DISTORTION-PRODUCT EMISSIONS AND AUDITORY-SENSITIVITY IN HUMAN EARS WITH NORMAL HEARING AND COCHLEAR HEARING-LOSS
DISTORTION-PRODUCT EMISSIONS AND AUDITORY-SENSITIVITY IN HUMAN EARS WITH NORMAL HEARING AND COCHLEAR HEARING-LOSS
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DOI：
10.1044/jshr.3505.1142
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发表时间：
1992-10-01
期刊：
影响因子：
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通讯作者：
KIMBERLEY, BP
中科院分区：
文献类型：
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作者：
NELSON, DA;KIMBERLEY, BP
在53只人耳中测量了2f 1-f2频率的畸变产物发射（DPE），其中21只表现出耳蜗性听力损失。在707 Hz和5656 Hz之间的7个频率区域获得作为刺激水平的函数的DPE（DPE生长曲线）。观察到几种明显不同形状或图案的DPE生长曲线。这些包括单段单调的增长曲线和不饱和在中等和高刺激水平，双相增长曲线与无效在中等刺激水平，和非单调的增长曲线与负斜率在高刺激水平。低水平，不规则形状的片段更常见于听力正常的耳朵，提示正常的低水平主动非线性从外毛细胞子系统。高水平，陡峭的斜坡段经常在听力受损的耳朵，提示残留的非线性从耳蜗分区没有功能性外毛细胞。的刺激水平，在该DPE可以只是从本底噪声，DPE检测阈值区分，表现出中度的正相关性（r的从0.50到0.81）与听觉阈值时，所有的耳朵，正常和受损，被认为是在一起。这些相关性还不足以精确地定量预测听觉阈值。然而，DPE阈值能够以一定的精度预测异常的听觉灵敏度。在本研究中，DPE阈值正确预测异常听觉灵敏度的时间为79%，在以前的研究中高达96%。这些结果表明，DPE阈值可能被证明是有用的听力筛查的情况下，合作的主题是有限的，或需要证实耳蜗听力损失。不同模式的DPE生长曲线表明潜在的微机械差异耳朵之间，但这些模式的鉴别诊断价值仍有待确定。
Distortion product emissions (DPEs) at 2f1-f2 frequencies were measured in 53 human ears; 21 of them exhibited cochlear hearing loss. DPEs were obtained as a function of stimulus level (DPE growth curves) at seven frequency regions between 707 Hz and 5656 Hz. Several distinctly different shapes or patterns of DPE growth curves were observed. These included single-segment monotonic growth curves with and without saturation at moderate and high stimulus levels, diphasic growth curves with nulls at moderate stimulus levels, and nonmonotonic growth curves with negative slopes at high stimulus levels. Low-level, irregularly shaped segments were more frequent in normal-hearing ears, suggestive of normal low-level active nonlinearities from the outer-hair-cell subsystem. High-level, steeply sloped segments were frequent in hearing-impaired ears, suggestive of residual nonlinearities from a cochlear partition without functional outer hair cells. The stimulus level at which the DPE could just be distinguished from the noise floor, the DPE detection threshold, demonstrated moderate positive correlations (r's from 0.50 to 0.81) with auditory thresholds when all ears, both normal and impaired, were considered together. Those correlations were not strong enough to quantitatively predict auditory thresholds with any great accuracy. However, DPE thresholds were able to predict abnormal auditory sensitivity with some precision. DPE thresholds correctly predicted abnormal auditory sensitivity 79% of the time in the present study, and up to 96% of the time in previous studies. These results suggest that DPE thresholds may prove useful for hearing screening in cases where cooperation from the subject is limited or where corroboration of cochlear hearing loss is required. Different patterns of DPE growth curves suggest underlying micro-mechanical differences between ears, but the differential diagnostic value of those patterns remains to be determined.