Telischi F F, Widick M P, Lonsbury-Martin B L, McCoy M J
Department of Otolaryngology, University of Miami Ear Institute, FL 33101, USA.
Am J Otol. 1995 Sep;16(5):597-608.
Distortion product otoacoustic emissions (DPOAEs) elicited by a bitonal stimulus complex are low-level sounds that are generated within the cochlea, and are easily measured by a miniature microphone system placed in the external auditory canal. Under conditions of rapid measurement, DPOAEs have been shown in an animal model to be exquisitely sensitive to interruption of the blood supply to the inner ear. Currently, there is no real-time procedure available for monitoring hearing function intraoperatively during neurotologic surgery. The goal of the present study was to determine the utility of DPOAEs in monitoring cochlear status intraoperatively, particularly during procedures commonly used to remove acoustic neuromas. Distortion product otoacoustic emissions were measured pre- and intraoperatively in 11 patients, who were under general anesthesia for a variety of otolaryngologic procedures, including acoustic neuroma resection. High frequency emissions (i.e., > or = 4 kHz) were less affected by the elevated levels of acoustic noise present in the operating-room environment, thus permitting emitted responses to be updated as quickly as every 2 seconds. However, a number of technical problems were encountered and addressed during development of the emission monitoring technique. Despite these difficulties, overall, DPOAEs appear to be a promising adjunct to the intraoperative monitoring of auditory function.
双音刺激复合物诱发的畸变产物耳声发射（DPOAE）是在耳蜗内产生的低水平声音，可通过置于外耳道的微型麦克风系统轻松测量。在快速测量条件下，动物模型显示DPOAE对内耳血液供应中断极为敏感。目前，在神经耳科手术期间尚无用于术中监测听力功能的实时程序。本研究的目的是确定DPOAE在术中监测耳蜗状态的效用，特别是在常用于切除听神经瘤的手术过程中。对11例接受全身麻醉进行各种耳鼻喉科手术（包括听神经瘤切除术）的患者在术前和术中测量畸变产物耳声发射。高频发射（即≥4kHz）受手术室环境中存在的高水平噪声影响较小，因此允许每2秒快速更新发射反应。然而，在发射监测技术的开发过程中遇到并解决了一些技术问题。尽管存在这些困难，但总体而言，DPOAE似乎是术中听觉功能监测的一种有前景的辅助手段。
