老年人听力障碍筛查量表结合畸变产物耳声发射诊断早期老年性聋

Hearing Handicap Inventory for the Elderly combined with Distortion Product Otoacoustic Emission testing in early diagnosis of presbycusis

摘要:

目的 研究老年人听力障碍筛查量表（HHIE）与畸变产物耳声发射（DPOAE）联合应用在早期老年性聋诊断中的作用。方法 对2013年5月至2014年10月在解放军总医院海南分院就诊的95例（男51例，女44例）年龄＞65周岁，听力下降＞1年的双耳感音神经性听力下降患者行纯音测听、声阻抗测试、DPOAE检查并填写HHIE。结果 11例纯音测听为轻度听力损失的患者HHIE平均为（30.1±5.0）分，其中1例≥43分，为重度听力障碍，占9.1%（1/11），DPOAE检出率81.8%，阈值（61.3±7.0）dB SPL；23例纯音测听为中度听力损失的患者HHIE平均为（35.6±4.0）分，其中3例≥43分，为重度听力障碍，占13.0%（3/23），DPOAE 检出率78.3%，阈值（68.3±5.0）dB SPL；34例纯音测听为中重度听力损失的患者HHIE平均为（39.3±6.0）分，其中12例≥43分，为重度听力障碍，占35.3%（12/34），DPOAE检出率52.9%，阈值（71.3±5.0）dB SPL；18例纯音测听为重度听力损失的患者HHIE平均（61.7±2.0）分，均为重度听力障碍，DPOAE检出率11.1%，阈值（80.4±3.0）dB SPL；9例纯音测听为极重度听力损失的患者HHIE平均（89.7±5.0）分，均为重度听力障碍，DPOAE检出率0.0%。结论 纯音测听不能全面真实反映老年性聋患者的听力障碍程度，HHIE结合DPOAE对诊断早期老年性聋具有重要意义。

Abstract:

Objective To determine the value of the Hearing Handicap Inventory for the Elderly (HHIE)-screening version and the Distortion Product Otoacoustic Emissions testing (DPOAE) in the diagnosis of early presbycusis. Methods Ninety-five elderly patients (51 males and 44 females, over 65 years old, with hearing loss for more than 1 year because of sensorineural hearing loss) admitted in the Hainan Branch of Chinese PLA General Hospital from May 2013 to October 2014 were enrolled in this study. The cohort underwent pure tone audiometry, acoustic impedance tests, DPOAE testing and was surveyed with hearing screening scale HHIE. Results For the 11 patients diagnosed as mild hearing loss by pure tone audiometry, their HHIE scored an average of (30.1±5.0) points, including 1 case ≥43 points [as severe hearing impairment, accounting for 9.1% (1/11)], and the detection rate of DPOAE was 81.8%, with a threshold of (61.3±7.0) dB SPL. For the 23 patients of moderate hearing loss by pure tone audiometry, their HHIE scores were averagely (35.6±4.0) points, including 3 cases ≥43 points [as severe hearing impairment, accounting for 13.0% (3/23)], and the detection rate of DPOAE was 78.3%, with a threshold of (68.3±5.0) dB SPL. For the 34 cases of moderately severe hearing loss by pure tone audiometry, their HHIE scored an average of (39.3±6.0) points, and 12 cases of them had ≥43 points [as severe hearing impairment, accounting for 35.3% (12/34)], and their DPOAE detection rate was 52.9% with a threshold of (71.3±5.0) dB SPL. For the 18 cases of severe hearing loss by pure tone audiometry, their HHIE scored an average of (61.7±2.0) points, all of them were severe hearing impairment, and the DPOAE detection rate was 11.1% with a threshold of (80.4±3.0) dB SPL. For the 9 cases of extremely severe hearing loss by pure tone audiometry, their HHIE scores were (89.7±5.0) points in average, all of them were severe hearing impairment, and the DPOAE detection rate was 0.0%. Conclusion Pure tone audiometry can not fully reflect the degree of hearing impairment in patients with senile deafness. HHIE screening combined with DPOAE testing is of great significance in the early diagnosis of presbycusis.