成年人純音聽力閾值與多頻穩定狀態聽性誘發反應閾值的比較

Comparison of Threshold between Pure Tone and Multi-channel Auditory Steady-state Responses in Adults

前言：由於法律和經濟層面的因素，患者多半會誇大其聽力障礙損失的程度﹔但也有一些患者由於工作上的需要，如警察、老師、職業軍人等反而會假裝其有好的聽力以符合體檢之需要。如何正確又快速的診斷聽力障礙，顯得相當重要。本實驗的研究對象為成人，主要目的在比較純音聽力閾值與多頻穩定狀態聽性誘發反應閾值的關係，以期必要時利用多頻穩定狀態聽性誘發反應檢查來作為成人聽力障礙判定之輔助工具。研究對象與方法：自2003年5月至2004年2月間，共50位成年人，僅限感覺神經性聽力障礙，均接受純音聽力檢查和多穩定狀態聽性誘發反應檢查，測試500Hz、1000Hz、2000Hz、4000Hz等四個常用頻率的閾值，並記錄檢查時間，比較兩種聽力閾值。結果：多頻穩定狀態聽性請發反應閾值與純音聽力閾值兩者差15分貝者佔71.3%；兩者差小於20分貝佔83.1%。相關係數在500Hz、1000Hz、2000Hz、4000Hz下，依次為0.90，0.94,0.95,0.97。每人測試多頻穩定狀態聽性誘發反應原時間平均為41分鍾。結論：多頻穩定狀態聽性誘發反應，為臨床上聽障鑑定，有力且方便的客觀性電生理聽力檢查。

An accurate and rapid objective assessment of hearing thresholds is essential in the evaluation of pseudohypacusis. This study was to compare the differences between hearing thresholds measured by multi-channel auditory steady-state response (multi-channel ASSR) and pure tone audiometry. Fifty adults with varied degree of sensorineural hearing loss, including 2lmales and 29 females, participated in the study. The behavioral audiograms and multi-channel auditory steady-state responses ere performed at carrier frequencies of 500, 1000, 2000 and 4000 Hz for each ear. Behavioral pure tone thresholds and auditory steady-state response thresholds were compared. The correlation coefficients (r) are 0.90, 0.94, 0.95, 0.97 at 500, 1000, 2000 and 4000Hz. respectively. The difference between thresholds of multi-channel ASSR and pure tone vas less than 15 dB in 71.3% of measurements; less than 20 dB in 83.1%. Multi-channel auditory steady-state responses are useful to predict behavioral hearing thresholds in each frequency. It is convenient to certificate hearing thresholds in pseudohypacusis.