Nottet Jean-Bertrand, Moulin Annie, Brossard Nicolas, Suc Benoît, Job Agnès
Hôpital d'Instruction des Armées Desgenettes, Service ORL, Lyon, France.
Laryngoscope. 2006 Jun;116(6):970-5. doi: 10.1097/01.MLG.0000216823.77995.13.
To follow up the auditory status of military personnel after an acute acoustic trauma and to identify the possible predictive value of hearing thresholds and otoacoustic emissions during the first 24 hours after the acoustic trauma.
A group of 24 young military subjects, aged 22 +/- 2.3 years, without any otologic problem before the acoustic trauma, were examined at three time intervals after an accidental acoustic trauma caused by the discharge of a firearm: 24 hours, 72 hours, and 15 days.
Each subject was submitted to medical examination and to a questionnaire detailing the circumstances of the acoustic trauma. Pure tone audiometry was performed from 1 to 8 kHz per half octave. Transiently evoked otoacoustic emissions were recorded in the nonlinear mode at 80 dB pSPL, and distortion product otoacoustic emissions were recorded from 1 to 6 kHz, using a distortion product-gram type procedure, at 65/55 dB SPL, with f2/f1 = 1.22. Two groups of subjects were defined: group 1 (n = 8) represented subjects with short-lasting tinnitus (<72 h) and group 2 (n = 16) subjects with long-lasting tinnitus (>72 h).
Hearing thresholds did not differ significantly between these two groups 24 hours after the acoustic trauma. However, otoacoustic emissions showed significantly lower amplitudes 24 hours after the acoustic trauma in subjects showing a longer lasting tinnitus.
Otoacoustic emissions appear to be a better predictor of the persistence of tinnitus than hearing thresholds alone 24 hours after an acute acoustic trauma.
随访军事人员急性声创伤后的听觉状况,并确定声创伤后最初24小时内听力阈值和耳声发射的可能预测价值。
一组24名年轻军事受试者,年龄22±2.3岁,在声创伤前无任何耳科问题,在火器发射导致意外声创伤后的三个时间点接受检查:24小时、72小时和15天。
每位受试者均接受医学检查,并填写一份详细描述声创伤情况的问卷。纯音听力测试在1至8 kHz每半倍频程进行。以80 dB pSPL的非线性模式记录瞬态诱发耳声发射,采用畸变产物图型程序,在65/55 dB SPL、f2/f1 = 1.22的条件下,从1至6 kHz记录畸变产物耳声发射。定义了两组受试者:第1组(n = 8)为耳鸣持续时间短(<72小时)的受试者,第2组(n = 16)为耳鸣持续时间长(>72小时)的受试者。
声创伤后24小时,这两组受试者的听力阈值无显著差异。然而,在耳鸣持续时间较长的受试者中,耳声发射在声创伤后24小时显示出明显较低的幅度。
急性声创伤后24小时,耳声发射似乎比单独的听力阈值更能预测耳鸣的持续情况。