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고음역난청 환자에서의 청성뇌간유발반응 및 등골근반사
Published Online: May 31, 2020
Abstract
Brainstem evoked response audiometry(BERA) is the most reliable objective method to determine the degree of hearing acuity by stimulation with click sound, but it represent the status of higher frequency area. So there is not any problem in flat type hearing loss but are some problems to determine the hearing level in ascending and descending type hearing loss.
Author evaluated frequency at which the threshold level of pure tone audiometry corresponds with that of BERA, and determined the hearing threshold level of the other frequencies with the results of acoustic reflex threshold (ART) for accurate evaluation of the hearing threshold level in the functional or maligering hearing loss is suspected.
The obtained results were as follows;
The frequency of PTA at which the hearing threshold level of BERA is concurrent with that of PTA was between 2~3KHz as 58.7%, and was between 2~4KHz as 80.8%, and the ratio concurrent with PTAbCaverage PTA of 1, 2 and 4KHz) was 42.6%.
The larger difference of pure tone threshold level between 4KHz and 1KHz(DPt4~1KHz), the larger difference between threshold of BERA and that of PTA at 1KHz. And about 60dB of DPt4~1KHz revealed 40dB difference between threshold of BERA and that of PTA at 1KHz.
The latencies of wave V of BERA at the sound level of threshold，threshold + 10dB, threshold + 20dB, threshold + 30dB and threshold + 40dB in normal were longer than those of high frequency hearing loss, but vice verse at threhold + 50dB and 95dB SPL.
The higher threshold level, the shorter latency of wave V at the threshold of BERA, but vice verse at 95dB SPL.
According to the DPt4~1KHZ, the latencies of wave V were longer in the cases of 41dB or more DPt4~1KHZ than those of 40dB or less DPt4~1KHZ. But there was no statistical significance (p=0.19).
The acoustic reflex thresholds(ARTs) according to sound frequencies in normal hearing persons tended to increase as frequency increase, and there was no difference between ART of ipsilateral reflex and that of contralateral reflex.
Compared with normal hearing persons，the degree of difference between ART and PTA in the patients with high frequency hearing loss decreased significantly，and this difference was apparent as frequency increase. On the other hand, the degree of difference between ART and PTA of recruitment positive ears is smaller than that of recruitment negative ears by short increment sensitivity index(SISI) test, with statistically significant ipsilateral reflex of 2KHz(p<0.10) and contralateral reflex of 2KHz(p<0.10) and 4KHz(p<0.05).