隐性听力损失的发病机制及听力学表现 - 中华耳科学杂志.PDF

·185 · 中华耳科学杂志2017 年第15卷第2 期 ·临床研究 · 隐性听力损失的发病机制及听力学表现 1，2 1 2 李国庆 吕萍 王秋菊 1 川北医学院附属医院耳鼻咽喉科(南充 637000) 2 解放军总医院耳鼻咽喉头颈外科耳鼻咽喉研究所（北京 100853） 【摘要】隐性听力损失是一种症状十分隐匿的阈上听觉感知功能缺陷，仅表现为噪声环境中言语识别率下降， 临床上常规听力阈值检查无法发现，因此往往未引起重视。本文着重从耳蜗传入通路三个重要环节（包括内毛细 胞、内毛细胞与螺旋神经节之间的突触和突触后传入通路）的障碍，耳蜗谷氨酸-谷氨酰胺循环障碍和耳蜗传出系 统（包括外侧橄榄耳蜗束与耳蜗传入突触复合体形成的第三突触和内侧橄榄耳蜗束）的障碍来阐述隐性听力损失 的发病机制和主客观听力学表现，从而为临床早期诊断隐性听力损失提供可靠的参考依据,并为隐性听力损失的 早期干预提供理论和实验依据。 【关键词】隐性听力损失；谷氨酸-谷氨酰胺循环；耳蜗传入突触复合体 【中图分类号】R764 【文献标识码】A 【文章编号】1672-2922 （2017 ）02-185-6 Pathogenesis and audiologic performances in hidden hearing loss 1 1 2 LI Guoqing , LV Ping , WANG Qiuju 1 Department of Otolaryngology, North Sichuan Medical College Affiliated Hospital, Nan chong 637000 2 Department of Otolaryngology ，Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing 100853 Corresponding author:WANG Qiuju Email: wqcr@263.net 【Abstract 】Hidden hearing loss is a suprathreshold auditory perceptual deficits which only manifests as deteriorat- ing speech recognition in noise, and is usually not identified by routine clinical hearing threshold tests and thus often un- detected. This article describes the pathogenesis and auditory performance in hidden hearing loss, focusing on impair- ment of three important parts of the cochlear afferent pathway, i.e. synapses between outer and inner hair cells and spiral ganglion cells and postsynaptic afferent pa