Khakzand Soheila, Maarefvand Mohammad, Ruzbahani Masoumeh, Tajdini Ardavan
Audiology Department, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.
Ear, Nose and Throat Department, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int Arch Otorhinolaryngol. 2024 Mar 15;28(3):e415-e423. doi: 10.1055/s-0043-1776728. eCollection 2024 Jul.
When cases of idiopathic sudden sensorineural hearing loss (SSNHL) are treated successfully, most clinicians assume the normality and symmetry of the auditory processing. This assumption is based on the recovery of the detection ability on the part of the patients, but the auditory processing involves much more than detection alone. Since certain studies have suggested a possible involvement of the central auditory system during the acute phase of sudden hearing loss, the present study hypothesized that auditory processing would be asymmetric in people who have experienced sudden hearing loss. To assess the physiologic and electrophysiological conditions of the cochlea and central auditory system, as well as behavioral discrimination, of three primary aspects of sound (intensity, frequency, and time) in subjects with normal ears and ears treated successfully for SSNHL. The study included 19 SSNHL patients whose normal and treated ears were assessed for otoacoustic emissions, speech auditory brainstem response, intensity and pitch discrimination, and temporal resolution in a within-subject design. The otoacoustic emissions were poorer in the treated ears compared to the normal ears. Ear- and sex-dependent differences were observed regarding otoacoustic emissions and pitch discrimination. The asymmetrical processing observed in the present study was not consistent with the hearing threshold values, which might suggest that the central auditory system would be affected regardless of the status of the peripheral hearing. Further experiments with larger samples, different recovery scenarios after treatment, and other assessments are required.
当特发性突发性感音神经性听力损失（SSNHL）病例得到成功治疗后，大多数临床医生会认为听觉处理功能恢复正常且对称。这种假设基于患者检测能力的恢复，但听觉处理所涉及的远不止单纯的检测。由于某些研究表明在突发听力损失的急性期中枢听觉系统可能参与其中，本研究假设经历过突发听力损失的人听觉处理会存在不对称性。
为评估正常耳朵以及成功治疗SSNHL的耳朵的受试者在声音的三个主要方面（强度、频率和时间）的耳蜗和中枢听觉系统的生理及电生理状况，以及行为辨别能力。
该研究纳入了19名SSNHL患者，采用受试者内设计对其正常耳朵和接受治疗的耳朵进行耳声发射、言语听觉脑干反应、强度和音高辨别以及时间分辨率的评估。
与正常耳朵相比，接受治疗的耳朵耳声发射较差。在耳声发射和音高辨别方面观察到了与耳朵及性别相关的差异。
本研究中观察到的不对称处理与听力阈值不一致，这可能表明无论外周听力状况如何，中枢听觉系统都会受到影响。需要进一步开展更大样本量、治疗后不同恢复情况以及其他评估的实验。
