语噪声和未匹配成功的病例外，患者的耳鸣平均频率为3 165.9±1 848.8 Hz，响度为4.5±2.2 dB SL；掩蔽曲线中有23例为间距型（61.9%），5例分离型（13.5%），4例汇聚型（10.8%），2例重叠型（5.4%），3例不能掩蔽型（8.1%）；RI试验中有完全残抑效果的有10例（27.5%），部分效果的25例（67.5%），2例（5.4%）没有出现掩蔽后效应。 结论 对神经性耳鸣患者进行心理声学测试是可行的, 能了解其耳鸣音调、响度、MML和RI等指标，为临床治疗提供量化指标以供参考。 【关键词】 耳鸣；心理声学；测试 Psychoacoustic Characteristics of Patients with Sensorineural Tinnitus  Liu Min, Jiang Hongyan，Jiang Guangli,Zhou Wei,Li Guangzhi （Otolaryngology Hospital of the First Affiliated Hospital of Sun  Yat-Sen University, Guangzhou, 510080, China） 【Abstract】 Objective To investigate the psychoacoustic characteristics of sensorineural tinnitus, including pitch, loudness and maskability. Methods Thirty-seven cases with tinnitus were studied. Tinnitus pitch-matching, loudness-matching, minimum masking level（MML）and residual inhibition tests were performed on the patients.Results Thirty-six cases could be matched, the average frequency of tinnitus pitch was 3 165.9±1 848.8 Hz; the other 3 cases reported their tinnitus like white noise and speech noise respectively. The average loudness was 4.5±2.2 dB SL. The patterns of masking curves were very different among the patients: 23 cases exhibited the pattern of distance , 5 cases divergence patterns, 4 cases convergence patterns, 2 cases congruence patterns, and 3 cases persistence patterns, respectively. RI evaluation findings revealed that 10 cases (27.5%）experienced complete inhibition, 25 cases(67.5%) partial inhibition, only 2 cases had no inhibition at all.Conclusion Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, such as pitch, loudness, MML and RI. These data can help clinician