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Objective Thresholds for auditory brain stem responses (ABRs) to tone burst and tone burst in notched noises of two different intensities were tested in adults with sensorineural hearing loss.The relationship between ABR and puretone thresholds was analyzed to identify an acoustic stimuli with better frequency-specificity.Methods Thirty-eight adults with sensorineural hearing loss (totally 45 ears) were included in the study.Tone burst used to elicit ABRs had 2.5 cycles on the rise and fall and no plateau.Notched noises of two different intensities were used to mask tone burst ipsilaterally when recording ABRs.Those two kinds of notched noises were 25 dB (intensity A) and 15 dB (intensity B) lower than tone burst in intensity respectively.Tone burst ABRs without masking were named tb-ABR,while tone burst ABRs in notched noises of intensity A and B named as amtb-ABR and bmtb-ABR.Thresholds for tb ABR,amtb ABR and bmtb-ABR were tested and analyzed.Results The regression coefficients between puretone thresholds and thresholds for tb-ABR,amtb-ABR and bmtb-ABR of all frequencies were greater than 0.8.The mean differences between ABR and puretone thresholds were all less than 10 dB.Tb-ABR thresholds the were the closest to puretone thresholds at 500 Hz,while bmtb ABR thresholds were the closest at the other three frequencies.Bmtb-ABR thresholds were more close to puretone thresholds in patients with steeply sloping hearing loss.Conclusion Thresholds for all those three ABRs could be used to predict puretone thresholds.In most condition,tb-ABR thresholds were able to estimate puretone thresholds.In some condition,different stimuli could be chosen to elicit ABR at different frequencies.It was reasonable to choose bmtb -ABR for puretone thresholds estimation in patients with steeply sloping hearing loss.
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Objective To investigate the constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons. Methods Data of gastroscopy center during August 2015 to July 2016 were analyzed. A total of 603 patients were diagnosed as primary bile reflux gastritis. After gastroscopy, the standardized constitution in Chinese medicine questionnaire was used to evaluation the scores of all kinds of constitutional types. The Constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons were analyzed. Results Among all seasons, the positive detection rate showed significant difference (χ2=13.041, P=0.005), and summer group showed the highest among the four seasons (23.38% vs. 17.63%,χ2=12.414, P<0.001). Among all seasons, constitutional types of Chinese medicine of primary bile reflux gastritis had significant difference (χ2=37.441, P<0.001). Damp-heated type had significant difference among seasons (χ2=8.472, P=0.037), especially during the summer (χ2=5.847, P=0.016). Conclusions The summer may have more primary bile reflux gastritis chance to be diagnosed as primary bile reflux gastritis. Yang-deficiency type, Gentleness type, Qi-deficiency type and damp-heat type were more common in primary bile reflux gastritis patients.
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Objective To compare the results of TEOAE and DPOAE in the same population of normal newborns, to provide information on choosing appropriate screening tools.Methods A two-steps protocol was taken with the first screening during the first 48 to 72 hours of birth and rescreened from one to two months old if the newborns failed the first screening.For each step of screening, TEOAE and DPOAE were performed simultaneously using AccuScreen hearing screening instrument (Madsen-GN Otometrics, Taastrup, Denmark).A total of 1 062 normal newborns (F/M=508/554) delivered in Peking Union Medical College Hospital were enrolled in this research for the first screening.Infants who failed either TEOAE or DPOAE screening in the first screening were referred to a second screening.Among them, 135 performed both DPOAE and TEOAE in the second step.The newborns who failed the second screening would receive ABR when they were 3 months old.Results In the first screening,the failure rate for TEOAE was 11.0% (117/1 062) and 13.7% (145/1 062) for DPOAE.In the second screening step, the failure rates were 17.8% (24/135) and 20.7% (28/135) for TEOAE and DPOAE, respectively.Chi-square and Fisher's test showed that the failure rates of DPOAE were significant higher than TEOAE for both steps (P<0.001).The agreements between TEOAE and DPOAE were 96.0% and 95.6% for the first and second steps respectively, and the kappa values were 0.817 and 0.857.As to the average time taken to accomplish the screening for one ear, TEOAE was 24±25 s and DPOAE was 40±34 s during the first screening;in the rescreening, TEOAE was 52±41 s and DPOAE was 73±62 s.Paired-t tests showed that the differences between DPOAE and TEOAE testing time were statistically significant (P=0.000) in both screening steps.Finally, 7 newborns (10 ears) were diagnosed conductive hearing loss(except 1 ear was sensorineural hearing loss).Conclusion As a screening tool, TEOAE got lower refer rates and took less time than DPOAE implicating TEOAE a better screening tool for normal neonates.
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Objective To study the false negative results of Gelle test .Methods Hearing test data between August 2013 to July 2014 were retrieved from outpatient records with hearing complaints of tinnitus or hearing loss . Recruiting criteria:no history of otitis media ,normal tympanic membrane ,no radiologic manifestations of lesions in middle ear and mastoid and abiltly of clear expression of changes of hearing .A total of 60 patients(120 ears ) were tested with conventional pure tone audiometry (PTA) and Gelle test .Acoustic immittance and distortion product otoacoustic emission (DPOAE) were tested in 110 and 113 ears ,respectively .Results Among 120 ears ,7 were di‐agnosed as conductive hearing loss ,23 as mixed hearing loss ,52 as sensorineural hearing loss ,and 38 as normal hearing by pure tone audiometry .The negative Gelle test results were detected in 5 ,11 ,16 and 3 ears ,respective‐ly .110 ears were tested with tympanometry ,types A ,B and C tympanograms were found in 102 ears ,2 ears and 6 ears ,respectively ,and the negative Gelle test results were 22 ,2 and 4 ,respectively .DPOAEs were recordable in 56 ears and negative in 57 ears ,and negative Gelle tests were recorded in 12 and 17 ears respectively .Conclusion False-negative results were found in all types of PTA ,tympanometry and DPOAE .It indicates that Gelle test might not be sensitive and accurate enough to evaluate the integrity and mobility of ossicular chain .Gelle test com‐bined with PTA and DPOAE may be better for assessment of hearing loss and entity of ossicular chain .
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Objective To compare the accuracy of auditory brain stem response (ABR) thresholds to tone burst and tone burst ipsilaterally masked by notched noise in estimating puretone thresholds of adults with normal hearing.To study characteristics of ABRs evoked by tone burst and tone burst in notched noise of two different intensities.These three kinds of ABRs were named as follows:tb-ABR,amtb-ABR and bmtb-ABR.Methods Puretone audiometry,ABRs to tone burst and tone burst ipsilaterally masked by notched noise of different intensities were tested in 20 adults (totally 40 ears) with normal hearing.Results ①Thresholds for tb-ABR,amtb-ABR and broth-ABR of each frequency all approximated each other,and there were no statistically significant differences between them.②The mean differences between puretone thresholds and thresholds for tb-ABR,amtb -ABR and bmtb-ABR of each frequency were all less than 15 dB.Those mean differences of different ABRs of the same frequency were approximate to each other and had no statistically differences.③No matter what kind of ABR was tested,the latencies of wave V shortened with increase of frequency in each ABR at the same intensity.When the intensity and frequency of the tone burst were the same,the latency of wave V of tb-ABR was always statistically shorter than that of amtb-ABR.The latter was also always statistically shorter than that of bmtb-ABR.Conclusion Thresholds for ABRs to tone burst and tone burst ipsilaterally masked by notched noise were useful in predicting puretone thresholds.
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OBJECTIVE@#To analyses the clinical characteristics of 28 chronic rhino-sinusitis patients only characterized olfactory disorders.@*METHOD@#Twenty-eight patients who have only olfactory disorder were diagnosed chronic rhino-sinusitis, among which 16 patients accepted intranasal budesonide for 15 days. All patients accepted CT scan, T&T test and olfactory event-related potentials test before and after treatment.@*RESULT@#(1) No difference was found between 21 patients ( 12 months) (P > 0.05), significant difference was found between maxillary sinus,ethmoid sinus and frontal sinus, sphenoid sinus in CT scan (P < 0.01). (2) Olfactory function improves after treatment (P < 0.01). Significant difference is found between 12 patients ( < or =12 months) and 4 patients (P < 0.01).@*CONCLUSION@#(1) Chronic rhino-sinusitis patients who have only olfactory disorder were found; (2) Intranasal budesonide treatment could improve olfactory functions of chronic rhino-sinusitis' patients.
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Adult , Aged , Female , Humans , Male , Middle Aged , Budesonide , Therapeutic Uses , Chronic Disease , Olfaction Disorders , Diagnosis , Drug Therapy , Olfactory Mucosa , Sinusitis , Diagnosis , Drug TherapyABSTRACT
Objective To study the characteristic of acoustically short latency negative response (ASNR) in auditory brainstem response (ABR) evoked by tone burst in children with hearing loss. Methods ABRs to click and tone burst were recorded from 0～6 years old children with hearing loss using SmartEP auditory evoked potential system. The threshold and latency was analyzed if ASNR was recorded. Results Among all the 80 ears tested, ASNR were recorded in 7 ears (8.75%) when using click, and in 40 ears (50%) when using tone burst. ASNR was most frequently evoked by 1 kHz tone burst (in 37 ears), and 2 kHz (in 25 ears) was the second. Among the ears with ASNR, the lowest threshold of ABR wave V was 65 dB nHL. The lowest threshold of ASNR was 80dB nHL. The latencies of ASNR for 0.5,1,2 and 4 kHz tone burst was 6～8, 5～7,3～5 and 3～4 ms, respectively. The latency decreased along with the increase of intensity. Conclusion ASNR can be recorded while recording tone-burst ABR, but it has no effect in predicting hearing level using the wave V threshold of tone-burst ABR.
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OBJECTIVE To study the characteristic of auditory brain stem responses (ABRs) to air-and bone-conducted tone pip recorded in adults with normal hearing, to access the feasibility of estimating pure tone behavioral thresholds using tone-pip evoked ABR and to examine the effects of bone-conducted ABR to tone pips on differentiating the type of hearing loss. METHODS Air-and bone-conducted ABR to tone pips were recorded from otologically normal persons (n=20, male/female 10/10) using Smart EP auditory evoked potential system. RESULTS ABR thresholds to air-conducted tone pips were (24.8?7.3) , (16.1?6.5) , (13.5?5.5) , (11.9?5.8) dB nHL for 0.5, 1, 2 and 4 kHz, and were (9.5?9.3) , (13.4? 6.6) , (12.2?6.0) , (12.2?7.2) dB higher than the pure tone behavior thresholds respectively; The ABR thresholds to bone-conducted tone pips were (28.4?9.2) , (19.0?7.4) , (15.1?7.7) , (13.6?6.4) dB nHL for 0.5, 1, 2 and 4 kHz, and were (32.0?10.3) , (19.4?10.0) , (14.2?8.2) , (16.1 ?6.9) dB higher than the pure tone behavioral thresholds respectively. There were no statistically significant differences between the ABR thresholds to AC and BC tone pips. The wave forms of tone-evoked ABR were similar to those of click-evoked ABR. The detectability of Wave Ⅰ and Wave Ⅲ decreased with the decrease of tone pip frequency. The wave latencies of tone-pipevoked ABR were longer than those of click-evoked ABR, and they prolonged with the decrease of tone pip frequency. The Wave Ⅴ latency of ABR to BC 0.5 and 1 kHz tone pips at thresholds were longer compared that to AC. CONCLUSION The thresholds of tone-pip evokedABR were useful in estimating the pure tone behavioral threshold and bone-conducted tone-evoked ABR might be helpful in differentiating the type of hearing loss.