Pethe J, Begall K, Mühler R, Smukalla K, von Specht H
Abteilung Experimentelle Audiologie und Medizinische Physik, Medizinischen Fakultät, Otto-von-Guericke-Universität Magdeburg.
Laryngorhinootologie. 1998 Mar;77(3):131-5. doi: 10.1055/s-2007-996947.
Estimation of hearing threshold in children is based on reliable identification of a response to a stimulus in the near-threshold range. It is well known that only wave V can be detected in brainstem potentials evoked by near-threshold stimuli. So the question arises as to whether or not a noncephalic reference electrode compared to the common lateral postition of the reference electrode on the ipsilateral mastoid produces a more stable wave V of increased amplitude.
Thirty-three normal hearing children in three age groups (< 6 years, 6-10 years, > 10 years) were investigated. For a near-threshold stimulation with 100-microsecond-clicks (10, 20, 30 dB nHL), bioactivity was simultaneously recorded with the reference electrode in four different locations (ipsilateral mastoid, contralateral mastoid, ipsilateral earlobe, and noncephalic electrode).
The noncephalic reference produced the highest absolute and scaled amplitudes. This finding was statistically significant. For all investigated intensities, recording with the noncephalic reference electrode yielded the highest number of reliable detectable potentials. Evaluation of the residual noise in the four recording locations revealed a significantly increased noise level for the noncephalic electrode at the nape of the neck.
Even if the residual noise is increased, the use of noncephalic reference results in a more reliable detection of wave V compared to the conventional locations of the reference electrode.
儿童听力阈值的估计基于对近阈值范围内刺激反应的可靠识别。众所周知，在近阈值刺激诱发的脑干电位中只能检测到波V。因此，与参考电极在同侧乳突的常见外侧位置相比，非头部参考电极是否会产生振幅增加且更稳定的波V这一问题便出现了。
对三个年龄组（<6岁、6 - 10岁、>10岁）的33名听力正常儿童进行了研究。对于100微秒点击的近阈值刺激（10、20、30 dB nHL），在四个不同位置（同侧乳突、对侧乳突、同侧耳垂和非头部电极）用参考电极同时记录生物活性。
非头部参考产生了最高的绝对振幅和标度振幅。这一发现具有统计学意义。对于所有研究强度，使用非头部参考电极记录产生的可靠可检测电位数量最多。对四个记录位置的残余噪声评估显示，颈部非头部电极的噪声水平显著增加。
即使残余噪声增加，但与参考电极的传统位置相比，使用非头部参考能更可靠地检测到波V。
