Mimura Tamie, Sato Eisuke, Sugiura Makoto, Yoshino Takahiko, Naganawa Shinji, Nakashima Tsutomu
Department of Otorhinolaryngology, Nagoya University School of Medicine, Nagoya, Japan.
Int J Audiol. 2005 Aug;44(8):466-9. doi: 10.1080/14992020500057665.
The Bing test is based on the principle that occlusion of the external auditory meatus improves the perception of bone-conducted sounds unless there is a conductive hearing impairment. An air-bone gap has been reported in patients with large vestibular aqueduct (LVA) syndrome without apparent middle ear dysfunction. We therefore performed the Bing test on nine patients with this syndrome to evaluate whether it is associated with an air-bone gap or middle ear dysfunction. Bone conduction thresholds did not change significantly during the Bing test in any patient. Because an air-bone gap is observed in patients with abnormal communication between the inner ear and cerebrospinal fluid through the LVA, dehiscent superior canal, or dilated inner ear meatus; we propose that a 'three windows' model (in which the abnormal communication provided by the enlarged endolymphatic duct and sac in LVA acts as the 'third window' for sound conductance) might explain the air-bone gap in such patients.
除非存在传导性听力障碍，否则外耳道堵塞会改善骨导声音的感知。据报道，在没有明显中耳功能障碍的大前庭导水管（LVA）综合征患者中存在气骨导间距。因此，我们对9例该综合征患者进行了宾氏试验，以评估其是否与气骨导间距或中耳功能障碍有关。在任何患者的宾氏试验过程中，骨导阈值均无显著变化。由于通过LVA、半规管裂或内耳道扩张在内耳与脑脊液之间存在异常连通的患者中观察到气骨导间距；我们提出一个“三窗”模型（其中LVA中扩大的内淋巴管和内淋巴囊提供的异常连通充当声音传导的“第三窗”）可能解释此类患者的气骨导间距。
