Lisowska Grazyna, Namysłowski Grzegorz, Morawski Krzysztof, Strojek Krzysztof
II Katedra i Klinika Laryngologii Sl.AM w Zabrzu.
Otolaryngol Pol. 2002;56(2):217-25.
The relationship between diabetes mellitus and hearing impairment has been studied for more than 100 years, and is still a matter of controversy. In our study hearing in diabetic patients was studied by tonal audiometry, brain stem auditory evoked responses and evoked otoacoustic emissions. The aim of this study was to evaluate the function of peripheral and central auditory pathway in subjects with insulin dependent diabetes mellitus (IDDM). Possible correlation between auditory function and microangiopathy (retinopathy or nephropathy) also have been investigated. Cochlear activity was evaluated by means of otoacoustic emissions. The functional changes in the brain stem were evaluated by ABR. OAEs and ABR were measured in 42 normally hearing IDDM patients aged between 21 and 42 years, and 33 aged- and sex-matched non-diabetic control subjects. IDDM patients were distributed into two groups, 17 patients without microangiopathy and 25 patients with microangiopathy.
Both of the groups (diabetic and control) had normal and undifferentiated results in tonal and impedance audiometry. The mean amplitudes of various DPOAEs were significantly reduced in the diabetic group compared with control subjects. No correlations were found between microangiopathy and DPOAE amplitudes reduced. ABR latencies were longer in diabetic patients when compared with those of control subjects. These findings indicate a central disturbance in the auditory pathway. Microvascular complications (retinopathy or nephropathy) were associated only with the prolongation wave I latency. In conclusion, the combined use of different procedures for monitoring the central and peripheral portions of the auditory pathway in diabetic patients showed the existence of the alterations in the cochlear micromechanics and in the retrocochlear auditory pathway.
糖尿病与听力障碍之间的关系已研究了100多年，至今仍是一个有争议的问题。在我们的研究中，通过纯音听力测定、脑干听觉诱发电位和耳声发射对糖尿病患者的听力进行了研究。本研究的目的是评估胰岛素依赖型糖尿病（IDDM）患者外周和中枢听觉通路的功能。还研究了听觉功能与微血管病变（视网膜病变或肾病）之间可能的相关性。通过耳声发射评估耳蜗活动。通过ABR评估脑干的功能变化。对42名年龄在21至42岁之间听力正常的IDDM患者以及33名年龄和性别匹配的非糖尿病对照受试者进行了耳声发射和ABR测量。IDDM患者分为两组，17名无微血管病变患者和25名有微血管病变患者。
糖尿病组和对照组在纯音和阻抗听力测定中均有正常且无差异的结果。与对照受试者相比，糖尿病组各种畸变产物耳声发射的平均幅值显著降低。未发现微血管病变与畸变产物耳声发射幅值降低之间存在相关性。与对照受试者相比，糖尿病患者的ABR潜伏期更长。这些发现表明听觉通路存在中枢性障碍。微血管并发症（视网膜病变或肾病）仅与I波潜伏期延长有关。总之，联合使用不同方法监测糖尿病患者听觉通路的中枢和外周部分，结果显示耳蜗微力学和蜗后听觉通路存在改变。
