Davies R A
Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK.
Handb Clin Neurol. 2016;137:157-76. doi: 10.1016/B978-0-444-63437-5.00011-X.
Hearing tests of the peripheral auditory system are well established and the pure-tone audiogram is generally regarded as the screening test of choice in adults. It allows the distinction to be made between conductive, i.e., outer- and middle-ear, and sensorineural, i.e., cochlear, hearing loss, and also to describe the configuration of the hearing thresholds in terms of severity and the frequency affected. Electrophysiologic testing with auditory potentials, e.g., the auditory brainstem response, can identify sites of lesion in the eighth nerve, brainstem, and more centrally. However, it is only in the last two decades that a battery of central auditory tests has been established that can probe the central pathways in more details, i.e., when the pure-tone audiogram may be normal, and yet the patient still has symptoms of hearing dysfunction.
外周听觉系统的听力测试已很成熟，纯音听力图通常被视为成人首选的筛查测试。它能够区分传导性听力损失（即外耳和中耳的听力损失）和感音神经性听力损失（即耳蜗的听力损失），还能根据严重程度和受影响频率描述听力阈值的形态。利用听觉诱发电位进行的电生理测试，例如听觉脑干反应，可确定第八神经、脑干及更中枢部位的病变位置。然而，直到最近二十年才建立起一套中枢听觉测试，能够更详细地探测中枢通路，也就是说，当纯音听力图可能正常，但患者仍有听力功能障碍症状时。
