Objective This paper is to explore the relationship between the placement of the bone oscillator and bone-conducted thresholds to ASSR stimuli in adults with normal hearing and to investigate the amplitude and the threshold differences to bone-conducted auditory steady-state responses (BC-ASSR) stimuli between single - and multiple-stimulus conditions. Methods Two groups of subjects were selected with 0. 5, 1, 2 and 4 kHz brief tones repeated at the rate of 77, 87, 93 and 101 Hz using a B-71 bone oscillator either in single- or multiple ted no significant differences between mastoid and behind-the-ear placements. The mean and standard deviations of bone-conducted behavioral thresholds to ASSR stimuli at 0.5, 1, 2 and 4 kHz were 62.6±4.8,47.1±4.8,46.8cant difference between the two conditions while the mean and standard deviations of BC-ASSR thresholds at 0.5, 1, 2 and 4 kHz were 96.7±9.7,70.3±11.6,60.6±7.4,52.8±7.2 dB re: 1μN (ppe), respectively. Conclusion The behavioral bone-conducted thresholds to ASSR stimuli with mastoid and behind-the-ear placemen yielded no significant differences. When the stimuli intensity was 50 dB nHL, the amplitudes in single-stimulus condition were significantly higher than those to multiple-stimulus condition. There were no significant differences for BC-ASSR thresholds between single- and multiple-stimulus condition.

Objective To explore artifactual responses of auditory steady-state reponses (ASSRs) to bone-conduction stimuli.Methods The present study involved a group of subjects,aged between 5 to 39 months,with bilateral profound sensorineural hearing losse.Recorded were the reponses to multiple bone-conducted 0.5,1,2,4 kHz tone pips repeated at the rates of 77～101 Hz.All the subjects were sedated by Hydrate Chloride during the testing.Results Artifactual ASSRs were seen at 115 and 100.5 dB (re:1?N) (The above levels are equivalent to around 60 dB HL) at 1 and 4 kHz.No artifactual responses were recorded at 0.5 and 2 kHz stimuli at the maximum output level.Conclusion Bone-conducted hearing loss greater than moderate can not be tested reliablely due to artifactual responses and lower maximum output level than that of air conduction.

Objective To explore some characters of auditory steady-state responses (ASSR) to multiple simultaneous stimuli in a sample of normal-hearing adults.Methods The ASSR to multiple simultaneous stimuli were recorded in a sample of 32 normal-hearing adults (64 ears). Simultaneous carrier tones (0.5, 1, 2 and 4 kHz), modulated in amplitude at different rate of 77, 85,93, 101 Hz for left ear and 79, 87, 95, 103 Hz for right ear, were presented binaurally by the insert phones. For each subject the response thresholds (RTHs) at 0.5, 1, 2 and 4 kHz were determined automatically and compared with the corresponding behavioral thresholds (BTHs).Results ①In the normal-hearing adults, RTHs were on average between 7～19 dB above the BTHs.②2-way repeated measures ANOVA (ear?carrier frequencies) showed significant main effect between carrier frequencies on RTH ( F =31.254; ? 3,179; P =0.000). Post Hoc analysis indicated that this effect was due to the highest threshold found at 0.5 kHz. The test showed no significant difference of threshold between left ear and right ear ( F =1.942; ? 1,179; P =0.165). ③Taking 60 dB SPL as analysis level, 2-way repeated measures ANOVA (gender?carrier frequencies) revealed significant difference of amplitude between male and female( F =16.490; ? 1,175; P =0.000); and difference of amplitude between carrier frequencies ( F =2.948; ?3, 175; P =0.034).④The average testing time was 61 minutes for male and 69 minutes for female. Independent t-test showed statistical significance within sex.⑤Two- way ANOVA (state?frequency)showed that background EEG noise were significantly higher in awake than that in sleep ( F =152.511; P =0.000). There were no appreciable significance in background noise among frequencies. Conclusion The ASSR to multiple simultaneous stimuli was proven to be a frequency specific, objective and valid technique for threshold estimation at least for normal-hearing adults. Issues concern ing clinical use were discussed.

OBJECTIVE: The purpose of the present study was to investigate the prevalence of hearing loss by studying the current status of hearing loss, risk factors of hearing loss, exposure level of noise, and everyday habit of hearing in a group of university students, so as to provide information for hearing loss prevention in university students. METHOD: According to the purposive sampling method, 642 freshmen students participated in the study. Pure tone audiometry, and exposure level of noise scale were performed in all participants. RESULT: (1) According to the hearing loss criterion of WHO/PDH97.3, high frequency hearing loss, and noise induced threshold shifts, the hearing loss prevalence was 0.36%, 20.91% and 6.73%, respectively. (2) Multivariant Logistic regression analysis of high-frequency hearing loss indicated that traffic noise exposure and ear infection were risk factor of high frequency hearing loss. CONCLUSION There is a high prevalence of high frequency hearing loss in university students (20.91%), which was high related with traffic noise exposure and ear infection.
Audiometry, Pure-Tone ; Cross-Sectional Studies ; Hearing Loss, High-Frequency ; epidemiology ; Humans ; Noise ; adverse effects ; Prevalence ; Risk Factors ; Students ; Universities

To improve the effect of teaching practice of blood cell morphology,typical cases of peripheral blood erythrocyte,granulocyte and platelet were chosen,case show and problem-based teaching way were applied to encourage students to find information of autonomous learning.Then teacher organized the class discussion,and the information was analyzed and summarized.In the implementation of the case teaching,we should pay attention to improving students' learning initiative.At the same time,teachers need to have knowledge,comprehensive ability and ability in organization and leadership,to promote students' active participation in discussion in the teaching,pay attention to the information feedback,and improve the teaching details

OBJECTIVE: To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan. METHOD: One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. RESULT: In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. CONCLUSION A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.
Acoustic Impedance Tests ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Otitis Media with Effusion ; diagnosis ; Sensitivity and Specificity

Objective To compare the performance of Mandarin screening version of hearing handicap inven-tory in elderly (HHIE-S)and the single question of hearing loss in the hearing screening in the old adults.Methods A total of 570 participants,aged from 50~85 years,of native Mandarin speakers were tested with standard pure tone audiometry (PTA),HHIE-S and single questionAre you now having difficulty in hearing?.HHIE-S>8 was taken as an indicator of hearing handicap.Sensitivity,specificity,negative predictive values and positive predic-tive values of both HHIE-S and single question inquiry when 0.5~4 kHz PTA average > 25 dB,>40 dB and >60 dB were compared.Results The prevalence was 83.9% (478)measured by PTA.The prevalence was 55.3%and 52.5% for HHIE-S and positive answer for single question,respectively.The sensitivity of HHIE-S when the participants grouped with 0.5~4 kHz PTA average > 25 dB,>40 dB and > 60 dB was 61%,85% and 96%, respectively,whereas the sensitivity of single question of the above 3 conditions was 58%,81% and 100%,respec-tively.The specificity of HHIE-S decreased with greater hearing loss.It was 72%,88% and 47% respectively for HHIE-S and 75%,61% and 50% for the single question.There was no significant difference either for sensitivity and specificity between the HHIE-S and the single question.Conclusion Both the Mandarin version of HHIE-S and single question are effective in the hearing screening of old adults.Depending on the purpose and availability of resources,one or both of them can be adopted.

OBJECTIVE The aim was to explore the clinical experiences and access the auditory performance and speech intelligibility of cochlear implantation in patients with inner ear malformations. METHODS Among 700 patients who received multi-channel cochlear implantation from 1997 to 2007 in Beijing Tongren Hospital, 108 patients were diagnosed with malformed inner ear. A retrospective study was performed about the surgical characteristics and the mapping characteristics after implantation. The long term follow-up of the rehabilitative efficacy will also be presented. RESULTS ①All patients restituted auditory after operation. ②After the regular rehabilitation, the long term follow-up of the auditory performance and speech intelligibility were very positive. Everyone has shown improved listening and communication skills evaluated by Categories of Auditory Performance and Speech Intelligibility Rating. ③Most of the children are studying or working and are actively involved in their local communities. CONCLUSION The cochlear implantation can be performed safely in patients with malformed inner ear. The results suggest that cochlear implantation could also provides long-term benefits to those malformed inner ear cases.

OBJECTIVE: In order to extend the knowledge of auditory neuropathy spectrum disorder (ANSD), the clinical data of a group of infants and young children with this disorder was reported. METHOD: This retrospective study involved 84 cases (151 ears). The subjects aged from 2 months to 6 years old. Descriptive analysis was carried out on case history, audiological and imaging results and the outcome of cochlear implantation. RESULT: There were a variety of case history, including 11 of hyperbilirubinemia, 2 of family history of deafness, 3 of hypoxia, 1 of prematurity, 1 of nuclei basales pathology, 2 of congenital atelencephalia,and 13 of cochlear nerve deficiency (CND). The audiological results varied too. Click ABR ranged from no response at the maximum output level to Wave V thresholds as low as 70 dB nHL. Behavioral thresholds were mild in 1, moderate in 2 and profound in 20. The inner ear MRI were normal in 16 cases, CND in 12 and CND accompanied by periventricular leukomalacia in 1. 5 cases were implanted in the affected ear. The results in 3 were comparable with that of cochlear loss, 1 were less effective than that of cochlear loss, 1 became none user of the device. CONCLUSION ANSD is a heterogeneous group with a wide variety on case history, audiological and imaging results and the outcome of cochlear implant. Therefore, comprehensive clinical examinations are necessary so that individualized intervention program can be made.
Audiometry, Pure-Tone ; Auditory Threshold ; Child ; Child, Preschool ; Cochlear Implantation ; Female ; Hearing Loss, Central ; pathology ; physiopathology ; therapy ; Humans ; Infant ; Male ; Retrospective Studies

OBJECTIVETo explore the law of wide band tympanometry energy reflectance (WBTER) in Chinese infants of Han nationality with normal outer and middle ears, and to provide the normal values for the clinical application of WBTER.

METHODSNinety four infants (170 ears) of Han nationality with normal outer and middle ears evidenced by temporal bone CT, and 226 Hz and 1 000 Hz tympanometry at the ages between three and 48 months (median age: 14 months) were selected and divided into four groups: 3-6 months (32 ears), 7-12 months (53 ears), 13-24 months (46 ears) and 25-48 months (39 ears). WBTER was conducted on these infants, and the basic law of energy reflectance under different frequencies, as well as the influence of age on energy reflectance were analyzed using SPSS 15.0.

RESULTSThe normal value of energy reflectance was higher at low frequency, gradually decreased with the increase of frequency, reached the minimum near 4 000 Hz , followed by constantly increased till 8 000 Hz. In the scope of frequency below 1 000 Hz and above 6 350 Hz, the energy reflectance values of infants in the group of 3-6 months were significantly lower than those of infants in other age groups (P < 0.05). In comparison to the group below six months, the groups over six months generally had higher energy reflectance and lower fluctuation.

CONCLUSIONSThe pattern of energy reflectance across frequency range for Chinese infants and children was consistent with that of other races reported in foreign countries. The WBTER changes with the growing of age, which tends to be stable after the first six months of birth.

Acoustic Impedance Tests ; statistics & numerical data ; Asian Continental Ancestry Group ; Audiometry, Pure-Tone ; Child, Preschool ; Ear, External ; physiology ; Ear, Middle ; physiology ; Female ; Humans ; Infant ; Reference Values