摘要
目的探讨部分急性低频感音神经性聋（acutelow--tonesensorineuralhearingloss，ALHL）镫骨肌声反射（acousticstapediusrefIex，AR）消失的原因及临床意义。方法分析21例（21耳）镫骨肌声反射消失的ALHL患者患耳的声顺值、共振频率、耳蜗电图、DPOAE及ABR的改变，与其健耳以及镫骨肌声反射正常的ALHL患者相应观察值进行对照，并比较患耳上述观察值治疗前后的变化。结果ALHL镫骨肌声反射消失耳的病变在内耳，其共振频率略高于健耳及对照组，但无显著性差异。患耳耳蜗电图-SP／AP值高于健耳及对照组，差异显著。糖皮质激素及利尿剂治疗后，听力恢复正常16耳。其中仅4耳AR可引出，12耳仍不能引出；其余5耳听力仅部分恢复，AR仍不能引出。结论膜迷路积水导致镫骨底板活动受限是AR消失的重要原因之一，膜迷路积水同时引起传声系统质量及劲度的改变，其对共振频率的影响取决于积水对镫骨底板活动度的影响程度。
Objective To explore the causes and clinical significance of the absence ot acoustic reflexes（AR） in patients with acute low-tone sensorineural hearing Ioss（ALHL）. Methods The static compliance values, resonant frequencies, ECochG,DPOAE and ABR results of 21 ALHL patients without AR in one ear （21 ears） were compared with those of their normal ears and the control group（ALHL patients with normal AR）. The changes of these data in ALHL ears without AR were compared before and after the treatment. Results The lesion of the ALHL ear without AR was in the inner ear. The resonant frequencies of the impaired ears were a little higher than those of the normal ears and the control groups, but the difference was insignificant. The ratios of -SP/AP in impaired ears were higher than those of normal ears and the control groups, showing a significant difference. After being treated with glucocorticoid and diuretic, the hearing of 16 impaired ears recovered, but AR can only be elicited in 4 ears. The other 5 ears had some hearing but ARs were still absent. Conlusion The limitation of stapes footplate motion due to endolymphatic hydrops was one of the major factors causing the absent AR. The endolymphatic hydrops can also cause changes in the quality and stiffness of the auditory conductive system and its effects on resonant frequency depend on the level of limitation of stapes footplate motion.
出处
《中国听力语言康复科学杂志》
2011年第6期18-21,共4页
Chinese Scientific Journal of Hearing and Speech Rehabilitation
关键词
急性低频感音神经性聋
镫骨肌声反射
膜迷路积水
共振频率
Acute low-tone sensorineural hearing loss
Acoustic reflex
Endolymphatichydrops
Resonant frequency
