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논문KCI 등재

청신경병증이 아닌 성인의 순음청력검사와 청성지속반응검사의 역치값 불일치

Threshold Mismatches between Pure-Tone Audiometry and Auditory Steady State Response in Non-Auditory Neuropathy Adults

이혜숙|노혜일
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2020.08|대한이비인후과학회지 두경부외과학 (Korean Journal of Otorhinolaryngology-Head and Neck Surgery)|제63권 제8호|pp. 350-357|DOI https://doi.org/10.3342/kjorl-hns.2019.00752

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참고문헌

키워드

Audiometryevoked response ㆍAudiometry
주제분류이비인후과학

초록

Background and Objectives To evaluate mismatches between pure-tone audiometry (PTA)and auditory steady-state response (ASSR) tests in non-auditory neuropathy adults and investigatebrain lesions that may explain the mismatches, especially in cases where the ASSR thresholdwas worse than the estimated PTA threshold. Subjects and Method PTA, speech audiometry, auditory brainstem response, ASSR, andneuroimaging tests were carried out on individuals selected. Among them, medical records of30 subjects (16 males, 14 females; mean age=54.4±13.2 years) with significant mismatches betweenPTA and estimated ASSR thresholds were analyzed retrospectively. All neuroimagingtests were reviewed to identify any neurologic abnormalities. Results Pathologic brain lesions were found in 19 cases (63.3%) in the study group, all of whichshowed significant mismatch in hearing threshold between PTA and ASSR. Seven case of ischemicbrain lesions (23.3%), five tumorous lesions (16.6%), and four brain vessel anomalies (13.3%)were found. Brain hemorrhage due to trauma were found in two cases (6.6%) as well as one case(3.3%) of unruptured aneurysm. Central auditory pathway disorder was suspected in two cases. The 11 cases showing normal results in the imaging studies included one mental retardation, onebrain concussion, and seven cases (23.3%) with no specific causes. Six tinnitus cases includedtwo subjects showing discrepancies between frequency matching in the tinnitogram. Conclusion In adults with a mismatch between PTA thresholds and estimated ASSR thresholds,especially for those with moderate to profound hearing loss, additional neuroimaging testsand other audiologic tests may reveal other possible causes of hearing loss.

Abstract

Background and Objectives To evaluate mismatches between pure-tone audiometry (PTA)and auditory steady-state response (ASSR) tests in non-auditory neuropathy adults and investigatebrain lesions that may explain the mismatches, especially in cases where the ASSR thresholdwas worse than the estimated PTA threshold. Subjects and Method PTA, speech audiometry, auditory brainstem response, ASSR, andneuroimaging tests were carried out on individuals selected. Among them, medical records of30 subjects (16 males, 14 females; mean age=54.4±13.2 years) with significant mismatches betweenPTA and estimated ASSR thresholds were analyzed retrospectively. All neuroimagingtests were reviewed to identify any neurologic abnormalities. Results Pathologic brain lesions were found in 19 cases (63.3%) in the study group, all of whichshowed significant mismatch in hearing threshold between PTA and ASSR. Seven case of ischemicbrain lesions (23.3%), five tumorous lesions (16.6%), and four brain vessel anomalies (13.3%)were found. Brain hemorrhage due to trauma were found in two cases (6.6%) as well as one case(3.3%) of unruptured aneurysm. Central auditory pathway disorder was suspected in two cases. The 11 cases showing normal results in the imaging studies included one mental retardation, onebrain concussion, and seven cases (23.3%) with no specific causes. Six tinnitus cases includedtwo subjects showing discrepancies between frequency matching in the tinnitogram. Conclusion In adults with a mismatch between PTA thresholds and estimated ASSR thresholds,especially for those with moderate to profound hearing loss, additional neuroimaging testsand other audiologic tests may reveal other possible causes of hearing loss.

참고문헌 (21)

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