高频测听的好处——一项回顾性研究

V. Svobodová, O. Profant, J. Kluh, J. Plzák
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简介:在常规听力检查中通常不进行高频测听。这是Motol大学医院耳鼻喉科诊所经常使用的一种方法(特别是在治疗桥小脑角肿瘤的患者中),尽管其确切的指示性标准尚未确定。我们的目的是表征一组患者,使用一种方法,提高了诊断的准确性。材料和方法:我们回顾性分析了1515张听力图。使用GN Otometrics公司的MADSEN Astera听音计对773名年龄在16-80岁(47.79±13.54)的成年人进行了2011-2018年的听力图。他们都接受了高频听力测量,包括所有常见的检测频率高达8千赫,以及更高频率的- 9千赫,10千赫,11.2千赫,12.5千赫,14千赫和16千赫。适应症非常多样——主观听觉减退/听觉亢进、耳鸣、前庭病变、针孔外伤或已知的桥小脑肿瘤。结果:我们发现了具有临床意义的听力不对称或病理性听力阈值升高,52例患者(6.73%)仅在频率高于8 kHz时可检测到。本组包括前庭神经鞘瘤(48.08%)、颞区其他肿瘤和血管畸形(11.53%)、前庭病变(3.85%)和未发生严重病理的患者(23.08%)。他们大多是单纯的耳聋或耳鸣患者。结论:在临床实践中,有一些患者的听力缺陷只能通过HFA才能检测出来。HFA明确了听力障碍的诊断,并可导致发现可能危及生命的疾病,如耳部肿瘤和血管畸形。关键词高频测听;听力损失;耳鸣
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The benefit of high-frequency audiometry – a retrospective study
Summary Introduction: High-frequency audiometry is not usually carried out during routine hearing examinations. It is a frequently used method at the ENT Clinic of the University Hospital Motol (especially in patients being treated for tumours of the pontocerebellar angle), although the exact indicative criteria for this have not been determined. We aimed to characterize a group of patients, using a method which improved the accuracy of the diagnostics. Material and methodology: We analysed 1,515 audiograms retrospectively. These audiograms were performed by using audiometer MADSEN Astera of GN Otometrics during 2011–2018 in 773 adults, aged 16–80 (47.79 ±13.54). They all underwent high-frequency audiometry comprising of all commonly examined frequencies up to 8 kHz, and also at higher frequencies of – 9 kHz, 10 kHz, 11.2 kHz, 12.5 kHz, 14 kHz a 16 kHz. The indication was very diverse – subjective hypacusis/hyperacusis, tinnitus, vestibulopathy, acutrauma, or an already known diagnosis of a pontocerebellar tumour. Results: We identifi ed a clinically signifi cant asymmetry or pathological elevation of the hearing threshold, which was only detectable at frequencies above 8 kHz in 52 patients (6.73%). This group consisted of patients with vestibular schwannoma (48.08%), other tumours and vascular malformations of the temporal region (11.53%), vestibulopathy (3.85%), and patients that had never developed a serious pathology (23.08%). They were mostly patients with straightforward hypacusis or tinnitus. Conclusion: In clinical practice, there are cases of patients with a hearing defect that can only be detected when HFA is performed. HFA clarifi es the diagnosis of hearing disorders and can lead to the detection of potentially life-threatening conditions such as tumours and vascular malformations of the otological area. Key words high-frequency audiometry – hearing loss – tinnitus
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