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Neonatal asphyxia, definitive markers and hearing loss. 新生儿窒息,明确标志和听力损失。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073038
L S Mencher, G T Mencher

A study of 56 severely asphyxiated infants (8 hearing impaired and 46 normally hearing) was designed to identify specific markers associated with asphyxia which could be related to hearing loss. Sixteen variables, including such items as: one- and five-minute Apgar scores, muscle tone, use of a ventilator, prolonged stay in the NICU, hypoxic-ischemic encephalopathy (HIE), other organ damage, and intra-uterine growth retardation (IUGR) were considered. Results suggested four factors related to asphyxia which are often found in the presence of hearing loss, but none of these was considered a definitive marker or predictor of such a disability. A combination of HIE, seizures, associated organ damage and IUGR should be considered a strong marker for the probability of a sensorineural hearing loss.

对56例重度窒息婴儿(8例听力受损,46例听力正常)进行研究,以确定可能与听力损失相关的窒息相关的特异性标志物。考虑了16个变量,包括:1分钟和5分钟Apgar评分、肌肉张力、使用呼吸机、在NICU停留时间延长、缺氧缺血性脑病(HIE)、其他器官损伤和子宫内生长迟缓(IUGR)。结果表明,有四个因素与窒息有关,这些因素通常在听力损失的情况下发现,但这些因素都不被认为是这种残疾的明确标志或预测因素。HIE、癫痫发作、相关器官损伤和IUGR的组合应被认为是感音神经性听力损失可能性的一个强有力的标志。
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引用次数: 28
Effectiveness of a single and a repeated screen for hearing loss in the elderly. 老年人听力损失单次和多次筛查的有效性。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073046
P J van den Berg, A Prins, H Verschuure, A W Hoes

The aim of this study was to assess the value of repeated audiometric screens offered to elderly in general practice. In 1991, an audiometric screen was performed on 660 participants, aged 60 years and over, enlisted in one general practice near Rotterdam, the Netherlands. We repeated the audiometric screen 5 years later in 80.2% (405/505) of the eligible participants of the first screen. After the first screen, 24.3% of those who were hearing impaired had discussed this with their general practitioner, 21.5% were referred to a specialist in otolaryngology and 12.1% had been prescribed a hearing aid. The effect of the repeated screen was lower as only 7.3% of the hearing impaired participants received a hearing aid. Efforts to screen on hearing loss will be fruitless and can best be avoided by general practitioners unless strategies are developed to increase the use of hearing aids after a positive screening result.

本研究的目的是评估在一般实践中提供给老年人的重复听力测量屏幕的价值。1991年,在荷兰鹿特丹附近的一家全科诊所,对660名年龄在60岁及以上的参与者进行了听力测试。5年后,我们在80.2%(405/505)的第一次筛查的合格参与者中重复了听力测量筛查。在第一次筛查后,24.3%的听力受损者与全科医生讨论过这个问题,21.5%的人被转介给耳鼻喉科专家,12.1%的人被开了助听器。重复筛查的效果较低,因为只有7.3%的听力受损参与者使用了助听器。筛查听力损失的努力将是徒劳的,全科医生最好避免这样做,除非制定策略,在筛查结果呈阳性后增加助听器的使用。
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引用次数: 9
Self-assessed hearing problems in Sweden: a demographic study. 瑞典自我评估的听力问题:一项人口统计学研究。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073044
U Rosenhall, R Jönsson, O Söderlind

A study of self-assessed hearing problems was performed comprising 48,680 Swedish inhabitants aged 16-84 years. The participants of the survey responded to personal interviews during the period 1986-1993. One of the questions in the interview concerned difficulties of hearing in background noise. The total prevalence of the reported hearing problems was 10.7 per cent, varying from 2.4 per cent in the youngest age group to 30 per cent in the oldest. Men reported difficulties in hearing more often than women, except in the youngest age group. Hearing problems were more often reported by manual workers, unemployed and by those who had taken early retirement, than by non-manual employees and the self-employed. Regional differences regarding hearing problems were observed. The prevalence of self-reported problems was lowest in metropolitan Stockholm (7.9 per cent) and increased in the following order: other major cities (9.4 per cent), other cities (10.5 per cent), small population centres (12.5 per cent), agricultural areas (13.5 per cent) and sparsely populated forest areas (15 per cent). In summary, a number of factors related to ageing, socioeconomic status and domicile were related to self-assessed difficulties hearing a conversation. These factors obviously include determinants such as genetics, health status, gender-related differences, exposure to noise and possible conditioning effects of low-level noise exposure.

对48,680名年龄在16-84岁之间的瑞典居民进行了一项自我评估的听力问题研究。调查参加者对1986-1993年期间的个人采访作出了答复。面试中的一个问题涉及在背景噪音中听力的困难。报告的听力问题的总患病率为10.7%,从最年轻年龄组的2.4%到最年长年龄组的30%不等。除了最年轻的年龄组外,男性报告的听力障碍比女性多。体力劳动者、失业者和提前退休的人比非体力劳动者和自雇人士更常报告有听力问题。在听力问题上观察到地区差异。自我报告问题的流行率在斯德哥尔摩大都市最低(7.9%),并按以下顺序增加:其他主要城市(9.4%)、其他城市(10.5%)、小人口中心(12.5%)、农业区(13.5%)和人口稀少的森林地区(15%)。总之,与老龄化、社会经济地位和住所有关的一些因素与自我评估的听不清谈话的困难有关。这些因素显然包括遗传、健康状况、性别差异、噪声暴露和低水平噪声暴露可能产生的调节效应等决定因素。
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引用次数: 53
The relationship between the acoustic reflex threshold and levels of loudness categories in hearing-impaired listeners. 听障听者声反射阈值与响度分类水平的关系。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073041
S O Olsen, A N Rasmussen, L H Nielsen, B V Borgkvist

When applied as a tool for hearing aid fitting, categorical loudness scaling (CLS) is time consuming and not feasible in all subjects. It is therefore desirable to use objective measures for accurate prediction of loudness categories among hearing-impaired individuals. The present study aimed at exploring whether loudness perception at the ART is constant with varying hearing threshold. Seventy-five subjects with various degrees of hearing impairment, measurable acoustic reflex and normal middle ear function participated. The HTLs, ARTs and the levels of six loudness categories at frequencies 0.5, 1, 2 and 4 kHz were determined for all subjects. Loudness at the ART was found to be correlated with the amount of hearing loss. On the basis of these results, it is concluded that the ART cannot be used for accurate estimation of loudness in hearing-impaired subjects.

分类响度法(CLS)作为助听器验配的一种工具,不仅耗时,而且并不适用于所有被试。因此,需要使用客观的测量方法来准确预测听力受损个体的响度类别。本研究旨在探讨在不同的听阈下,ART的响度感知是否恒定。75名不同程度的听力障碍、可测量的声反射和中耳功能正常的受试者参加了实验。测定了所有受试者在0.5、1、2和4 kHz频率下的HTLs、ARTs和6个响度类别的水平。研究发现,接受ART治疗时的响度与听力损失的程度相关。基于这些结果,我们得出结论,ART不能用于准确估计听障受试者的响度。
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引用次数: 7
Contribution of click frequency bands to the human binaural interaction components. 点击频带对人双耳交互分量的贡献。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073043
A Polyakov, H Pratt

The purpose of this study was to determine the contribution of click frequency bands (broad-band, >2000 Hz, <2000 Hz and <1000 Hz) to binaural interaction components (BICs) of the human auditory brainstem evoked potentials (ABEPs). The human BICs were studied by subtracting the potentials to binaural clicks from the algebraic sum of monaurally evoked potentials to either ear. Effective frequency bands were derived using clicks alone or clicks with ipsilateral or binaural masking noise, high- or low-pass filtered at different cut-off frequencies. Analysis included single-channel vertex-cervical spinous process VII derivation of BIC and ABEP, as well as estimating the single, centrally located dipole equivalent of the surface activity from three orthogonally positioned electrode pairs, using the three-channel Lissajous' trajectory (3-CLT) analysis. All BIC 3-CLTs included three major components (labeled BdII, BeI, and BeII) approximately corresponding in latency to IIIn, V and VI ABEP peaks. All apex latencies of BIC 3-CLT, except BeI, were longer in response to <2000 Hz and <1000 Hz (low-frequency) effective clicks. Apex amplitude of components BeI and BeII of BIC 3-CLT were smaller with low-frequency effective clicks than with broad-band or high-frequency (>2000 Hz) clicks. We suggest that binaural interaction component BeI is mainly tuned to high frequencies, showing no frequency effect on latency, and decreasing in amplitude with decreasing click high frequency content. In contrast, BdII and BeII of the human BICs are evoked more synchronously by high-frequency binaural inputs, but are also sensitive to low frequencies, increasing in latency according to the cochleotopic activation pattern. These differences between BIC components may reflect their roles in sound localization.

本研究的目的是确定点击频带(宽带,>2000 Hz, 2000 Hz)的贡献。我们认为双耳交互分量BeI主要被调谐到高频,对延迟没有频率影响,并且振幅随着点击高频内容的减少而减小。相比之下,人类bic的BdII和BeII被高频双耳输入更同步地激发,但对低频也很敏感,根据耳蜗异位激活模式,潜伏期增加。BIC成分之间的这些差异可能反映了它们在声音定位中的作用。
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引用次数: 6
First audiometric results with the Vibrant soundbridge, a semi-implantable hearing device for sensorineural hearing loss. 第一听力测量结果与充满活力的音桥,半植入式听力装置为感音神经性听力损失。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073045
A F Snik, C W Cremers

The Vibrant soundbridge is a semi-implantable hearing device. The implanted electromagnetic transducer is attached to the incus and it is linked by telemetry to the externally worn audio processor. In Nijmegen, this device has been applied to seven patients with moderate or severe sensorineural hearing loss (PTA between 43 and 71 dB HL) who could not tolerate ear moulds. As the amplification of the device depends on the input level (amplifier with wide dynamic range compression), loudness scaling measurements were performed. The gain as a function of input level was determined from aided and unaided loudness growth curves. The mean gain was 21 dB at an input level of 40 dB SPL. The mean gain decreased to 5 dB at an input level of 90 dB SPL. Measured gain values were lower than target values prescribed by the FIG6 method, mainly however for the low-frequency range and for low-level sounds. It was concluded that this device is very promising for patients who cannot tolerate an ear mould.

“活力音桥”是一种半植入式助听器。所述植入的电磁换能器连接到所述基座上,并通过遥测连接到所述外部佩戴的音频处理器。在奈梅亨,该装置已应用于7例不能耐受耳模的中度或重度感音神经性听力损失(PTA在43 - 71 dB HL之间)患者。由于该装置的放大取决于输入电平(宽动态范围压缩放大器),因此进行了响度缩放测量。增益作为输入电平的函数由辅助和非辅助响度增长曲线确定。在40 dB SPL的输入电平下,平均增益为21 dB。当输入电平为90 dB SPL时,平均增益降至5 dB。测量到的增益值低于FIG6方法规定的目标值,但主要是针对低频范围和低电平声音。结论是,这种装置对不能忍受耳霉菌的患者非常有希望。
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引用次数: 45
Separate and combined effects of a benzodiazepine (alprazolam) and noise on auditory brainstem responses in man. 苯二氮卓类药物(阿普唑仑)和噪音对人听觉脑干反应的单独和联合影响。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073042
J Parrot, J C Petiot, S Morizot, M T Petiot, H J Smolik

Auditory brainstem responses (ABRs) were recorded in 60 male or female, anxious or anxiety-free university students, before and after separated or simultaneous intake of alprazolam and exposure to noise. A significant increase of the latencies of the ABRs was found when subjects took alprazolam. This effect is consistent with the presence of gamma-aminobutyric acid (GABA), one of the neurotransmitters at terminals of cochlear efferent fibres A significant increase of the latencies was observed after noise alone. In subjects taking alprazolam when they are exposed to noise, the effect of noise on the ABR latencies is reduced, but not abolished. The effects of alprazolam on the ABR are consistent with the presence of GABA in the medulla and pons. Significant effects of noise upon III-V and I-V intervals suggest that auditory 'fatigue' may involve a retrocochlear component. Differences due to sex appear to be abolished by anxiety.

本文记录了60名焦虑或无焦虑的大学生在分别或同时摄入阿普唑仑和暴露于噪音前后的听觉脑干反应(ABRs)。当受试者服用阿普唑仑时,发现abr的潜伏期显著增加。这种效应与γ -氨基丁酸(GABA)的存在是一致的,GABA是耳蜗传出纤维末端的一种神经递质。在服用阿普唑仑的受试者中,当他们暴露于噪音时,噪音对ABR潜伏期的影响减弱,但没有消除。阿普唑仑对ABR的影响与脑髓和脑桥中GABA的存在一致。噪声对III-V和I-V音程的显著影响表明听觉“疲劳”可能涉及耳蜗后成分。性别差异似乎被焦虑所消除。
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引用次数: 0
Neonatal hearing screening with transient evoked otoacoustic emissions: a learning curve. 新生儿听力筛查瞬态诱发耳声发射:一个学习曲线。
Pub Date : 1999-11-01 DOI: 10.3109/00206099909073039
G De Ceulaer, K Daemers, K Van Driessche, S Mariën, T Somers, F E Offeciers, P J Govaerts

The present paper reports on the implementation of a neonatal hearing screening programme in a private hospital in Belgium. A maternity-based neonatal hearing screening project with transient evoked otoacoustic emissions (TEOAEs) was started in 1993. The cost of the test was not covered by the public health insurance, so the parents had to pay the full cost for screening their child (approximately 30 Euro). Since 1993 the programme strategies have been changed on several occasions to improve the quality and efficacy. A retrospective analysis was performed on: (1) the test pass rate; (2) the coverage; and (3) the number of children who become 'Lost to follow-up' after failing the initial test. The data show a steady learning curve with a time course of several years. They also demonstrate that it is worthwhile and feasible to run a high-quality screening programme in a private establishment.

本文件报告了比利时一家私立医院实施新生儿听力筛查方案的情况。1993年开始了一项以产妇为基础的瞬态诱发耳声发射(teoae)新生儿听力筛查项目。公共健康保险不包括检查费用,因此父母必须支付孩子检查的全部费用(大约30欧元)。自1993年以来,方案战略已多次改变,以提高质量和效力。回顾性分析:(1)试验合格率;(二)覆盖范围;(3)在初始测试失败后成为“无法跟进”的儿童人数。数据显示出一个稳定的学习曲线,其时间过程为几年。它们还表明,在私人机构开展高质量的筛查项目是值得和可行的。
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引用次数: 22
Audiogram fine structure and spontaneous otoacoustic emissions in patients with Menière's disease. meni<e:1>病患者的听图精细结构和自发耳声发射。
Pub Date : 1999-09-01 DOI: 10.3109/00206099909073033
J Wiebe Horst, E de Kleine

The incidence of and inter-relationship between audiogram fine structure and spontaneous otoacoustic emissions (SOAEs) was investigated in patients with Menière's disease. This project is a part of a comprehensive longitudinal study in which a range of tests of cochlear and vestibular function in patients who suffer from Menière's disease, is carried out and repeated over time. In this paper we present preliminary data from both ears (in most cases an affected and an unaffected ear) of 13 patients. The thresholds in these 26 ears ranged from normal to 80 dB HL. SOAEs could be measured in only four ears; these ears had near-normal thresholds. Data from seven ears had to be excluded because of the possibility of cross-over effects. In 16 out of the 19 remaining ears, audiogram fine structure was found. Our data confirm that (1) SOAEs correspond to behavioural sensitivity peaks. (2) There is no simple relationship between SOAE level and height of sensitivity peaks. (3) Sensitivity peaks may occur at frequencies without measurable SOAEs. In addition, our data show that: (1) Audiogram fine structure may occur in ears without observable SOAEs. (2) Fine structure can be present in ears without normal thresholds. (3) There is a weak tendency for fine structure to be more pronounced in ears with milder hearing loss.

探讨meni病患者听图精细结构与自发性耳声发射(soae)的发生率及其相互关系。该项目是一项综合纵向研究的一部分,在该研究中,对患有梅尼垂尔氏病的患者进行了一系列耳蜗和前庭功能测试,并在一段时间内反复进行。在本文中,我们介绍了13例患者双耳(在大多数情况下,受影响的耳朵和未受影响的耳朵)的初步数据。这26只耳朵的阈值范围从正常到80 dB HL。soae只能在4耳内测量;这些耳朵的阈值接近正常。由于交叉效应的可能性,必须排除来自七个耳朵的数据。剩下的19只耳中有16只发现了听音精细结构。我们的数据证实(1)soae对应于行为敏感性峰值。(2) SOAE水平与敏感峰高度关系不简单。(3)灵敏度峰值可能出现在无法测量soae的频率上。此外,我们的数据表明:(1)没有可观察到的soae的耳朵可能会出现听力图精细结构。(2)无正常阈值的耳内可出现精细结构。(3)听力损失较轻的耳部,细结构较明显的趋势较弱。
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引用次数: 8
Frequency-specific information from click evoked otoacoustic emissions in noise-induced hearing loss. 在噪音引起的听力损失中,点击引起的耳声发射的频率特定信息。
Pub Date : 1999-09-01 DOI: 10.3109/00206099909073029
G Tognola, F Grandori, P Avan, P Ravazzani, P Bonfils

Click evoked otoacoustic emissions (CEOAEs), pure-tone audiograms (PTAs), and Bekesy sweep frequency audiograms were recorded from 15 ears of 11 subjects with noise-induced hearing loss. For all ears, hearing threshold levels > or = 30 dB HL were found at the high frequencies. The aims of the study were to examine whether the decomposition of CEOAEs into narrow band components could identify hearing loss in a frequency-specific manner and to what extent audiometric thresholds could be predicted. CEOAEs were parcelled into 0.5-kHz-wide components by means of the wavelet transform. Reproducibility of CEOAE components was compared with audiometric threshold at corresponding frequencies. A general trend of low reproducibility for increasing audiometric thresholds was found. A reproducibility value of 60 per cent was found to best separate normal and elevated thresholds. The presence of a CEOAE component at a given frequency was always associated with audiometric thresholds < or = 20-25 dB HL. On the other hand, the absence of a component was equally associated either with normal or abnormal hearing levels. Large inter-subject variability was observed. A weak linear relationship was found between reproducibility and audiometric thresholds at corresponding frequencies, indicating that analysis of narrow band CEOAE components is valuable for separating normal from hearing-impaired ears but cannot replace the audiogram.

记录了11例噪声性听力损失患者15耳的点击诱发耳声发射(ceoae)、纯音听力图(PTAs)和Bekesy扫频听力图。对于所有耳,在高频处发现听力阈值水平>或= 30 dB HL。本研究的目的是检验将ceoae分解为窄带分量是否可以以特定频率的方式识别听力损失,以及听力阈值可以预测到何种程度。利用小波变换将ceoae分解成0.5 khz宽的分量。在相应频率下,将CEOAE分量的再现性与听力学阈值进行比较。发现增加听力学阈值的一般趋势是低再现性。发现60%的再现性值可以最好地区分正常阈值和升高阈值。在给定频率上存在CEOAE分量总是与听力阈值<或= 20-25 dB HL相关。另一方面,一个成分的缺失同样与正常或异常的听力水平相关。观察到很大的受试者间变异性。在相应频率下,再现性与听力阈值之间存在微弱的线性关系,表明窄带CEOAE分量分析对于区分正常和听力受损的耳朵是有价值的,但不能取代听力图。
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引用次数: 21
期刊
Audiology : official organ of the International Society of Audiology
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