查詢結果分析
來源資料
頁籤選單縮合
題名 | 腦幹聽性反應檢查用於神經耳科學診斷的效度=The Validity of Auditory Brainstem Response in Neurotological Diagnosis |
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作者 | 許權振; 林凱南; Hsu, Chuan-jen; Lin, Kai-nan; |
期刊 | 中華民國耳鼻喉科醫學會雜誌 |
出版日期 | 19980200 |
卷期 | 33:1 1998.02[民87.02] |
頁次 | 頁25-30 |
分類號 | 416.81 |
語文 | chi |
關鍵詞 | 顱內病變; 不對稱感覺神經性聽力損失; 眩暈; 耳鳴; Intracranial lesion; Asymmetric sensorineural hearing loss; Vertigo; Tinnitus; |
中文摘要 | 背景:對於神經耳科學診斷, 腦幹聽性反應檢查是有效而普遍使用的檢查方法之 一,就節省醫療資源的觀點,評估對所有主訴聽力損失、耳鳴或眩暈而懷疑顱內病變的病人 均先用腦幹聽性反應檢查偵測顱內病變的效度和成本效益。 方法:對象對主訴聽力損失、耳鳴或眩暈而接受純音聽力檢查和氣導腦幹聽性反應檢查的 1285 名病人,男性 630 名,女性 655 名,分為漸進性不對稱感覺神經性聽力損失 763 名 、 突變性耳聾 166 名、低頻聽力損失 42 名和對稱感覺神經性聽力損失或聽力正常者 314 名等 4 組;其中 174 名接受磁振影像檢查。計算各組之腦幹聽性反應檢查偵測耳蝸後病變 的效度,並評估腦幹聽性反應檢查用於神經耳科學診斷的成本效益。 結果:腦幹聽性反應異常而懷疑有顱內病變的有 12 %( 158/1285 ),無腦幹聽性反應的 有 7 %( 88/1285 )。磁振影像檢查確定耳蝸後病變的有 39 %( 68/174 )。各組病例 用腦幹聽性反應檢查偵測顱內病變之偽陽性率╱偽陰性率分別為:漸進性聽力損失者 46 % /0 %、突發性耳聾者 25 % /9 %、對稱性聽力者 57 % /17 %。總括全部病例的話,偽 陽性率為 45 %,偽陰性率為 9 %。 若全部病人均先檢查腦幹聽性反應,有異常和無反應 者才做磁振影像檢查的話, 則診斷 1 個顱內病變所花的費用約為全部病人均直接做磁振影 像檢查的 1/4。 結論:腦幹聽性反應檢查是神經耳科學診斷上可靠且靈敏度高的檢查,對所有主訴聽力損失 、耳鳴或眩暈而懷疑顱內病變的病人均先用腦幹聽性反應檢查篩檢是合乎成本效益的。 |
英文摘要 | Background: The auditory brainstem response (ABR) test is a useful screening method for retrocochlear disease. The advent of magnetic resonance imaging (MRI) has significantly increased the ability to detect small retrocochlear lesions. We evaluated the validity of ABR as a screening test for intracranial lesions in patients with asymmetric sensorineural hearing loss, tinnitus or vertigo. Method: A total of 1285 cases received ABR testing. They were devided into 4 groups: progressive hearing loss, sudden hearing loss, low-tone hearing loss and symmetric hearing. MRI was available in 174 cases. Result: Positive ABR finding was noted in 12% and non-conclusive ABR was noted in 8% of all cases. Sixty-eight cases (39%) revealed intracranial lesions in MRI. The false-positive rate and false-negative rate for progressive hearing loss group, sudden hearing loss group and symmetric hearing group were 46%/0%, 25%/9% and 57%/17%, respectively. The false-positive rate (45%) and false-negative rate (9%) for total cases were still acceptable. In stead of MRI study for all cases, it costs only 1/4 expense to diagnose an intracranial lesion if ABR screening test is performed before MRI study which is done only for those with positive ABR finding. Conclusion: We suggest to continue to use ABR as a screening test for suspicious intracranial lesions in patients with asymmetric sensorineural hearing loss, tinnitus or vertigo. |
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