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1、听神经病患者的临床听力学特征分析作者：张喜琴，朱庆文,段乃超，韩海霞,郝芙蓉单位：石家庄市，河北医科大学第二医院耳鼻喉科河北医科大学第二医院院级基金课题(编号：2hl200805)
【摘要】目的总结52例听神经病(AN)患者的临床表现特点和听力学特征，分析听力学检测在AN诊断中的意义并探讨其病损部位。方法冋顾性分析52例AN患者的临床表现、纯咅听力、声导抗、言语识别率、听性脑干反应(ABR)、畸变产物耳声发射(DPOAE)及对侧H噪声抑制试验的结果。结果木组52例AV患者纯咅听阈测试结杲均为件、气导一致性下降的感咅神经性
2、聋。两耳间的差异无统计学意义(P>0.05),言语识别率明显差于纯音听力；鼓室导抗图为“A”型,磴骨肌声反射未引出，ABR不能引出或严重异常；52例(104耳)DPOAE全部正常引出；对侧声抑制减弱或消失。影像学检查(HRCT或MRI)无界常发现。结论AN的临床表现和系统的听力学检杏对认识和明确诊断有重要意义。AN的病损部位可能在耳蜗神经传入通路和耳蜗传出周围通路。【关键词】听神经病；听力学检测；感音神经性听力损失；病损部位Analysisfortheclinicalaudiologicalchara
3、cteristicsinpatientswithauditoryneuropathyZHANGXiqin.ZHUQingwen,DUANNaichao,etal.DepartmentofOtolaryngology,TheSecondHospitalofHebeiMedicalUniversity,Shijiazhuang050000,China[Abstract】ObjectiveTosummarizethefeaturesofclinicalmanifestationandaudiologicalcharacterist
4、icsinpatientswithauditoryneuropathy(AN)inordertoanalyzethesignificanceofaudiometrydetectioninthediagnosisofAN,andtoinvestigateitslesionsite.MethodsTheaudiologicaldataof52ANpatientswereretrospectivereviewed.Thepatients’clinicalfindings,puretonethresholdandthee
5、xaminationresultsbyacousticimpedanceaudiometry,speechaudiometry,auditorybrainstemresponse(ABR),distortionproductotoacousticemission(DPOAE)andcontralateralsuppressionwereanalyzed・ResultsInallthepatients,theratioofgenderswas1:1.70(male:female)・Thepatients’rangc
6、wasbetween5and31years,andaveragedagewas(16±7)years・Allthepatientscomplainedofbilateralgradualhearingloss.Thepatientscouldnotdiscriminatespeechcorrectly,especiallyinnoisyenvironment.Among52patients28patients(50.85%)complainedoflastordiscontinuoustinnitus.4pat
7、ientsdevelopedevidenceforaperipheralneuropathy.Mostpatients’audiogramsshowedalowfrequencyloss(93・3%,97/104).Thepatients’spcechhearingwasworseobviouslythanthepuretonehearing.ABRwasabsentorabnormalseverely,butDPOAEinallthepatientswerenormallyrecorded・Acou
8、sticstapediusreflexwasabsentandthecontralateralsuppressioneffectofDPOAEwasdisappeared.Tympanogramcurvewas“A”curve,andipsilateralandco
