Mangham C A
Seattle Ear Clinic, WA 98122.
Otolaryngol Head Neck Surg. 1991 Dec;105(6):814-7. doi: 10.1177/019459989110500607.
This study addresses the question, what difference in hearing between ears puts a patient at sufficient risk of acoustic tumor to warrant further diagnostic tests? The subjects were 210 patients with surgically confirmed unilateral acoustic tumors and a control group comprised of 112 patients referred for audiometry. Hearing thresholds were determined at octave intervals from 250 Hz to 8 kHz. The threshold in the nonsuspect ear was subtracted from the threshold in the suspect ear. The rank order in effectiveness for threshold difference was: 2 kHz, 4 kHz, 1 kHz, 8 kHz, 500 Hz, and 250 Hz. We found that the most effective diagnostic strategy was to refer patients for magnetic resonance imaging if their average threshold difference at 1 to 8 kHz was 20 dB or greater and refer patients for auditory brainstem response testing if their average threshold was 5 to 20 dB.
两耳听力存在何种差异会使患者面临听神经瘤的足够风险，从而需要进一步的诊断测试？研究对象为210例经手术证实患有单侧听神经瘤的患者以及一个由112例被转诊进行听力测定的患者组成的对照组。在从250赫兹至8千赫兹的倍频程间隔上测定听力阈值。将患侧耳的阈值减去对侧耳的阈值。阈值差异有效性的排序为：2千赫兹、4千赫兹、1千赫兹、8千赫兹、500赫兹和250赫兹。我们发现，最有效的诊断策略是，如果患者在1至8千赫兹的平均阈值差异为20分贝或更大，则将其转诊进行磁共振成像检查；如果患者的平均阈值为5至20分贝，则将其转诊进行听性脑干反应测试。
