Hajduk Agata, Lisowska Grazyna, Namysłowski Grzegorz, Szprynger Krystyna, Szczepańska Maria, Widziszowska Agnieszka
Katedra i Oddział Kliniczny Laryngologii w Zabrzu, Sl AM w Katowicach.
Otolaryngol Pol. 2006;60(1):61-6.
Chronic renal failure (CRF) causes a lot of systemic side-effects, among them: neurological and otological complications. In present study hearing evaluation was made in young patients, using distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR).
(1) objective assessment of hearing organ activity in CRF children, (2) localization of hearing organ part involved in CRF, (3) establishing best parameters of ipsilateral stimulation in DPOAEs for clinical use.
Hearing acuity was assessed in 22 CRF children ranging in age from 9 to 17 years and 18 healthy children ranging in age from 10 to 18 years. At first pure tone audiometry and tympanometry were evaluate. Only patients with normal middle ear condition and hearing threshold better than 30 dB HL were put forward further investigations. Objective assessment of hearing condition included: (1) DPOAEs using DP-gram format. Two simultaneous pure-tone signals (primaries) were presented to the ear at two different frequencies (f1 and f2, where f2 > f1) and the 2f1-f2 were analyzed. Five pairs of non equal level and L2 were used L1 and L2: panel A1: L1 = 65 and L2 = 60 dB SPL, panel A2: L1 = 63 and L2 = 55 dB SPL, panel A3: L1 = 59 and L2 = 45 dB SPL, panel A4: L1 = 55 and L2 = 35 dB SPL, panel A5: L1 = 51 and L2 = 25 dB SPL; (2) ABR investigation using click stimulus, at 90 dB nHL level. Wave I, III, V latencies and intervals I-III, III-V, I-V were evaluated. Our results reviled significantly lower mean DPOAEs amplitudes in CRF children when compare to healthy children, at all frequencies measured. No differences in ABR evaluation were observed. Most optimal DPOAEs parameters in clinical use seem to be panel A1, A2 and A3 of level L1 and L2.
慢性肾衰竭（CRF）会引发许多全身性副作用，其中包括：神经和耳科并发症。在本研究中，对年轻患者进行了听力评估，采用了畸变产物耳声发射（DPOAE）和听觉脑干反应（ABR）。
（1）客观评估CRF患儿听力器官的活动情况；（2）确定CRF中受累的听力器官部位；（3）确定DPOAE中同侧刺激的最佳临床应用参数。
对22名年龄在9至17岁的CRF患儿和18名年龄在10至18岁的健康儿童进行了听力敏锐度评估。首先进行纯音听力测定和鼓室图检查。只有中耳状况正常且听力阈值优于30dB HL的患者才进行进一步检查.听力状况的客观评估包括：（1）使用DP-gram格式的DPOAE。两个同时呈现的纯音信号（原信号）以两个不同频率（f1和f2，其中f2>f1）传入耳内，并分析2f1-f2。使用了五对不等水平的L₁和L₂：A1组：L₁ = 65dB SPL且L₂ = 60dB SPL，A2组：L₁ = 63dB SPL且L₂ = 55dB SPL，A3组：L₁ = 59dB SPL且L₂ = 45dB SPL，A4组：L₁ = 55dB SPL且L₂ = 35dB SPL，A5组：L₁ = 51dB SPL且L₂ = 25dB SPL；（2）使用90dB nHL水平的短声刺激进行ABR检查。评估波I、III、V的潜伏期以及I-III、III-V、I-V的间期。我们的结果显示，与健康儿童相比，CRF患儿在所有测量频率下的平均DPOAE振幅均显著降低。在ABR评估中未观察到差异。临床应用中最理想的DPOAE参数似乎是L₁和L₂水平的A1、A2和A3组。
