Hsu S Y, Wang P C, Yang T H, Lin T F, Hsu S H, Hsu C J
Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan.
B-ENT. 2013;9(2):101-9.
To investigate the function of the auditory efferent system in patients with chronic idiopathic tinnitus, but normal pure-tone audiograms.
We studied 15 subjects with normal hearing that had experienced either unilateral or bilateral persistent tinnitus for at least 3 months. The ears of the 15 subjects were classified into tinnitus-positive-ear (TPE) and tinnitus-negative-ear (TNE) groups. The control-ear group (CE) comprised the ears of 15 subjects with normal hearing and no tinnitus. We measured different types of otoacoustic emissions (OAEs), including spontaneous (SOAEs), transient evoked (TEOAEs), and distortion product (DPOAEs). We also analyzed contralateral suppression of OAEs and auditory brainstem responses (ABRs). Data were compared among TPE, TNE, and CE groups.
The data associated with cochlear mechanics, including the prevalence of SOAEs, the number of SOAE peaks, and the overall TEOAE responses in the absence of a contralateral stimulus, were not significantly different among the TPE, TNE, and CE groups. In the TPE group, contralateral stimuli failed to significantly suppress overall TEOAEs, and contralateral suppression of DPOAEs was significantly reduced over a limited frequency range. Furthermore, the TPE group showed prolonged latencies in waves III and V of ABRs.
This study demonstrated that abnormal contralateral suppression of OAEs and ABRs indicated a dysfunction in the ipsilateral efferent medial olivocochlear system; this might play a role in normal-hearing tinnitus.
研究慢性特发性耳鸣但纯音听力图正常患者的听觉传出系统功能。
我们研究了15名听力正常且经历单侧或双侧持续性耳鸣至少3个月的受试者。将这15名受试者的耳朵分为耳鸣阳性耳(TPE)组和耳鸣阴性耳(TNE)组。对照耳组(CE)由15名听力正常且无耳鸣的受试者的耳朵组成。我们测量了不同类型的耳声发射(OAEs),包括自发性(SOAEs)、瞬态诱发(TEOAEs)和畸变产物(DPOAEs)。我们还分析了OAEs的对侧抑制和听觉脑干反应(ABRs)。对TPE、TNE和CE组的数据进行了比较。
与耳蜗力学相关的数据,包括SOAEs的发生率、SOAE峰值数量以及在无对侧刺激时的总体TEOAE反应,在TPE、TNE和CE组之间无显著差异。在TPE组中,对侧刺激未能显著抑制总体TEOAEs,并且在有限的频率范围内DPOAEs的对侧抑制显著降低。此外,TPE组在ABRs的波III和波V中显示出潜伏期延长。
本研究表明,OAEs和ABRs的对侧抑制异常表明同侧传出内侧橄榄耳蜗系统功能障碍;这可能在听力正常的耳鸣中起作用。