Böhme G
Institut für Gefässerkrankungen, Zentral-krankenhaus Gauting/München.
Laryngol Rhinol Otol (Stuttg). 1987 Dec;66(12):638-42.
Otologic-audiologic examination was carried out in 171 patients (aged between 37-86; average age 64) with confirmed internal angiologic peripheral arterial vascular disease. Additional findings were observed in 94 of these patients who revealed an obliteration of the internal carotid artery or cerebral ischaemic stroke. Diseases of the ear were excluded clinically and audiologically. The mean hearing loss shows a sensory-neural high-tone loss in the tone audiogram. The range of scatter increases proportionately to the increase in tone loss. If compared with the physiologic examination of geriatric patients, the total word comprehension and minimal discrimination loss in the speech audiogram point towards a pathologic impairment of hearing in old age. The total word comprehension amounts to 251.20% in the 51-60 age group, 250.40% in the persons 61-70 years of age, 180.96% for the 71-80 age group and 131.67% for those over 80 years of age. The minimal discrimination loss comprises 4.00% for the 51-60 age group, 4.19% for the 61-70 group, 21.35% for 71-80 age bracket and 35.62% for those over 80. On the strength of these findings, an arterial sclerotic vascular disease should be considered as one of the multifactorial genesis of hearing impairment in old age. Special attention should be focussed on decompensation of the total word comprehension and minimal discrimination loss before the age of eighty. This would contribute towards a differentiation of physiologic and pathologic hearing diseases in old age.
对171例确诊患有颅内血管性外周动脉血管疾病的患者(年龄在37 - 86岁之间;平均年龄64岁)进行了耳科 - 听力学检查。在这些患者中,有94例还发现了颈内动脉闭塞或脑缺血性中风。临床和听力学检查排除了耳部疾病。纯音听力图显示平均听力损失为感音神经性高频听力损失。离散范围随音调损失的增加而相应增加。与老年患者的生理检查相比,言语听力图中的总单词理解率和最小辨别损失表明老年人听力存在病理性损害。51 - 60岁年龄组的总单词理解率为251.20%,61 - 70岁人群为250.40%,71 - 80岁年龄组为180.96%,80岁以上人群为131.67%。最小辨别损失在51 - 60岁年龄组为4.00%,61 - 70岁组为4.19%,71 - 80岁年龄组为21.35%,80岁以上人群为35.62%。基于这些发现,动脉粥样硬化性血管疾病应被视为老年听力损害多因素成因之一。应特别关注80岁之前总单词理解率和最小辨别损失的失代偿情况。这将有助于区分老年生理性和病理性听力疾病。