Schöler C, Schönweiler R, Ptok M
Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover.
HNO. 1997 Dec;45(12):1008-15. doi: 10.1007/s001060050186.
Transient click-evoked otoacoustic emissions (TEOAE) and distortion-product otoacoustic emissions (DPOAE) are produced by an active biomechanical process in the cochlea, presumably related to outer hair-cell activity. Although it is generally accepted that in most cases of hearing loss with absent auditory evoked potentials neither TEOAE nor DPOAE can be found, some cases with such a constellation have been described. Here we report another four cases of children with severe to profound hearing loss where we discovered reproducible TEOAE and DPAOE, whereas auditory evoked potentials were missing. TEOAE and DPOAE recordings in these cases indicate substantially preserved outer hair-cell function independent of profound pre-sensineural hearing loss. Since the incidence of children with preserved otoacoustic emissions together with impairment of synaptic or postsynaptic function of the first neuron is not known, the unconditioned use of TEOAE nor DPOAE as a screening instrument must be seriously questioned. Secondly, in conjunction with subjective audiometry and brain-stem-evoked potentials, emission recordings is an indispensable measurement prior to cochlear implantation and use of high-power hearing aids.
瞬态诱发性耳声发射（TEOAE）和畸变产物耳声发射（DPOAE）是由耳蜗中的一种活跃生物力学过程产生的，可能与外毛细胞活动有关。虽然人们普遍认为，在大多数听觉诱发电位缺失的听力损失病例中，既无法检测到TEOAE也无法检测到DPOAE，但也有一些具有这种情况的病例被描述过。在此，我们报告另外4例重度至极重度听力损失儿童病例，我们在这些病例中发现了可重复的TEOAE和DPAOE，而听觉诱发电位缺失。这些病例中的TEOAE和DPOAE记录表明，外毛细胞功能基本保留，与重度感音神经性听力损失无关。由于具有保留的耳声发射同时伴有第一神经元突触或突触后功能受损的儿童发病率尚不清楚，因此，将TEOAE或DPOAE无条件用作筛查工具这一做法必须受到严肃质疑。其次，结合主观听力测定和脑干诱发电位，耳声发射记录是在进行人工耳蜗植入和使用大功率助听器之前必不可少的测量手段。
