正常听阈单侧耳鸣者电生理特征及临床意义

吴文静; 姜振东; 兰发璋; 何亚; 钟诚

doi:10.16016/j.2097-0927.202401124

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正常听阈单侧耳鸣者电生理特征及临床意义

临床医学 | 更新时间：2026-01-09

- 正常听阈单侧耳鸣者电生理特征及临床意义
- Electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold
- 陆军军医大学学报 2024年46卷第17期页码：2016-2020
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院耳鼻咽喉头颈外科
- 作者简介：
  
  [钟诚，E-mail：agm95zc@163.com ZHONG Cheng, E-mail: agm95zc@163.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202401124
  中图分类号： R338.8;R339.16;R764.45
- 收稿：2024-01-28，
  
  修回：2024-05-19，
  
  纸质出版：2024-09-15
- 稿件说明：
移动端阅览
吴文静, 姜振东, 兰发璋, 等. 正常听阈单侧耳鸣者电生理特征及临床意义[J]. 陆军军医大学学报, 2024,46(17):2016-2020.

Wenjing WU, Zhendong JIANG, Fazhang LAN, et al. Electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold[J]. Journal of Army Medical University, 2024, 46(17): 2016-2020.
吴文静, 姜振东, 兰发璋, 等. 正常听阈单侧耳鸣者电生理特征及临床意义[J]. 陆军军医大学学报, 2024,46(17):2016-2020. DOI： 10.16016/j.2097-0927.202401124.

Wenjing WU, Zhendong JIANG, Fazhang LAN, et al. Electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold[J]. Journal of Army Medical University, 2024, 46(17): 2016-2020. DOI： 10.16016/j.2097-0927.202401124.

摘要

目的

探究正常听阈单侧耳鸣患者电生理特征及临床意义。

方法

选取2022年5月至2023年2月陆军军医大学第一附属医院耳鼻咽喉头颈外科收治的34例听力正常主诉单侧耳鸣患者作为研究对象，以患侧组与健侧组检测数据进行对比。对患者双侧分别进行纯音听阈检测、畸变产物耳声发射(distortion product otoacoustic emissions

DPOAE)、听性脑干反应(auditory brainstem response，ABR)检测及扩展高频测听。

结果

ABR的波Ⅰ潜伏期患侧组较健侧组明显缩短，且差异具有统计学意义(1.60

1.73 ms

=0.018)。ABR的波Ⅰ幅值患侧组较健侧组明显下降(0.19

0.23 μV

=0.003)。患侧组34耳中波Ⅲ波幅大于波Ⅴ波幅有18耳(52.94%)，健侧组未发现波Ⅲ波幅大于波Ⅴ波幅，2组比较差异具有统计学意义(

=24.480，

0.001)。在12.5、14.0、16.0、18.0、20.0 kHz患侧组34耳扩展高频测听平均听阈值均高于健侧组，差异具有统计学意义(

0.05)。

结论

正常听阈主观性耳鸣者进行ABR检查可有助于初步判断听觉通路是否出现隐性功能改变，波Ⅰ幅值下降、波Ⅰ潜伏期缩短、波Ⅲ波幅大于波Ⅴ波幅等可作为客观参考指标。

Abstract

Objective

To investigate the electrophysiological characteristics and clinical significance of unilateral tinnitus with normal hearing threshold.

Methods

A total of 34 patients with normal hearing but unilateral tinnitus admitted to our department from May 2022 to February 2023 were recruited as the study subjects. Pure tone hearing threshold detection

distortion product otoacoustic emission (DPOAE)

auditory brainstem response (ABR) detection and extended high-frequency pure tone audiometry were performed on both ears (affected side and healthy side) of every patient. The data of the affected side group and those of healthy side group were compared.

Results

The Ⅰ-wave latency of ABR was significantly shorter (1.60

1.73 ms

=0.018)

and its amplitude was obviously decreased (0.19

0.23 μV

=0.003) in the affected side group when compared with the healthy side group. In the affected group (34 ears)

there were 18 ears (52.94%) having amplitude of wave Ⅲ greater than that of wave Ⅴ

while in the healthy group

no such difference in the amplitude between wave Ⅲ and wave Ⅴ was observed. There was statistical significance between the 2 groups (

Chi

-square=24.480

0.001). In the 12.5

14.0

16.0

18.0 and 20.0 kHz conditions

the average hearing threshold of extended high-frequency audiometry was all significantly higher in the affected side group than the healthy group (

0.05).

Conclusion

For subjective tinnitus patients with normal hearing threshold

ABR examination is helpful in preliminarily determining whether there are hidden functional changes in the auditory pathway. Decreased Ⅰ-wave amplitude

shortened Ⅰ-wave latency

and wave Ⅲ amplitude greater than wave Ⅴ amplitude can be used as objective reference indicators.

关键词

Keywords

references

DOMARECKA E, OLZE H, SZCZEPEK A J. Auditory brainstem responses (ABR) of rats during experimentally induced tinnitus: literature review[J]. Brain Sci, 2020, 10(12): 901. DOI: 10.3390/brainsci10120901.

蒋佳琪, 赖媛, 陈杰荣, 等. 学龄前儿童言语诱发听性脑干反应的性别差异[J]. 听力学及言语疾病杂志, 2023, 31(1): 31-34. DOI: 10.3969/j.issn.1006-7299.2023.01.007.

JIANG J Q, LAI Y, CHEN J R, et al . The gender differences of speech-evoked auditory brainstem response in preschoolers[J ] . J Audiol Speech Pathol, 2023, 31(1): 31-34. DOI: 10.3969/j.issn.1006-7299.2023.01.007.

CHEN F F, ZHAO F, MAHAFZA N, et al . Detecting noise-induced cochlear synaptopathy by auditory brainstem response in tinnitus patients with normal hearing thresholds: a meta-analysis[J ] . Front Neurosci, 2021, 15: 778197. DOI: 10.3389/fnins.2021.778197.

宋勇莉, 齐柳, 陈阳, 等. 慢性耳鸣患者合并焦虑和抑郁影响因素的分析[J]. 听力学及言语疾病杂志, 2021, 29(4): 398-402. DOI: 10.3969/j.issn.1006-7299.2021.04.009.

SONG Y L, QI L, CHEN Y, et al . Influencing factors of anxiety and depression in patients with chronic tinnitus[J ] . J Audiol Speech Pathol, 2021, 29(4): 398-402. DOI: 10.3969/j.issn.1006-7299.2021.04.009.

JIMOH Z, MAROUF A, ZENKE J, et al . Functional brain regions linked to tinnitus pathology and compensation during task performance: a systematic review[J ] . Otolaryngol Head Neck Surg, 2023, 169(6): 1409-1423. DOI: 10.1002/ohn.459.

LIBERMAN M C, KUJAWA S G. Cochlear synaptopathy in acquired sensorineural hearing loss: Manifestations and mechanisms[J]. Hear Res, 2017, 349: 138-147. DOI: 10.1016/j.heares.2017.01.003.

MA X Y, SHEN W D, YANG S M, et al . The significance of extended high-frequency audiometry in tinnitus patients with normal hearing as evaluated via conventional pure tone audiometry[J ] . J Laryngol Otol, 2024, 138(4): 381-387. DOI: 10.1017/S0022215123000920..

JACXSENS L, PAUW J D, CARDON E, et al . Brainstem evoked auditory potentials in tinnitus: a best-evidence synthesis and meta-analysis[J ] . Front Neurol, 2022, 13: 941876. DOI: 10.3389/fneur.2022.941876.

范博雅, 王刚, 陈绍奇, 等. 脉冲噪声所致爆震性听力损失人员中耳聋基因的突变谱研究[J]. 陆军军医大学学报, 2023, 45(16): 1748-1754. DOI: 10.16016/j.2097-0927.202303066.

FAN B Y, WANG G, CHEN S Q, et al . Mutations profiles of deafness genes in explosion-induced hearing loss caused by impulse noise[J ] . J Army Med Univ, 2023, 45(16): 1748-1754. DOI: 10.16016/j.2097-0927.202303066.

王露露, 谢飞, 赵清远, 等. 人Waardenburg综合征点突变SOX10 p. R106W小鼠模型的构建及听力表型初步研究[J]. 陆军军医大学学报, 2023, 45(24): 2512-2520. DOI: 10.16016/j.2097-0927.202309001.

WANG L L, XIE F, ZHAO Q Y, et al . Construction and otological phenotypic characterization of a mouse model harboring orthologous human Waardenburg syndrome mutation SOX10 p. R106W[J ] . J Army Med Univ, 2023, 45(24): 2512-2520. DOI: 10.16016/j.2097-0927.202309001.

李世昌, 王梓敬, 王文伦, 等. 生理状态下小鼠听阈及耳蜗内IL-1β、IL-6、TNF-α、CCL-2和GR mRNA水平昼夜变化的研究[J]. 中华耳科学杂志, 2022, 20(5): 778-783. DOI: 10.3969/j.issn.1672-2922.2022.05.013.

LI S C, WANG Z J, WANG W L, et al . Patterns of physiological circadian changes of hearing thresholds and messenger RNA levels of IL-1β, IL-6, TNF-α, CCL-2 and GR in cochlea in mice[J ] . Chin J Otol, 2022, 20(5): 778-783. DOI: 10.3969/j.issn.1672-2922.2022.05.013.

HAN M S, JEONG Y J, IM G J, et al . Auditory brainstem response test results in normal hearing adolescents with subjective tinnitus[J ] . Int J Pediatr Otorhinolaryngol, 2021, 146: 110775. DOI: 10.1016/j.ijporl.2021.110775.

BRAMHALL N F, MCMILLAN G P, GALLUN F J, et al . Auditory brainstem response demonstrates that reduced peripheral auditory input is associated with self-report of tinnitus[J ] . J Acoust Soc Am, 2019, 146(5): 3849. DOI: 10.1121/1.5132708.

DING Z W, ZHANG C, WANG F Y, et al . Extended high-frequency audiometric analyses of tinnitus patients exhibiting normal hearing on conventional pure-tone audiometry[J ] . Acta Otolaryngol, 2022, 142(7/8): 579-584. DOI: 10.1080/00016489.2022.2112972.

TZIRIDIS K, FORSTER J, BUCHHEIDT-DÖRFLER I, et al . Tinnitus development is associated with synaptopathy of inner hair cells in Mongolian gerbils[J ] . Eur J Neurosci, 2021, 54(3): 4768-4780. DOI: 10.1111/ejn.15334.

ISHIBASHI K, AKAMA T, YOSHIDA H, et al . Effects of transient cerebral hypoperfusion on human auditory brainstem responses[J ] . FASEB J, 2021, 35(S1): fasebj. 2021.35. S1.04900. DOI: 10.1096/fasebj.2021.35.s1.04900.

BRAMHALL N F, KONRAD-MARTIN D, MCMILLAN G P. Tinnitus and auditory perception after a history of noise exposure: relationship to auditory brainstem response measures[J]. Ear Hear, 2018, 39(5): 881-894. DOI: 10.1097/AUD.0000000000000544.

段新艳, 宋忠义, 王宁, 等. DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 6-10, 17. DOI: 10.6040/j.issn.1673-3770.0.2021.404.

DUAN X Y, SONG Z Y, WANG N, et al . Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus[J ] . J Otolaryngol Ophthalmol Shandong Univ, 2022, 36(5): 6-10, 17. DOI: 10.6040/j.issn.1673-3770.0.2021.404.

LUQUE C G, ATKINS-LABELLE C, PAUWELS J, et al . Intranasal Dexmedetomidine increases the successful sedation of children with autism for out-patient auditory brainstem response hearing tests[J ] . Int J Pediatr Otorhinolaryngol, 2021, 151: 110945. DOI: 10.1016/j.ijporl.2021.110945.

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