Gunzenhäusser E, Maurer J, Beck A, Mann W
Hals-, Nasen-, Ohrenklinik, Johannes-Gutenberg Universität Mainz.
Laryngorhinootologie. 1994 Jun;73(6):311-4. doi: 10.1055/s-2007-997137.
23 patients with unilateral hearing loss and presence of TEOAE on both ears were examined with regard to the association between contralateral acoustic stimulation and evoked otoacoustic emissions. Contralateral white noise of 40 dB HL, 50 dB HL and 60 dB HL decreases the amplitude of TEOAE both at the ear with and without hearing loss. In comparison with a group of subjects with normal hearing, the decrease in the amplitude of TEOAE was less in the group of patients with hearing loss. Two paradoxical cases were found with an increase in the TEOAE amplitude in the ear with hearing loss during contralateral stimulation. It is assumed that impairment of the efferent synapses on the outer hair cells or of the decussated efferent nerve fibres at the floor of the fourth ventricle contributes to the pathogenesis of hearing loss. Impairment of the efferent system at brainstem level can explain the lower decrease in the amplitude both in the diseased ear and the normal ear. The behaviour of the normal ear during stimulation of the diseased ear can also be caused by disturbance of the afferent system.
对23例单侧听力损失且双耳均存在瞬态诱发性耳声发射（TEOAE）的患者，就对侧声刺激与诱发性耳声发射之间的关联进行了检查。40 dB HL、50 dB HL和60 dB HL的对侧白噪声会降低有听力损失和无听力损失耳的TEOAE幅度。与一组听力正常的受试者相比，听力损失患者组中TEOAE幅度的降低幅度较小。发现两例矛盾的病例，即在对侧刺激期间，有听力损失耳的TEOAE幅度增加。据推测，外毛细胞上的传出突触或第四脑室底部交叉的传出神经纤维受损有助于听力损失的发病机制。脑干水平传出系统的损伤可以解释患耳和正常耳中幅度降低幅度较小的原因。患耳受刺激时正常耳的表现也可能由传入系统的紊乱引起。
