【摘要】：目的分析Gelle(蓋萊)試驗(yàn)假陰性的原因。方法 2013年8月~2014年7月間因耳聾或耳鳴就診的60例(120耳)患者行純音聽(tīng)閾(PTA)、聲導(dǎo)抗、畸變產(chǎn)物耳聲發(fā)射(DPOAE)測(cè)試和Gelle試驗(yàn),根據(jù)Gelle試驗(yàn)為陰性、但純音測(cè)聽(tīng)顯示為感音神經(jīng)性聾或聽(tīng)閾正常則初步判定為Gelle試驗(yàn)"假陰性";分析Gelle試驗(yàn)陰性耳中假陰性耳數(shù)及可能原因。結(jié)果 60例(120耳)純音測(cè)聽(tīng)顯示:7耳為傳導(dǎo)性聾,23耳為混合性聾,52耳為感音神經(jīng)性聾,38耳純音聽(tīng)閾正常,這4類(lèi)純音測(cè)聽(tīng)結(jié)果相對(duì)應(yīng)的Gelle試驗(yàn)陰性耳分別為5、11、16、3耳,其中19耳判定為"假陰性"(3耳純音聽(tīng)閾正常,16耳為感音神經(jīng)性聾)。110耳同時(shí)進(jìn)行了聲導(dǎo)抗測(cè)試,鼓室圖為A、B及C型者分別為102、2、6耳,這三類(lèi)鼓室導(dǎo)抗圖者Gelle試驗(yàn)陰性者分別為22、2、4耳(其中假陰性分別為A型12耳,As型2耳,Ad型1耳,C型2耳);113耳同時(shí)進(jìn)行了DPOAE測(cè)試,56耳可引出,57耳未引出,Gelle試驗(yàn)陰性者DPOAE引出和未引出分別為12、17耳(其中假陰性分別為DPOAE引出10耳、未引出8耳)。結(jié)論各種類(lèi)型的聽(tīng)力損失患者中均存在Gelle試驗(yàn)陰性者,但部分受試者可能為Gelle試驗(yàn)假陰性。在診斷聽(tīng)骨鏈異常時(shí),Gelle試驗(yàn)檢查只能作為輔助檢查手段,須結(jié)合病史、純音測(cè)聽(tīng)、聲導(dǎo)抗、DPOAE等檢查綜合判斷。
[Abstract]:Objective to analyze the causes of false negative Gelle test. Methods from August 2013 to July 2014, 60 patients (120 ears) with deafness or tinnitus underwent pure tone threshold (PTA), acoustic impedance test, distortion product otoacoustic emission (DPOAE) test and Gelle test. According to Gelle test, 60 patients (120 ears) were negative. But if pure tone audiometry showed sensorineural hearing loss or normal hearing threshold, it was preliminarily determined as "false negative" by Gelle test, and the number of false negative ears in negative ears of Gelle test and the possible causes were analyzed. Results the pure tone audiometry of 60 cases (120 ears) showed that 23 ears were conductive deafness and 23 ears were mixed deafness, 52 ears were sensorineural deafness and 38 ears had normal pure tone hearing threshold. The negative ears of Gelle test corresponding to the four kinds of pure tone audiometry were 5111,163 ears, respectively. Among them, 19 ears were diagnosed as "false negative" (3 ears with normal pure tone hearing threshold and 16 ears with sensorineural hearing loss) .110 ears were tested for acoustic conductance at the same time. These three types of tympanograms were negative for Gelle test in 22 / 22 ears (including false negative for A type 12 ears and as type 2 ears for Ad 1 ear / C type 2 ears), and 56 ears were tested for DPOAE, 57 ears were negative for Gelle test and 57 ears were negative for Gelle test. The DPOAE elicitation and uneliction were 12 and 17 ears, respectively (10 ears were false negative for DPOAE, respectively). No 8 ears). Conclusion Gelle test is negative in all kinds of hearing loss patients, but some of them may be false negative in Gelle test. In the diagnosis of ossicular chain abnormalities, the Gelle test can only be used as an auxiliary examination method. It should be combined with medical history, pure tone audiometry, acoustic conductance and DPOAE, and so on.
【作者單位】： 中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)院耳鼻咽喉科;協(xié)和醫(yī)院轉(zhuǎn)化醫(yī)學(xué)中心;
【基金】：十二五國(guó)家科技支撐計(jì)劃資助項(xiàng)目課題(2012BAI12B00/2012BAI12B01)資助
【分類(lèi)號(hào)】：R764
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本文編號(hào)：2149014