Presbiakuzide, saf ses ve konuşma odyometrisi, otoakustik emisyon, beyin sapı odyometrik incelemelerini kullanarak patolojinin lokalizasyonunun değerlendirilmesi
Özet
The Evaluation of Pathologic Localization By Using Pure Tone Audiometry, Speech Audiometry, Distortion Product Otoacoustic Emission, and Auditory Brain Stem Response in Presbycusis Presbycusis is one of the major diseases in elderly which reduces the communicating activity of older adults and limits the duty of induvidual activity in the society. The pathologic basis of presbycusis is partially understood. The aim of this study is to evaluate the changes of peripheric and central auditory pathways in presbycusis and to localize the pathology by using pure tone audiometry, speech audiometry, Distortion Product Otoacoustic Emission (DPOAE), and Auditory Brain Stem Responses (ABR). In this study, 40 patients with precbycusis, who applied to Ankara University Medical School Department of Otorhinolaryngology, were included. In Ankara University Audiology Unit, pure tone audiometry, speech audiometry, DPOAE, ABR were recorded to evaluate the hearing loss. Mean value of the Pure Tone Average (PTA) was 44.83±1.78 dB and 44.68+1.75 dB in right and left ear, mean value of speech discrimination ratio (SDR) was 78.83+2.24% and 78.1±2.07% in right and left ear. According to our findings, there was a significant relation between the age and the PTA, SDR, Speech Reception Treshold (SRT) (p<0.05). Also there was no significant relation between the audiogram types and age (p>0.05). The ratio of DPOAE presence at 1000 Hz was 52%, at 2000 Hz was 27.5%, at 3000 and 4000 Hz was 10%, at 5000 Hz was 5 %. There was no significant relation between DPOAE existance and age (p>0.05). In our cases even if ABR wave latencies became 0.2 msn longer, a pathologic change was not seen. I-HI, I-V, III-V interpeak latencies were all in normal limits. When we compared PTA, SDR, SRT, DPOAE existance and ABR wave latencies of the men and women there was no significant difference (p>0.05). There was no difference between the patients with tinnitus and without tinnitus when they were compared in respect to PTA, SDR, SRT, DPOAE existance and ABR wave latencies (p>0.05). There was a significant relation between PTA and SDR, SRT (p<0.05). There was not any difference between patients who had chronic disease (Diabetus Mellitus and Hypertension) and patients who had no chronic disease in respect to PTA, SDR, SRT, DPOAE existance and ABR wave latencies (p>0.05). In conclusion, it was found that the pure tone and speech audiometric results changed and hearing loss increased because of aging. DPOAE's absence increased in high frequencies and the presence of outer hair cell dysfunction in other words cochlear damage was seen in elderly. Although ABR wave latencies had become 0.2 msn longer, it was thought that there was no pathology in brain stem auditory pathways because of the normal levels of I-DI, I-V, III-V interpeak latencies. The exact pathologic localization can be understood by electrophysiologic tests with histopathologic findings. As the pathologic localization is being explained, it will be easier to develop pharmacologic treatments and hearing aids. 31Key Words: Distortion Product Otoacoustic Emission (DPOAE), Auditory Brain Stem Responses (ABR), Speech Audiometry, Prebycusis, Pure Tone Audiometry. 32