CAJ | 학술논문

目的分析106例听神经病患者的临床特点和听力学测试结果.探讨听神经病纯音听力图和听性脑干反应(ABR)的特点.方法回顾性分析2001年12月至2007年5月就诊的106例(212耳)听神经病患者的症状及纯音听阈、声导抗图及镫骨肌反射、ABR、畸变产物耳声发射(DPOAE)和颅脑影像学检查的结果.结果患者中男54例,女52例;年龄11～37岁,以青少年居多(75例,70.8%).伴有其他外周神经病者8例,伴视神经病者4例,未查出明确病因者94例.患者均为双耳发病.在212耳中,有173耳(81.6%)听力下降最多的频率为0.25 kHz和0.5 kHz.轻至中度听力损失共209耳(98.6%),均为感音神经性听力损失.按WHO(1997)听阈的均值计算法统计,本组有49耳(23.1%)的听阈≤25 dB,按WHO推荐的听力减退分级标准,使这些有听力障碍的病耳列入了正常范围.212耳听性脑干反应的测试中,各波形皆未引出者124耳(58.5%),余88耳有1或2个波未引出,而可引出的波的波幅很小,但有重复性.在1或2个可引出小波病例中,有23例其另1侧耳各波皆缺失.另有2例伴其他周围神经病和1例伴视神经病的患者,其双耳均有1或2个小波可引出.畸变产物耳声发射除1例左侧3～6 kHz,右侧5～6 kHz未引出外,余均可引出.结论听神经病在青少年中并不罕见.因听神经病大多以低频听力下降为主,对听神经病患者平均听阈的计算方法值得讨论.
목적 분석106례은신경병환자적림상특점화은역학측시결과.탐토은신경병순음은력도화은성뇌간반응(ABR)적특점.방법 회고성분석2001년12월지2007년5월취진적106례(212이)은신경병환자적증상급순음은역、성도항도급등골기반사、ABR、기변산물이성발사(DPOAE)화로뇌영상학검사적결과.결과 환자중남54례,녀52례;년령11～37세,이청소년거다(75례,70.8%).반유기타외주신경병자8례,반시신경병자4례,미사출명학병인자94례.환자균위쌍이발병.재212이중,유173이(81.6%)은력하강최다적빈솔위0.25 kHz화0.5 kHz.경지중도은력손실공209이(98.6%),균위감음신경성은력손실.안WHO(1997)은역적균치계산법통계,본조유49이(23.1%)적은역≤25 dB,안WHO추천적은력감퇴분급표준,사저사유은력장애적병이렬입료정상범위.212이은성뇌간반응적측시중,각파형개미인출자124이(58.5%),여88이유1혹2개파미인출,이가인출적파적파폭흔소,단유중복성.재1혹2개가인출소파병례중,유23례기령1측이각파개결실.령유2례반기타주위신경병화1례반시신경병적환자,기쌍이균유1혹2개소파가인출.기변산물이성발사제1례좌측3～6 kHz,우측5～6 kHz미인출외,여균가인출.결론 은신경병재청소년중병불한견.인은신경병대다이저빈은력하강위주,대은신경병환자평균은역적계산방법치득토론.
Objective To analyses the clinical characteristics and electrophysiologieal finding of 106 patients with auditory neuropathy (AN).Investigate the differencial curve type of pure tone audiogram and the abnormal ABR.Methods Review the history of patients,pure tone audiometry,middle ear acoustic reflexes,auditory brainstem response,distortion product otoacoustic emission and radiologic imaging studies of the brain of 106 patients with AN during December 2001 to May 2007 in retrospect.Results The 106 patients with AN were of both genders.The age were between 11-37 years old.and the average age was 17.5 years old.The most patients were adolescences(70.8%).Twelve cases of the 106 patients had evidence of other peripheral neuropathy in addition to hearing loss.Another 94 patients were idiopathic origins.The pure tone audiogram showed a minimal to moderate sensorineural hearing loss at low frequencies 0.5 kHz and 0.25 kHz in 209 errs(98.6%).The average hearing threshold(WHO 1997)in 23.2% of disordered ears at less than 25 dB in the "normal" range.Auditory brainstem response could not be recorded in 124 ears (58.5%) at maximum stimulus.The other 88 ears showed lor 2 wave,but the wave were small.There were 23 patients which one side ear ABR was 1 or 2 small waves presented.but the contralateral side were all waves absent.In 3 cases of AN with other peripheral neuropathy which ABR were both ears 1 or 2 small wave ear recorded.However,1 patient in our sample could not be detected distortion product otoacoustic emission at 3-6 kHz(left ear) and 5-6 kHz(right ear).Conclusions AN was not rare in adolescences.The average hearing threshold for AN should be discussed.