听力正常耳鸣患者治疗前后诱发性耳声发射临床探究.docVIP

听力正常耳鸣患者治疗前后诱发性耳声发射临床探究 　 作者：吴立新 尚小领 范淑敏 林彦涛 张玉英 【摘要】 目的：分析耳鸣与耳蜗毛细胞早期损害的关系， 以及听力正常耳鸣患者治疗后基本痊愈和显效的病耳耳蜗毛细胞恢复情况。方法：40例（66耳）纯音听力正常的耳鸣患者， 行诱发性耳声发射检查：瞬态耳声发射（TEOAE）和畸变产物耳声发射（DPOAE）检查，并对耳鸣患者给予相应治疗，对基本痊愈和显效的病耳治疗前DPOAE或 TEOAE未通过的复查DPOAE或TEOAE。结果：①治疗前TEOAE检查28耳通过，38耳未通过；DPOAE检查34耳通过，32耳未通过；② 经治疗，38耳治疗前TEOAE检查未通过的患耳基本痊愈和显效的病耳有15耳， 复查TEOAE，3耳通过； 32耳DPOAE检查未通过的患耳基本痊愈和显效的病耳有13耳，复查 DPOAE，4耳通过。结论： 部分听力正常的耳鸣患者已有耳蜗毛细胞的损害，而且不易恢复。 【关键词】 耳鸣；诱发性耳声发射；治疗 【ABSTRACT】 Objective：To investigate the relationship between tinnitus and early harmness of outer hair cell in cochlear, and recovered situation of outer hair cell in cochlear that was treated (being cured and evidently effective) in tinnitus patients with normal hearing was studied as well.Methods： 40 cases (66 ears altogether) of normal hearing with tinnitus, were tested by evoked otoacoustic emissions(TEOAE and DPOAE). Treat the patients with tinnitus. The sick ears that were cured and showed evident effectiveness, but didnt pass TEOAE or DPOAE before treatment were checked again. Results：①Before treatment, for TEOAE: 28 ears passed, 38 ears did not pass; DPOAE: 34 ears passed, 32 ears did not pass. ②After treatment, TEOAE: 15 ears that did not pass before treatment were cured and showed evident effectiveness, check TEOAE again,3 ears passed; DPOAE: 13 ears that did not pass before treatment were cured and showed evident effectiveness, check DPOAE again, 4 ears passed. Conclusion：Some patients of normal hearing with tinnitus have had early harmness of outer hair cell in cochlear, and are not easily recovered. 【KEY WORDS】 Tinnitus; Evoked otoacoustic emissions; Treatment 耳声发射是耳蜗的生理功能，主要反映外毛细胞的功能状态，是产于耳蜗，经听骨链、鼓膜释放入外耳道的音频能量，目前研究较多的是畸变产物耳声发射（DPOAE）、瞬态耳声发射（TEOAE）。耳鸣是在无外界声刺激或电刺激时，人体产生的耳内或脑内声音感觉，是耳鼻咽喉科的常见病症，发生率为17%，给患者可带来极大痛苦。以往报道较多的是听力正常耳鸣患者畸变产物耳声发射（DPOAE）、瞬态耳声发射（TEOAE ）的通过率，对未通过的患耳经治疗基本痊愈和显效的患耳复查DPOAE、TEOAE未见报道，我们对40例（66耳）纯音听力正常的耳鸣患者， 行诱发性耳声发射检查：瞬态耳声发射（TEOAE）和畸变产物耳声发射（DPOAE）检查，并对耳鸣患者给予相应治疗，对基本痊愈和显效的病耳治疗前DPOAE或 TEOAE未通过的复查DPOAE或TEOAE，研究耳蜗