山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (4): 62-67.doi: 10.6040/j.issn.1673-3770.0.2023.093

• • 上一篇    

纯音听阈值正常的中青年耳鸣群体耳蜗功能分析

熊彬彬1,卢子昂2,杨晶1,徐文强1,周潞茹1,孙平原1,袁丁1,朱佳浩1   

  1. 1.珠海市中西医结合医院 听力障碍与眩晕诊疗中心, 广东 珠海 519000 ;
    2.深圳市龙华区中心医院 耳鼻咽喉科, 广东 深圳 518110
  • 发布日期:2023-07-27
  • 通讯作者: 熊彬彬. E-mail:xiongbb2015@126.com;朱佳浩. E-mail:Dr.zhujh@outlook.com
  • 基金资助:
    2022年珠海市社会发展领域科技计划重点项目(222000400085);2021年广东省临床教学基地教学改革研究项目(2021JD152)

Analysis of Cochlear function in young and middle-aged tinnitus patients with normal pure tone audiometry threshold

XIONG Binbin1, LU Ziang2, YANG Jing1, XU Wenqiang1, ZHOU Luru1, SUN Pinyuan1, YUAN Ding1, ZHU Jiahao1   

  1. 1. Center for hearing and balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai 519000, Guangdong, China2. Department of Otorhinolaryngology, Shenzhen Longhua District Central Hospital, Shenzhen 518110, Guangdong, China
  • Published:2023-07-27

摘要: 目的 通过纯音听阈值正常的中青年耳鸣群体的耳声发射结果探讨耳鸣群体的耳蜗功能对耳鸣发生的作用。 方法 回顾性分析比较64例中青年耳鸣患者和30例纯音听阈值正常的无耳鸣人群畸变产物耳声发射(distortion product otoacoustic emission, DPOAE)、瞬态诱发耳声发射(transient evoked otoacoustic emission, TEOAE)、自发性耳声发射(spontaneous otoacoustic emission, SOAE)的结果,并对SOAE的频率和耳鸣群体的耳鸣匹配频率进行分析和比较。 结果 耳鸣组和对照组性别、年龄和平均纯音听阈阈值差异均无统计学意义(P=0.079,P=0.078,P=0.081)。耳鸣组和对照组DPOAE测试所有频率的通过率,除6 000 Hz(P=0.012),两组之间差异无统计学意义(P均>0.05)。耳鸣组和对照组TEOAE测试所有频率的通过率两组之间差异有统计学意义(P均<0.05)。对照组SOAE引出率为31.67%,频率范围分布在1 211~4 453 Hz;耳鸣组SOAE引出率为43.62%,频率范围分布在859~4 570 Hz,两组之间无统计学差异(χ2=2.199,P=0.138)。SOAE的频率和耳鸣匹配的频率之间无明显相关性(r=0.1143, P=0.540)。 结论 纯音听阈值正常的中青年耳鸣患者的DPOAE和TEOAE的通过率与无耳鸣人群有明显差异,但仅在某些频率点出现异常,提示大部分听力正常的耳鸣患者耳蜗功能可能存在轻度损伤,虽不影响阈值,但作为参与耳鸣发生的一种隐匿性损伤值得关注和重视。

关键词: 耳鸣, 瞬态耳声发射, 畸变耳声发射, 自发性耳声发射, 耳鸣精细化测试

Abstract: Objective Otoacoustic emission(OAE)data were analyzed to explore cochlear function in young and middle-age adults with tinnitus and normal pure-tone thresholds. Methods Data from 30 non-tinnitus patients with normal pure-tone average(PTA)threshold and 64 young and middle-age patients with tinnitus were collected from a tinnitus clinic from September 2021 to June 2022. All patients underwent objective testing by audiologists including distortion product otoacoustic emission(DPOAE), transient evoked otoacoustic emission(TEOAE), and spontaneous otoacoustic emission(SOAE). Results were compared, and the frequency of SOAE and the frequency of precision tinnitus matching were analyzed and compared. Results There were no statistically significant differences in sex, age, or average PTA threshold between the tinnitus patients and normal young individuals(P1=0.079,P2=0.078,P3=0.0810, respectively). DPOAE testing revealed no statistically significant differences in pass rates for all frequencies between the tinnitus and the control groups(P>0.05)except at 6000 Hz(P<0.05). In contrast, TEOAE testing revealed a statistically significant difference in pass rate for all frequencies between the two groups(P<0.05). Elicited SOAE rates in the control and tinnitus groups were 31.67% and 43.62%, respectively, ranging from 1 211 Hz to 4 453 Hz and 859 Hz to 4 570 Hz, respectively, with no statistical difference between the groups(χ2=2.199, P=0.138). Finally, there was no significant correlation between the frequency of SOAE and the frequency of precision tinnitus matching(r=0.1143, P=0.540). Conclusion DPOAE and TEOAE pass rates in young and middle-age patients with tinnitus and normal PTA threshold were significantly different from individuals without tinnitus. The differences occurred at some frequency points, which suggests early stages of mild cochlear damage but not yet affecting the threshold. As a “hidden” injury among patients with tinnitus, this warrants attention.

Key words: Tinnitus, Transient otoacoustic emissions, Distortion otoacoustic emissions, Spontaneous otoacoustic emissions, Precision tinnitus assessment

中图分类号: 

  • R764.45
[1] Park B, Choi HG, Lee HJ, et al. Analysis of the prevalence of and risk factors for tinnitus in a young population[J]. Otol Neurotol, 2014, 35(7): 1218-1222. doi:10.1097/MAO.0000000000000472
[2] Watts EJ, Fackrell K, Smith S, et al. Why is tinnitus a problem? A qualitative analysis of problems reported by tinnitus patients[J]. Trends Hear, 2018, 22: 2331216518812250. doi:10.1177/2331216518812250
[3] Alshabory HF, Gabr TA, Kotait MA. Distortion product otoacoustic emissions(DPOAEs)in tinnitus patients[J]. Int Arch Otorhinolaryngol, 2022, 26(1): e046-e057. doi:10.1055/s-0040-1722248
[4] 陈向红, 李佳, 张驰, 等. 不同病程听力正常耳鸣患者畸变产物耳声发射结果分析[J]. 中华耳科学杂志, 2019, 17(4): 532-535. doi:10.3969/j.issn.1672-2922.2019.04.017 CHEN Xianghong, LI Jia, ZHANG Chi, et al. Distortion product otoacoustic emissions in tinnitus patients with normal hearing[J]. Chinese Journal of Otology, 2019, 17(4): 532-535. doi:10.3969/j.issn.1672-2922.2019.04.017
[5] Sztuka A, Pospiech L, Gawron W, et al. DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing[J]. Auris Nasus Larynx, 2010, 37(1): 55-60. doi:10.1016/j.anl.2009.05.001
[6] 段新艳, 宋忠义, 王宁, 等. DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404 DUAN Xinyan, SONG Zhongyi, WANG Ning, et al. Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 6-10. doi:10.6040/j.issn.1673-3770.0.2021.404
[7] Jastreboff PJ. Phantom auditory perception(tinnitus): mechanisms of generation and perception[J]. Neurosci Res, 1990, 8(4): 221-254. doi:10.1016/0168-0102(90)90031-9
[8] Herraiz C. Physiopathological mechanisms in tinnitus generation and persistence[J]. Acta Otorrinolaringol Esp, 2005, 56(8): 335-342. doi:10.1016/s0001-6519(05)78626-x
[9] Xiong BB, Liu Z, Liu QX, et al. Missed hearing loss in tinnitus patients with normal audiograms[J]. Hear Res, 2019, 384: 107826. doi:10.1016/j.heares.2019.107826
[10] Kemp DT. Otoacoustic emissions, their origin in cochlear function, and use[J]. Br Med Bull, 2002, 63: 223-241. doi:10.1093/bmb/63.1.223
[11] Igna CD, Schmidt LP, Smith M, et al. Otoacoustic emissions in patients with tinnitus and normal hearing[J]. Otolaryngol Head Neck Surg, 2004, 131(2): 279. doi:10.1016/j.otohns.2004.06.593
[12] Qasem H, Assaf S, Jamous NA, et al. Otoacoustic emissions and tinnitus in normal hearing[J]. JRMS, 2010, 17(2): 27-31.
[13] Ozimek E, Wicher A, Szyfter W, et al. Distortion product otoacoustic emission(DPOAE)in tinnitus patients[J]. J Acoust Soc Am, 2006, 119(1): 527-538. doi:10.1121/1.2141297
[14] Gouveris H, Maurer J, Mann W. DPOAE-grams in patients with acute tonal tinnitus[J]. Otolaryngol Head Neck Surg, 2005, 132(4): 550-553. doi:10.1016/j.otohns.2004.09.031
[15] Sztuka A, Pospiech L, Gawron W, et al. DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing[J]. Auris Nasus Larynx, 2010, 37(1): 55-60. doi:10.1016/j.anl.2009.05.001
[16] Gentil F, Meireles S, Roza T, et al. Comparison of otoacoustic emissions in patients with tinnitus having normal hearing versus mild hearing loss[J]. Int Tinnitus J, 2015, 19(2): 39-46. doi:10.5935/0946-5448.20150007
[17] Putterman DB, Keefe DH, Hunter LL, et al. Assessing sensorineural hearing loss using various transient-evoked otoacoustic emission stimulus conditions[J]. Ear Hear, 2017, 38(4): 507-520. doi:10.1097/AUD.0000000000000425
[18] Hussain DM, Gorga MP, Neely ST, et al. Transient evoked otoacoustic emissions in patients with normal hearing and in patients with hearing loss[J]. Ear Hear, 1998, 19(6): 434-449. doi:10.1097/00003446-199812000-00005
[19] Stamate MC, Todor N, Cosgarea M. Comparative multivariate analyses of transient otoacoustic emissions and distorsion products in normal and impaired hearing[J]. Clujul Med, 2015, 88(4): 500-512. doi:10.15386/cjmed-467
[20] Thabet EM. Evaluation of tinnitus patients with normal hearing sensitivity using TEOAEs and TEN test[J]. Auris Nasus Larynx, 2009, 36(6): 633-636. doi:10.1016/j.anl.2009.01.002
[21] 刘博, 刘鋋, 郭连生, 等. 自发性耳声发射临床特性的研究[J]. 临床耳鼻咽喉科杂志, 2004, 18(10): 590-592 LIU Bo, LIU Chan, GUO Liansheng, et al. Research on the basic properties of spontaneous otoacoustic emissions[J]. Journal of Clinical Otorhinolaryngology, 2004, 18(10): 590-592
[22] 石宝玉, 刘锦峰, 王宁宇, 等. 新生儿自发性耳声发射与瞬态诱发性耳声发射的相关性[J]. 中国耳鼻咽喉头颈外科, 2010, 17(1): 33-36. doi:10.16066/j.1672-7002.2010.01.010 SHI Baoyu, LIU Jinfeng, WANG Ningyu, et al. Correlation between spontaneous otoacoustic emissions and transient evoked otoacoustic emissions in neonate[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2010, 17(1): 33-36. doi:10.16066/j.1672-7002.2010.01.010
[23] 徐丽娜, 赵静, 王孟冬, 等. 正常青年人自发性耳声发射检测结果分析[J]. 听力学及言语疾病杂志, 2014, 22(6): 649-650. doi:10.3969/j.issn.1006-7299.2014.06.025 XU Lina, ZHAO Jing, WANG Mengdong, et al. Analysis of detection results of spontaneous otoacoustic emission in normal young people[J]. Journal of Audiology and Speech Pathology, 2014, 22(6): 649-650. doi:10.3969/j.issn.1006-7299.2014.06.025
[24] 于红, 于德林, 丁国玉. 正常青年人自发性耳声发射的测试及意义[J]. 临床耳鼻咽喉科杂志, 1999, 13(7): 303-304 YU Hong, YU Delin, DING Guoyu. Measuring of spontaneous otoacoustic emissions ofadolescence and its significance[J]. Journal of Clinical Otorhinolaryngology, 1999, 13(7): 303-304
[25] Norton SJ, Schmidt AR, Stover LJ. Tinnitus and otoacoustic emissions: is there a link?[J]. Ear Hear, 1990, 11(2): 159-166. doi:10.1097/00003446-199004000-00011
[26] 潘庆春, 李蓓, 米雪芹, 等. 耳鸣患者1/24倍频程精细化纯音测试结果分析[J]. 中国听力语言康复科学杂志, 2021, 19(1): 30-32. doi:10.3969/j.issn.1672-4933.2021.01.009 PAN Qingchun, LI Bei, MI Xueqin, et al. Analysis of 1/24 octave pure tone test on tinnitus[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation, 2021, 19(1): 30-32. doi:10.3969/j.issn.1672-4933.2021.01.009
[27] 熊彬彬, 赵晓明, 罗彬, 等. 主观性耳鸣患者精细化听力学检测结果的初步分析[J]. 中华耳科学杂志, 2018, 16(4): 521-525. doi:10.3969/j.issn.1672-2922.2018.04.017 XIONG Binbin, ZHAO Xiaoming, LUO Bin, et al. Precision audiology testing in patients with subjective tinnitus[J]. Chinese Journal of Otology, 2018, 16(4): 521-525. doi:10.3969/j.issn.1672-2922.2018.04.017
[28] 吴文丽, 丁雷, 高铭媛, 等. 单侧急性耳鸣患者耳蜗电生理学研究[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(5): 357-361. doi:10.13201/j.issn.2096-7993.2022.05.007 WU Wenli, DING Lei, GAO Mingyuan, et al. Electrophysiological study of the cochlea in patients with unilateral acute tinnitus[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2022, 36(5): 357-361. doi:10.13201/j.issn.2096-7993.2022.05.007
[29] Levine RA, Oron Y. Tinnitus[J]. Handb Clin Neurol. 2015, 129: 409-431. doi: 10.1016/B978-0-444-62630-1.00023-8
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