| ObjectiveObstructive sleep apnea hypopnea syndrome(OSAHS) is a common disorder of sleep breathing with recurrently complete or incomplete collapse of upper airway obstruction during performance, and can also cause sleep apnea pause and hypoventilation, pushing the body into long period of hypoxia and hypercapnia state. Long-term chronic hypoxia and intermittent episodes of hypoxemia of OSAHS will damage organs need large metabolism and high oxygen demand. Because of the anatomy of auditory system is special, it could be very sensitive to hypoxic injury and susceptible to chronic hypoxia. This study was designed to investigate hearing characteristics of OSAHS patients by middle ear analysis, pure tone audiometry testing, distortion product otoacoustic emission(DPOAE) and auditory brainstem responses(ABR).Our research also made extensions of different stimuli rates ABR examination, and analyzed the correlation between oxygen parameter in polysomnography(PSG). To assessment the values of extended period change indicators in high stimulation rate ABR in OSAHS patients. MethodComparing observing indexes of middle ear analyzing, pure tone audiometry testing, distortion product otoacoustic emission(DPOAE) and auditory brainstem response(ABR) at different stimulate rate of 11.1, 31.1, 51.1 / s which are collected from the 38(78 ears) patients with moderate to severe sleep apnea hypopnea syndrome(OSAHS) treated in the Otorhinolaryngology Head and Neck Surgery Sleep Center and normal control group made of 34 cases(68 ears). Analyzing the correlation between the statistically significant results of high stimulation rate ABR and the indexes of polysonography apnea hypopnea such as the lowest oxygen saturation, mean oxygen saturation, the percentage of the total time of oxygen saturation ? 90% monitoring and the percentage of the total time of oxygen saturation ?80% monitoring. Results1. Results of pure tone audiometry test:The threshold value of OSAHS group in frequencies of 4kHz, 8kHz were higher than that in the control group. The differences were statistically significant(P <0.05).2. Results of DPOAE: The amplitude of OSAHS group in frequencies of 0.75 kHz, 1kHz, 1.5kHz, 2kHz, 3kHz, 4kHz, 6kHz, 8kHz frequency points were lower than that in the control group. The differences were statistically significant(P <0.05).3. Results of different stimulate rate ABR :At the rate of 11.1/s,wave latencies of ?,interpeak latencies in ?~?and ?~?in OSAHS patients were prolonger than those in the control group.At the rate of 31.1/s, wave latencies of ?and?, interpeak latencies in ?~? and ?~? in OSAHS patients were prolonger than those in the control group.At the rate of 51.1/s, wave latencies of ?and?, interpeak latencies in ?~?in OSAHS patients are prolonger than those in the control group.When the stimulation rate increased from 11.1/s to 31.1/s,? wave latency ??in OSAHS group prolonged more than control group. And stimulation rate increased from 11.1/s to 51.1/s, OSAHS group?wave latency ?? also prolonged more. All above differences were statistically significant(P <0.05).4.correlation between high stimulation rate ABR and polysonography apnea hypopnea indexes: ??31.1-11.1 has negative correlation with LSaO2, and has positive correlation with SIT90 and SIT80.??51.1-11.1 has negative correlation with LSaO2, MSaO2,and has positive correlation with SIT90 and SIT80.The correlation is statistically significant(P <0.05). ConclusionModerate to severe OSAHS patients had a high frequency hearing lose that always above 4000 Hz. High frequency pure tone hearing tests can help diagnose it. Cochlear dysfunction also can be check out in OSAHS patients. high stimulation rate ABR can help analyzing the cochlea and auditory nerve damage near the cochlea paragraph. The test results had relationship with blood oxygen saturation and duration of hypoxia. |
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