Regional Military Medical Center, Military Medical Service, Swiss Armed Forces, Thun, Switzerland.
Otol Neurotol. 2012 Oct;33(8):1315-22. doi: 10.1097/MAO.0b013e318263d598.
We sought to evaluate the relative value of pure tone audiometry (PTA), extended high-frequency audiometry (EFA) and transiently evoked otoacoustic emissions (OAE) and distortion products when monitoring acute acoustic trauma (AAT).
Controlled prospective clinical study.
Tertiary referral center.
Seventy one active duty soldiers in the same age with normal hearing
Forty one soldiers suffered assault-rifle-induced acute acoustic traumas with hearing loss and tinnitus. Thirty soldiers served as a control group.
Pure tone threshold changes detected by PTA and EFA, amplitude and reproducibility changes in transiently evoked OAE, distortion products, and tinnitus analysis based on a visual analog scale.
Assault rifle-induced AAT caused unilateral temporary threshold shifts (TTS) in PTA and bilateral TTS in EFA. Two frequency regions with the largest threshold shifts were identified: one between 3 and 6 kHz and another between 11 and 14 kHz. The reproducibility of transiently evoked OAEs revealed changes related to the acoustic trauma in the 3- to 5-kHz frequency window. The amplitudes of the low stimulation level distortion products at 6 kHz were correlated with the audiometric AAT-induced TTS.
Acute acoustic trauma-induced audiometric TTS are predominantly confined to 2 specific frequency regions. PTA and EFA are both necessary to identify the full extent of acute acoustic trauma. PTA and EFA revealed that the TTSs were correlated to with distortion product OAE amplitude shifts at 6 kHz and changes in the reproducibility of transiently evoked OAE in the 3- to 5-kHz frequency window. PTA remains the most important measurement to monitor AAT. It may be useful to complement it with EFA, focusing on the 11 to 14 kHz frequency range. If used, OAE should be analyzed in the frequency range of 3 to 6 kHz.
我们旨在评估纯音听阈测试（PTA）、扩展高频听阈测试（EFA）和瞬态诱发耳声发射（OAE）及畸变产物在监测急性声创伤（AAT）时的相对价值。
对照前瞻性临床研究。
三级转诊中心。
71 名年龄相同、听力正常的现役军人。
41 名士兵遭受突击步枪引起的急性声创伤，伴有听力损失和耳鸣。30 名士兵作为对照组。
PTA 和 EFA 检测到的纯音阈值变化，瞬态诱发 OAE 的幅度和可重复性变化，基于视觉模拟量表的畸变产物和耳鸣分析。
突击步枪引起的 AAT 在 PTA 中导致单侧暂时阈移（TTS），在 EFA 中导致双侧 TTS。确定了两个阈值变化最大的频率区域：一个在 3 至 6 kHz 之间，另一个在 11 至 14 kHz 之间。瞬态诱发 OAE 的可重复性显示出与 3 至 5 kHz 频率窗口中的声创伤相关的变化。6 kHz 处低刺激水平畸变产物的幅度与听力 AAT 诱导的 TTS 相关。
急性声创伤诱导的听力 TTS 主要局限于 2 个特定的频率区域。PTA 和 EFA 均有必要确定急性声创伤的全部范围。PTA 和 EFA 表明，TTS 与 6 kHz 处畸变产物 OAE 幅度变化以及 3 至 5 kHz 频率窗口中瞬态诱发 OAE 的可重复性变化相关。PTA 仍然是监测 AAT 的最重要的测量方法。用 EFA 来补充它可能是有用的，重点关注 11 至 14 kHz 的频率范围。如果使用 OAE，应在 3 至 6 kHz 的频率范围内进行分析。
