Department of Audiovestibular Medicine, Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY, UK.
Int J Audiol. 2010 Feb;49(2):95-8. doi: 10.3109/14992020903300423.
It is a common misconception that high frequency audiometric notches are diagnostic of noise induced hearing loss. The aim of this study was to identify the prevalence of high frequency notch (HFN) in an audiovestibular medicine outpatient clinic population at a district general hospital. One hundred and forty nine consecutive adult patients were assessed. According to standard practice at the audiovestibular clinic, a full clinical history with particular emphasis on neuro-otological symptoms, noise exposure, and medical risk factors for sensorineural hearing loss was taken. After standard 8-frequency pure tone audiometry, subjects were divided into those with HFN and those without. There were 84 (56%) females and 65 (44%) males with a mean age of 45 years (range: 19 to 91 years). A total of 39.6% had notches not attributable to noise (occupational or recreational) or any other known risk factor. In 29 (49.2%) and 15 (25.4%) the HFN was present in the left and right ear respectively whereas 15 (25.4%) were bilateral. The frequency least affected was 3 kHz while 4 kHz and 6 kHz were affected in almost equal proportions. In 53 ears (71.6%), the notch depth was less than 20 dBHL (10-19 dB) compared to 21 ears (28.4%) with a depth of 20 dBHL or more. This study concludes that high frequency notch without excessive noise exposure or any other known factor is common. It is neither diagnostic of, nor invariable with NIHL unless a convincing history of hazardous noise exposure is elicited from the history.
人们普遍认为高频听力切迹是噪声性听力损失的诊断依据。本研究旨在确定在区综合医院的听觉医学门诊人群中高频切迹（HFN）的患病率。对 149 例连续成年患者进行评估。根据听觉诊所的标准实践，对每位患者进行全面的临床病史评估，特别强调神经耳科症状、噪声暴露和感音神经性听力损失的医学危险因素。在进行标准的 8 频率纯音测听后，将受试者分为有 HFN 和无 HFN 两组。其中 84 例（56%）为女性，65 例（44%）为男性，平均年龄为 45 岁（范围：19-91 岁）。共有 39.6%的患者没有可归因于噪声（职业性或娱乐性）或任何其他已知危险因素的切迹。在 29 例（49.2%）和 15 例（25.4%）患者中，左、右耳分别存在 HFN，而 15 例（25.4%）为双侧。受影响最小的频率为 3 kHz，而 4 kHz 和 6 kHz 的影响比例几乎相等。在 53 只耳朵（71.6%）中，切迹深度小于 20 dBHL（10-19 dB），而 21 只耳朵（28.4%）的切迹深度为 20 dBHL 或更高。本研究得出结论，高频切迹而没有过度的噪声暴露或任何其他已知因素是很常见的。除非从病史中引出有说服力的危险噪声暴露史，否则它既不是噪声性听力损失的诊断依据，也不一定与噪声性听力损失相关。
