耳蜗死区在老年性聋患者中的初步临床分析
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摘要
目的探讨老年性聋患者中耳蜗死区及其分布情况。方法采用均衡噪声阈值检测法检测200例(370耳)老年性聋患者和25例(50耳)正常听力老年人中耳蜗死区分布情况,并比较耳蜗死区与老年性患者听力损失程度、病程以及合并高血压病之间的关系。结果 200例老年性聋患者中有38%(76/200)存在耳蜗死区。其中合并高血压病的老年性聋患者中有45%(56/124)存在耳蜗死区,是否合并高血压病组间耳蜗死区检出差异具有统计学意义(P<0.05)。正常听力老年人中无耳蜗死区,同老年性聋患者中比较差异具有统计学意义(P<0.01)。在不同听力损失程度、病程及合并高血压病的老年性聋患者中耳蜗死区的检出率差异有统计学意义(P<0.05)。结论在老年性聋患者中存在耳蜗死区,并且与听力损失严重程度、病程长短以及是否合并高血压病有关,听力损失程度越重、听力受损时间越长,存在耳蜗死区的可能性越大。
Objective To investigate the distribution of cochlear dead regions in patients with presbycusis. Methods Cochlear dead regions in 200 patients(370 ears) with presbycusis and 25 seniors(50 ears) with normal hearing were tested using the Threshold Equalizing Noise Test. Correlation of cochlear dead region data with degree of hearing loss, course of disease and hypertension in presbycusis patients was analyzed. Results Cochlear dead zone was detected in 76 of the 200 presbycusis patients(30%), and in 56 of the 124 presbycusis patients with hypertension(45%)(P<0.05). Cochlear dead zone was not found among those with normal hearing in contrast with the presbycusis patients(P<0.01). Cochlear dead zone detection also varied along with different levels of hearing loss and courses of disease(P<0.05). Conclusion Cochlear dead regions exist in individuals with presbycusis, and are correlated to the severity of hearing loss, length of disease course and coexisting hypertension.
Objective To investigate the distribution of cochlear dead regions in patients with presbycusis. Methods Cochlear dead regions in 200 patients(370 ears) with presbycusis and 25 seniors(50 ears) with normal hearing were tested using the Threshold Equalizing Noise Test. Correlation of cochlear dead region data with degree of hearing loss, course of disease and hypertension in presbycusis patients was analyzed. Results Cochlear dead zone was detected in 76 of the 200 presbycusis patients(30%), and in 56 of the 124 presbycusis patients with hypertension(45%)(P<0.05). Cochlear dead zone was not found among those with normal hearing in contrast with the presbycusis patients(P<0.01). Cochlear dead zone detection also varied along with different levels of hearing loss and courses of disease(P<0.05). Conclusion Cochlear dead regions exist in individuals with presbycusis, and are correlated to the severity of hearing loss, length of disease course and coexisting hypertension.
引文
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2 Moore BC,Vickers DA,Glasberg BR,et al.Comparison of real and simulated hearing impairment in subjects with unilateral and bilateral cochlear hearing loss[J].Br J Audiol,1997,31(4):227-245.
3 Moore BC.Testing for cochlear dead regions:audiometer implementation of the TEN(HL)test[J].Hear Review,2010,17(2):10-16.
4 Cairns S,Frith R,Munro KJ,et al.Repeatability of the TEN(HL)test for detecting cochlear dead regions[J].Int J Audiol,2007,46(10):575-584.
5中国残疾人联合会,中华人民共和国卫生部.残疾人分类和分级听力残疾评定手册[M].北京.华夏出版社2014,3-10.China Disabled Persons’Federation,Ministry of Health of the People`s Republic of China.Handbook of classification and grading criteria of disability[M].Beijing.Huaxia Publishing House.2014,3-10.
6 Moore BC,Glasberg BR,Stone MA.New version of the TEN test with calibrations in d B HL[J].Ear Hear,2004,25(5):478-487.
7 Vinay,Moore BC.Prevalence of dead regions in subjects with sensorineural hearing loss[J].Ear Hear,2007,28(2):231-241.
8许雪波,祝晓芬,兰明.均衡噪声阈值检测法研究耳蜗死区在感音神经性聋患者耳蜗中的分布[J].听力学及言语疾病杂志,2012,20(5):433-437.Xu XB,Zhu Xf,Lan M.Application of the TEN(HL)Test on the study of Distribution of Cochlear Dead Regions in Sensorineural Hearing Loss Patients[J].Jourrnal of Audiology and Speech Pathology 2012,20(5):433-437.
9祝晓芬,汪峘,杨燕珍.耳蜗死区与言语分辨率相关性研究.中华耳科学杂志,2016,14(2):208-212.Zhu XF,Wang H,Yang YZ.Correlation study between the cochlea dead regions and the words recognition score[J].Chinese Journal of Otology,2016,14(2):208-212.
10 Moore BC.Cochlear hearing loss:physiological,psychological and technical issues[J].Journal of the Acoustical Society of America.2008,124(5):2665-2666.
11 Huss M,Moore BC.Dead regions and noisiness of pure tones[J].Int J Audiol,2005,44(10):599-611.
12 Pepler A,Munro KJ,Lewis K,et al.Prevalence of cochlear dead regions in new referrals and existing adult hearing aid users[J].Ear Hear,2014,35(3):e99-e109.
13 Tseng LM,Lee GS,Yang E,et al.Cochlear dead region and word recognition of Mandarin Chinese in Taiwan[J].Chin J Physiol,2013,56(3):129-137.
14 Cox RM,Johnson JA,Alexander GC.Implications of high-frequency cochlear dead regions for fitting hearing aids to adults with mild to moderately severe hearing loss[J].Ear Hear,2012,33(5):573-587.
15 Heggdal PO,Lind O,Brannstrom KJ.Frequency discrimination in ears with and without contralateral cochlear dead regions[J].Int JAudiol,2013,52(8):553-557.
16 Vinay,Moore BC.Speech recognition as a function of high-pass filter cutoff frequency for people with and without low-frequency cochlear dead regions[J].J Acoust Soc Am,2007,122(1):542-553.
17许敏达,黄丽琴,楼继先,等.老年性聋与血管紧张素转换酶的关系[J].中国中西医结合耳鼻咽喉科杂志,2008,16(3):200-200.Xu MD,Huang LQ,Lou JX,et al.Relation between presbycusis and Angiotensin converting enzyme[J],Chinese journal of surgery of integrated traditional and western medicine,2008,16(3):200-200.
18 Cvorovic L,Deric D,Probst R,et al.Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss[J].Otol Neurotol,2008,29(4):464-469.
19 Michel O.The revised version of the german guidelines"sudden idiopathic sensorineural hearing loss"[J].Laryngorhinootologie,2011,90(5):290-293.
2 Moore BC,Vickers DA,Glasberg BR,et al.Comparison of real and simulated hearing impairment in subjects with unilateral and bilateral cochlear hearing loss[J].Br J Audiol,1997,31(4):227-245.
3 Moore BC.Testing for cochlear dead regions:audiometer implementation of the TEN(HL)test[J].Hear Review,2010,17(2):10-16.
4 Cairns S,Frith R,Munro KJ,et al.Repeatability of the TEN(HL)test for detecting cochlear dead regions[J].Int J Audiol,2007,46(10):575-584.
5中国残疾人联合会,中华人民共和国卫生部.残疾人分类和分级听力残疾评定手册[M].北京.华夏出版社2014,3-10.China Disabled Persons’Federation,Ministry of Health of the People`s Republic of China.Handbook of classification and grading criteria of disability[M].Beijing.Huaxia Publishing House.2014,3-10.
6 Moore BC,Glasberg BR,Stone MA.New version of the TEN test with calibrations in d B HL[J].Ear Hear,2004,25(5):478-487.
7 Vinay,Moore BC.Prevalence of dead regions in subjects with sensorineural hearing loss[J].Ear Hear,2007,28(2):231-241.
8许雪波,祝晓芬,兰明.均衡噪声阈值检测法研究耳蜗死区在感音神经性聋患者耳蜗中的分布[J].听力学及言语疾病杂志,2012,20(5):433-437.Xu XB,Zhu Xf,Lan M.Application of the TEN(HL)Test on the study of Distribution of Cochlear Dead Regions in Sensorineural Hearing Loss Patients[J].Jourrnal of Audiology and Speech Pathology 2012,20(5):433-437.
9祝晓芬,汪峘,杨燕珍.耳蜗死区与言语分辨率相关性研究.中华耳科学杂志,2016,14(2):208-212.Zhu XF,Wang H,Yang YZ.Correlation study between the cochlea dead regions and the words recognition score[J].Chinese Journal of Otology,2016,14(2):208-212.
10 Moore BC.Cochlear hearing loss:physiological,psychological and technical issues[J].Journal of the Acoustical Society of America.2008,124(5):2665-2666.
11 Huss M,Moore BC.Dead regions and noisiness of pure tones[J].Int J Audiol,2005,44(10):599-611.
12 Pepler A,Munro KJ,Lewis K,et al.Prevalence of cochlear dead regions in new referrals and existing adult hearing aid users[J].Ear Hear,2014,35(3):e99-e109.
13 Tseng LM,Lee GS,Yang E,et al.Cochlear dead region and word recognition of Mandarin Chinese in Taiwan[J].Chin J Physiol,2013,56(3):129-137.
14 Cox RM,Johnson JA,Alexander GC.Implications of high-frequency cochlear dead regions for fitting hearing aids to adults with mild to moderately severe hearing loss[J].Ear Hear,2012,33(5):573-587.
15 Heggdal PO,Lind O,Brannstrom KJ.Frequency discrimination in ears with and without contralateral cochlear dead regions[J].Int JAudiol,2013,52(8):553-557.
16 Vinay,Moore BC.Speech recognition as a function of high-pass filter cutoff frequency for people with and without low-frequency cochlear dead regions[J].J Acoust Soc Am,2007,122(1):542-553.
17许敏达,黄丽琴,楼继先,等.老年性聋与血管紧张素转换酶的关系[J].中国中西医结合耳鼻咽喉科杂志,2008,16(3):200-200.Xu MD,Huang LQ,Lou JX,et al.Relation between presbycusis and Angiotensin converting enzyme[J],Chinese journal of surgery of integrated traditional and western medicine,2008,16(3):200-200.
18 Cvorovic L,Deric D,Probst R,et al.Prognostic model for predicting hearing recovery in idiopathic sudden sensorineural hearing loss[J].Otol Neurotol,2008,29(4):464-469.
19 Michel O.The revised version of the german guidelines"sudden idiopathic sensorineural hearing loss"[J].Laryngorhinootologie,2011,90(5):290-293.