Thabet Elsaeid Mohamed
ENT - HNS Dept., Mansoura College of Medicine, Mansoura University, 29 Bank Misr St., Mansoura, Egypt.
Auris Nasus Larynx. 2009 Dec;36(6):633-6. doi: 10.1016/j.anl.2009.01.002. Epub 2009 Mar 13.
This study was designed to investigate the possibility of underlying cochlear damage whether outer hair cells (OHCs) or inner hair cells (IHCs) in tinnitus suffering patients with normal hearing sensitivity, using transient evoked otoacoustic emission (TEOAEs) and threshold equalizing noise (TEN) test, if any.
Twenty patients suffering from unilateral tinnitus with normal hearing sensitivity participated in this study. Their other ear acted as control ears. They were subjected to full history taking, otoscopy, basic audiologic evaluation, TEOAEs and TEN test.
TEOAEs were abnormal in 85% of the tinnitus ears compared to 20% in control ears; this difference was statistically significant. The abnormal TEOAEs frequency bands in the tinnitus ears were statistically significant above 2000 Hz when compared to the control ears and were more common for the 4000 and 5000 Hz. This suggests that OHCs dysfunction may be important in the generation of tinnitus. TEN test demonstrated dead regions in the cochlea in 15% of the tinnitus ears only. This might be attributed to increased resistance of IHCs to damage compared to OHCs vulnerability. The affected frequency location was at 500 Hz in 5%, 3000 and 4000 Hz in 10% of tinnitus ears.
This work has shown a higher prevalence of OAE abnormalities in tinnitus patients with normal hearing in contrast to TEN test denoting the more vulnerability of OHCs to damage.
本研究旨在利用瞬态诱发耳声发射(TEOAEs)和阈值均衡噪声(TEN)测试,调查听力敏感度正常的耳鸣患者是否存在潜在的耳蜗损伤,以及损伤的是外毛细胞(OHCs)还是内毛细胞(IHCs)。
20例单侧耳鸣且听力敏感度正常的患者参与了本研究。他们的对侧耳作为对照耳。对患者进行了全面的病史采集、耳镜检查、基本听力评估、TEOAEs和TEN测试。
与对照耳的20%相比,85%的耳鸣耳TEOAEs异常;这种差异具有统计学意义。与对照耳相比,耳鸣耳TEOAEs异常频段在2000Hz以上具有统计学意义,在4000Hz和5000Hz更为常见。这表明OHCs功能障碍可能在耳鸣的产生中起重要作用。TEN测试仅在15%的耳鸣耳中显示耳蜗存在死区。这可能归因于与OHCs易损性相比,IHCs对损伤的抵抗力增强。受影响的频率位置在5%的耳鸣耳中为500Hz,在10%的耳鸣耳中为3000Hz和4000Hz。
这项研究表明,听力正常的耳鸣患者中OAE异常的发生率较高,而TEN测试表明OHCs更容易受到损伤。