Schmidt W, Lehnhardt E, Battmer R D
HNO. 1983 Apr;31(4):109-16.
The reliability on audiometric findings in hearing disorders of different genesis has been considerably improved by the ERA. By no means, the ERA can replace the conventional hearing tests, rather it is an additional technique of examination. Apparently it does not reveal specific findings of psychogenic hearing disorders - unless the prolongation of the cortical response as repeatedly seen by us. In case of aggravation ERA renders us possible to detect the kind of hearing defects and the actual threshold - e.g. with respect to high frequency range by brain stem responses, for 500 and 1,000 Hz according to the cortical responses. The neural hearing impairment caused by tumours always exhibits extremely prolonged latencies even at high intensities, eventually concomitant with a response threshold elevated versus the subjective threshold. These reactions, above all, become apparent in the brain stem rather than in the cortex. In contrast to this the sensoric hearing disorders the ERA elucidates even objectively the recruitment: normal latencies at high intensities. The latency of the objective response, thus, corresponds to the sound stimulus is perceived loud, and it is long for stimuli perceived relatively low - even in spite of great intensity. Comprising the ERA the quote of audiometric failures in excluding an acoustic neuroma is reduced to a minimum.
ERA极大地提高了不同病因听力障碍听力学检查结果的可靠性。ERA绝不能取代传统的听力测试,它只是一种辅助检查技术。显然,它无法揭示心因性听力障碍的特定表现——除非像我们多次观察到的那样出现皮质反应延长。在病情加重的情况下,ERA使我们能够检测出听力缺陷的类型和实际阈值——例如,通过脑干反应检测高频范围,根据皮质反应检测500和1000赫兹的情况。肿瘤引起的神经性听力损害即使在高强度时也总是表现出极长的潜伏期,最终伴随着反应阈值相对于主观阈值升高。这些反应首先在脑干而非皮质中表现明显。与此相反,对于感音性听力障碍,ERA甚至能客观地阐明重振现象:高强度时潜伏期正常。因此,客观反应的潜伏期与被感知为响亮的声音刺激相对应,而对于被感知为相对较弱的刺激,即使强度很大,潜伏期也较长。将ERA纳入后,排除听神经瘤时听力测试失败的比例降至最低。