机械纺织工人畸变产物耳声发射的临床研究

A Clinical Study on Distortion Product Otoacoustic Emissions in Textile Workers

陈月华;汪贺媛;胡俊兰;张素芹;陈红;

1:石家庄市第一医院耳鼻喉科

2:石家庄市第一医院耳鼻喉科

3:河北医科大学第四医院耳鼻喉科

4:石家庄市第一医院耳鼻喉科

摘要
目的研究畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)在监测和早期发现噪声性聋(noise induced hearingloss,NIHL)方面的应用价值。方法检测160名(285耳)机械纺织工人(其中噪声性聋组125例224耳,有噪声接触史但纯音听阈正常者为对照组,共35例61耳)和75名听力正常人(正常对照组)的鼓室导抗图、镫骨肌反射、纯音听阈及DPOAE,比较三组的DPOAE幅值和引出率。结果①噪声性聋组DPOAE幅值及引出率均较正常对照组明显下降(P<0.05);②对照组与正常对照组比较,对照组的DPOAE幅值在4kHz处、引出率在36kHz处明显下降(P<0.05);③随着接触噪声工龄的延长,DPOAE引出率逐渐下降(P<0.05)。结论DPOAE可以客观地监测和早期发现噪声性聋,较纯音测听更有意义。
关键词
畸变产物耳声发射;纯音测听;噪声性聋
基金项目(Foundation):
作者
陈月华;汪贺媛;胡俊兰;张素芹;陈红;
参考文献

1Gorga MP,Stephen T,Neely ST,et al.Fromlaboratoryto clinic:Alarge-scale study of distortion product otoacoustic emissions in ears with normal hearing and with hearingloss[J].Ear Hear,1997,18:440.

2姜泗长,顾瑞,王正敏,主编.耳科学[M].上海:上海科学技术出版社,2002.869~876.

3Saunders JC,Cohen YE,Szymko YM.The structural and functional consequences of acoustic injury in the cochlea and peripheral auditory system:a five year update[J].J Acoust Soc Am,1986,79:1481.

4黄选兆,汪吉宝,主编.实用耳鼻咽喉科学[M].北京:北京人民卫生出版社,1998.1066~1067.

5Nolson DA,Kimberley BP.Distortion products emissions and auditory sensitivityin human ears with normal hearing and cochlear hearingloss[J].J Speech Hear Res,1992,35:1142.

6Eddins AC,Inskov M,Salvi RJ.Changes in distortion product otoa-coustic emissions during prolonged noise exposure[J].Hearing Re-search,1999,127:119.

7张其然,雷正秀,石建华,等.钻井工人畸变产物耳声发射的检测[J].临床耳鼻咽喉科杂志,2000,14:78.

8Widick MP.Early effects of cerebellopontine angle compression on rabbit distortion-product otoacoustic emissions:a model for monitoring cochlear function during acoustic neuronal surgery[J].Head Neck Surg,1994,111:407.

9Boettcher FA,Schmiedt RA.Distortion-product otoacoustic emissions in Mongolian gerbils with resistance to noise-induced hearing loss[J].J Acoust Soc Am,1995,98:3215.

10Martin GK,Ohlms LA,Franklin DJ,et al.Distortion product emis-sionsin humans.Influence of sensor neural hearing loss[J].Ann Otol Rhinol Laryngol,1990,99:30.

11Gorge MP,Necly ST,Bergman B,et al.Otoacoustic emissions from normal hearingand hearing-impairedsubjects:distortion product re-sponses[J].J Acoust Soc Am,1993,93:2051.

12董玉云,刘辉,刘博,等.畸变产物耳声发射临床应用价值的探讨[J].听力学及言语疾病杂志,1997,5:118.

13姜伟,汪磊,江平,等.畸变产物耳声发射在舰艇员听力调查中的应用[J].听力学及言语疾病杂志,2001,9:166.

14Lonsbury-Martin BL,Martin GK.The clinical utility of distortion product otoacoustic emissions[J].Ear Hear,1990,11:144.