聽力正常的耳鳴病患之高頻變頻耳聲傳射分析

Analysis of High Frequency DPOAE in Tinnitus Patients with Normal Hearing Thresholds

邱昱嘉(Yu-Chia Chiu) ； 陳正文(Jeng-Wen Chen) ； 邱耀興(Yao-Hsing Chiu) ； 劉必筠(Pi-Yun Liu) ； 林秀茵(Hsiu-Yin Lin)

《台灣耳鼻喉頭頸外科雜誌》 40卷2期 (2005/04) Pp. 45-50

https://doi.org/10.6286/2005.40.2.45

摘要

背景：耳鳴(tinnitus)大部分是一種主觀的症狀，在臨床上很難用客觀的方法加以評估。本研究的目的在利用高頻變頻耳聲傳射(Distortion Product Otoacoustic Emission; DPOAE)，探討聽力閾值(healing threshold)正常之主觀性耳鳴病患的耳蝸活動(cochlear activity)，尋找可以早期診斷的客觀評估工具。
方法：我們比較並分析門診聽力閾值正常的主觀性耳鳴病患（觀察組）與對照組（聽力閾值正常，無耳科疾患的正常人）之間，高頻DPOAE檢查(2-12kHz)的結果。
結果：聽力閾值正常之主觀性耳鳴病患的平均變頻耳聲傳射值(DP letel)在4, 6, 8, 10kHz等頻率出現顯著下降的情形，且任一頻率出現DP level顯著下降的比例(49.3%)較對照組(l4.5%)爲高。
結論：持續性主觀耳鳴的病患，即使聽力閾值正常，臨床上也可以運用高頻DPOAE加以客觀地評估，DP level的下降特別容易出現在4,6,8,10 kHz等頻率範圍。臨床醫師可利用此早期出現的客觀證據，建議部分聽力正常的耳鳴病患更嚴格地遵守聽力保護措施，以預防聽力及耳鳴的惡化。

關鍵字

耳鳴 ； 變頻耳聲傳射 ； 噪音暴露

並列摘要

BACKGROUND: Differential diagnosis of tinnitus is usually difficult because of its subjectivity. We investigate cochlear activity in normal hearing tinnitus patients using high frequency Distortion Product Otoacoustic Emissions (DPOAE).
METHODS: High frequency DPOAE (2-12 kHz) was measured and compared in normal hearing tinnitus patients (observation group) and normal subjects (controlgroup).
RESULTS: The averaged DP-gram of the normal hearing tinnitus patient was significantly different from that of the normal subject in 4, 6, 8, 10 kHz. Significant decreases in DPOAE amplitude over a limited frequency range were observed in 49.3% of the normal hearing tinnitus patient and in 14.5% of the control group.
CONCLUSIONS: Tinnitus can be objectively evaluated by DPOAE, especially in high frequencies (4, 6, 8, 10 kHz). Significant decreases in DP amplitude over some frequencies (4-10 kHz) are indicators which help to convince normal hearing tinnitus patient of more aggressive hearing protection strategies.

並列關鍵字

tinnitus ； distortion product otoacoustic emission ； noise exposure