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目的探讨多频稳态诱发电位(ASSR)及瞬态诱发耳声发射(TEOAE)在职业性听力损伤诊断中的应用。方法以87名高频听损≥50 dB和语频听损≥25 dB的噪声作业人员为调查对象,进行TEOAE及ASSR测试。结果87名患者中检出TEOAE共71名,其中有17名纯音听阈0.5、1.0、2.0、4.0 kHz的平均值>50 dB;平均值>50 dB的16名未能检出TEOAE,证实是患者的真实听阈。16名未能检出TEOAE及检出TEOAE的71名中54名纯音听阈的平均值<50 dB的患者,ASSR听阈与纯音测听听阈相符;在检出TEOAE的纯音听阈平均值>50 dB的17名患者中,3名患者ASSR值在正常参考值范围,纯音测听听阈比ASSR听阈高,诊断为伪聋;其他14名人员的纯音听阈与ASSR值差异也比较大,有夸大性聋。结论TEOAE、ASSR对职业性听力损伤的听力评估具有重要的临床意义。
Objective To investigate the application of multi-frequency steady-state evoked potential (ASSR) and transient evoked otoacoustic emissions (TEOAE) in the diagnosis of occupational hearing impairment. Methods Twenty-seven noise workers with ≥50 dB hearing loss and ≥25 dB hearing loss were selected as the test subjects for TEOAE and ASSR tests. Results A total of 71 TEOAE were detected in 87 patients, of which 17 pure tone thresholds were> 50 dB at 0.5, 1.0, 2.0 and 4.0 kHz, and TEOAE was detected in 16 patients with an average of> 50 dB The real hearing threshold. The ASSR threshold was in good agreement with the pure audiometry threshold in patients with a mean of 54 pure audiometric thresholds of 71 out of 71 non-detectable TEOAE and TEOAE detected. On average, pure audiometric thresholds of TEOAE> 50 dB were detected Among the 17 patients, the ASSR values of 3 patients were within the normal reference range, pure tone audiometry threshold was higher than ASSR hearing threshold, the diagnosis was false deafness; other 14 staffs pure tone hearing threshold and ASSR values were also different, with exaggerated deafness. Conclusion TEOAE and ASSR have important clinical significance in hearing assessment of occupational hearing impairment.