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耳声发射在职业性噪声性听力损失的鉴别诊断中有用吗?

[Is otoacoustic emission useful in the differential diagnosis of occupational noise-induced hearing loss?].

作者信息

Sliwińska-Kowalska M, Kotylo P

机构信息

Zakładu Zagrozeń Fizycznych Instytutu Medycyny Pracy, Lodzi.

出版信息

Med Pr. 1997;48(6):613-20.

PMID:9558629
Abstract

It is very difficult to distinguish between occupational noise-induced hearing loss and other diseases with cochlear hearing loss by the means of conventional audiometric tests. Otoacoustic emission measurement is a relatively new tool for assessing the inner ear function. It gives an opportunity of monitoring the status of the outer hair cells, the elements which are the most sensitive to noise-induced damage. In this study the results of distortion product otoacoustic emission (DPOAE) measurement in subjects with industrial noise-induced hearing loss, presbycusis and hearing impairment caused by gentamycin, are presented. In all these cases pure-tone audiometry revealed similar shape of the audiograms with cochlear hearing loss mainly at high frequencies. In the cases of industrial noise-induced hearing loss, DPOAE measurements demonstrated a very typical shape of DP-gram with the decrease (notch) in otoacoustic primarily at the frequencies of 3-4 kHz. Such a notch in DP-grams was not observed in the cochlear hearing loss caused by factors other than noise. The data indicate that otoacoustic emissions may be useful in the differential diagnosis of occupational noise-induced hearing loss.

摘要

通过传统听力测试手段,很难区分职业性噪声性听力损失与其他伴有耳蜗性听力损失的疾病。耳声发射测量是评估内耳功能的一种相对较新的工具。它提供了一个监测外毛细胞状态的机会,外毛细胞是对噪声损伤最敏感的细胞成分。在本研究中,呈现了对患有工业噪声性听力损失、老年性耳聋以及庆大霉素所致听力损伤的受试者进行畸变产物耳声发射(DPOAE)测量的结果。在所有这些病例中,纯音听力测试显示听力图形状相似,耳蜗性听力损失主要出现在高频。在工业噪声性听力损失病例中,DPOAE测量显示出非常典型的DP图形状,耳声在3 - 4kHz频率处主要出现下降(切迹)。在由噪声以外的因素导致的耳蜗性听力损失中未观察到DP图中的这种切迹。数据表明,耳声发射可能有助于职业性噪声性听力损失的鉴别诊断。

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