Wu Bozhen, Xiao Mang
Department of Otolaryngology Head and Neck Surgery,Sir Run Run Shaw Hospital,Hangzhou,310016,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Apr;39(4):328-332. doi: 10.13201/j.issn.2096-7993.2025.04.007.
To compare the changes in distortion product otoacoustic emission (DPOAE) test results in clinical patients with negative middle ear pressure after equalizing the pressure in the external canal and the middle ear cavity. This study aims to analyze the effect of negative middle ear pressure on otoacoustic emissions and investigate the correlation between the degree of negative middle ear pressure and the changes in amplitude and signal-to-noise ratio of DPOAE. Twenty-seven clinical patients were included, with 34 ears exhibiting negative middle ear pressure. Acoustic conductance tests, pure tone hearing threshold tests, and DPOAE tests were conducted under ambient pressure and peak pressure after equalizing the middle ear pressure for all tested ears. The amplitude and signal-to-noise ratio of DPOAE before and after compensating for middle ear pressure were recorded and statistically analyzed. At 1.0 k Hz, 1.5 k Hz, and 8.0 k Hz, the DPOAE amplitude under ambient pressure was significantly higher than that under negative pressure (<0.05). A significant difference in the DPOAE signal-to-noise ratio was observed at 1.0 k Hz and 8.0 k Hz (<0.05). The difference in both amplitude and signal-to-noise ratio between these two test conditions was more pronounced at 1.0 k Hz (<0.01). There was no correlation between the negative pressure value from the tympanogram and the change in amplitude, with a weak negative correlation trend observed only at 0.75 k Hz (=-0.328, =0.054). However, a significant negative correlation was found between the negative pressure value from the tympanogram and the change in signal-to-noise ratio at 0.75 k Hz (=-0.366, <0.05). Compensating for middle ear pressure significantly improves the amplitude and signal-to-noise ratio of DPOAE in cases of negative middle ear pressure, particularly in the medium-frequency range. The smaller the degree of negative pressure in the middle ear, the weaker the effect of equalizing middle ear pressure is, especially in the low-frequency range.
比较外耳道与中耳腔压力平衡后临床中耳压力为负压患者的畸变产物耳声发射(DPOAE)测试结果变化。本研究旨在分析中耳负压对耳声发射的影响,并探讨中耳负压程度与DPOAE幅值及信噪比变化之间的相关性。纳入27例临床患者,34耳表现为中耳负压。对所有受试耳在环境压力及中耳压力平衡后的峰值压力下进行声导抗测试、纯音听阈测试及DPOAE测试。记录并统计分析中耳压力补偿前后DPOAE的幅值及信噪比。在1.0kHz、1.5kHz及8.0kHz时,环境压力下的DPOAE幅值显著高于负压下的幅值(P<0.05)。在1.0kHz及8.0kHz时观察到DPOAE信噪比有显著差异(P<0.05)。这两种测试条件下幅值及信噪比的差异在1.0kHz时更明显(P<0.01)。鼓室图负压值与幅值变化之间无相关性,仅在0.75kHz时观察到微弱的负相关趋势(r=-0.328,P=0.054)。然而,在0.75kHz时鼓室图负压值与信噪比变化之间存在显著负相关(r=-0.366,P<0.05)。补偿中耳压力可显著改善中耳负压情况下DPOAE的幅值及信噪比,尤其是在中频范围。中耳负压程度越小,中耳压力平衡的效果越弱,尤其是在低频范围。