CAJ | 학술논문

目的：探讨听神经瘤听力损失的病理生理机制。方法：对14例(16耳)听神经瘤患者行纯音听阈、阻抗、听性脑干反应(ABR)、诱发耳声发射测试(EOAE)及CT和(或)MRI扫描。EOAE能引出的4耳还检测其传出抑制功能，ABR不能检测且EOAE不能引出的重度聋(听力损失大于80dB)有5耳行鼓岬刺激试验(PST)。结果：16耳听神经瘤中2耳(12.50%)听力损失源于神经性损害；6耳(37.50%)蜗性损害；8耳(50%)蜗-神经性损害。能引出EOAE的4耳均有传出功能障碍。结论：EOAE可评价听神经瘤的耳蜗功能状态；ABR结合PST能分析听神经瘤的蜗后神经功能。听神经瘤的听觉病理可同时或单独发生于听外周的耳蜗水平、第Ⅷ对颅神经(传入神经)水平和橄榄核耳蜗传出神经水平。
목적：탐토은신경류은력손실적병리생리궤제。방법：대14례(16이)은신경류환자행순음은역、조항、은성뇌간반응(ABR)、유발이성발사측시(EOAE)급CT화(혹)MRI소묘。EOAE능인출적4이환검측기전출억제공능，ABR불능검측차EOAE불능인출적중도롱(은력손실대우80dB)유5이행고갑자격시험(PST)。결과：16이은신경류중2이(12.50%)은력손실원우신경성손해；6이(37.50%)와성손해；8이(50%)와-신경성손해。능인출EOAE적4이균유전출공능장애。결론：EOAE가평개은신경류적이와공능상태；ABR결합PST능분석은신경류적와후신경공능。은신경류적은각병리가동시혹단독발생우은외주적이와수평、제Ⅷ대로신경(전입신경)수평화감람핵이와전출신경수평。
Objective:To investigate the relationship between hearing loss and acoustic neuroma(AN),the tests of pure tone audiometry,acoustic emissions impedance audiometry,audiometry brainstem response(ABR)and evoked otoacoustic emissions(EOAE)wee measured in 14 patients (16 ears)from March 1999 to December 2000.Methods:Fourteen patients (16 ears)with acoustic neuroma (8 males and 6 females,ranging in age from 21 to 72 years old)were diagnosed by CT or MRI scaning,and final confirmed by surgery and pathology.In the auditory tests ,efferent suppression test was curried out only in 4 ears with recordable emissions,promontory stimulation test (PST)was examined only in 5 ears with severe or profound deafness (hearing loss≥80dB SPL)who have no both measurable ABR and recordable EOAE.Results:It was found that 2 ears (12.5%,2/16)of the AN ears showed neural impairment,6 ears (37.5%,6/16)were cochlear impairment and 8 ears (50.0%,8/16)were cochlear-retrocochlear impairment.All of 4 tumors ears with EOAE emission have a disorders of efferent function.Conclusion:EOAE test had significant value for evaluation of the status of cochlear function (at the level of outer hair cells)in AN patients.The retrocochlear auditory nerve function of AN patients were evaluated by the tests of ABR combined PST which showed significant value.Results showed that the hearing impairment of AN have different levels of the peripheral auditory system according to auditory tests,including cochlear,eighth cranial nerve and efferent nerve level at the same or independently.