굴절교정된 정상안에서 운무 전후에 따른 순음청력역치의 비교

조수진,주석희,이군자,최인실,임현성 한국안광학회 2009 한국안광학회지 Vol.14 No.3

목적: 본 연구는 굴절교정된 정상안에서 운무 전후에 따른 순음청력검사 값의 변화를 알아보고자 시행하였다. 방 법: 안질환이나 청각질환이 없으며, 교정시력이 1.0이상의 젊은 성인 50명(남자: 30명, 여자: 20명)을 대상으로 하였 다. 시력교정 전후의 순음청력역치(pure tone threshold)의 변화를 순음청력검사(pure tone audiometry)를 통해서 비 교해 보고자 하였다. 결과: 전 주파수 대역에서 운무 후의 순음청력역치가 운무 전보다 더 높게 나타났으며, 그 차 이는 2000Hz를 제외한 전 주파수 대역에서 통계적으로 유의하게 측정되었다(p<.05). 저주파수 대역인 250Hz와 500Hz에서 각각 6.8±8.4dBHL과 4.3±6.6dBHL로 나타나 다른 주파수 대역에 비해서 그 차이가 크게 나타났고, 중주파수 대역인 2000Hz에서는 0.8±4.5dBHL로 가장 작게 나타났다. 결론: 굴절교정된 정상인에서 운무 전과 후 의 순음청력검사의 역치값이 다르게 나타나 망막상의 선명도와 청각은 서로 영향을 주는 것으로 판단되며 이 결과 는 굴절교정과 청각의 상관성을 제공하는 기초자료로 활용될 수 있을 것으로 사료된다. Purpose: To purpose of this study was the pure-tone audimetry changes to compare pre and post fogging after visual correction in normally hearing adults. Methods: The estimated that no ocular and audiolar disesases, we selected (male: 30, female: 20) in corrected visual acuity over the 1.0 eye. Pre and post fogging were measured using the pure-tone audimetry. Results: To compared fre and post fogging, fre fogging was higher than fre fogging. The take value were just about every kind of Hz but 200Hz, respectively which were statistically significant (p<.05). Low Hz area in 250 and 500 Hz were 6.8.4dBHL, 4.3.6dBHL, there is not all the difference between any other area, 2000Hz in the middle Hz area was 0.8.5dBHL. Conclusions: The study presents different results of measurements in within normal limits. we thought that pure-tone thresholds to the pre and post fogging after refractive correction in normal adults and would be used basic data.

객관적 평가를 이용한 과대 난청 평가

허승덕(Seung-Deok Heo),이재명(Jae-Myeong Lee),박지상(Ji-Sang Park),최아현(Ah-Hyun Choi),강명구(Myung-Koo Kang) 한국언어청각임상학회 2008 Communication Sciences and Disorders Vol.13 No.3

배경 및 목적: 이 연구는 사회경제적 이득을 목적으로 방문한 피 검자의 순음청력검사(pure tone audiometry: PTA, 이하 PTA) 반응 양상, 어음청력검사(speech audiometry: SA, 이하 SA) 그리고 청성뇌간유발반응(auditory brainstem response: ABR, 이하 ABR) 결과들을 이용하여 사청 비율과 과대 난청 정도를 예측하고자 수행되었다. 방법: 2006년 6월 부터 2007년 9월까지 청각학적 진단을 위해 방문하였던 18.4세부터 86.9세 사이의 54(남 48, 여 6)명 의 의무기록을 후향적으로 분석하였다. 이들의 반응 양상을 기준으로 사청군과 대조군으로 분류하 고 두 군간 차이를 통계학적으로 검증하였다. 결과: 하강법과 상승법 반응 역치의 차이는 1㎑에서 사청군이 24.77㏈, 대조군이 -1.11㏈의 유의한 차이를 보였다(p < .001). 검사간 차이로 반응 역치 평균 (pure tone averages: PTAs, 이하 PTAs)인 2 PTAs 와 어음청취역치(speech reception threshold: SRT, 이하 SRT; p < .001), ABR 역치와 high 3 PTAs (p = .002), ABR 역치와 SRT (p < .001)는 모 두 통계학적으로 유의하였다. 논의 및 결론: 이 연구에서 확인한 사청비율은 84.48%였으며, 이들의 과대 난청 정도는 상승법 반응 역치를 기준으로 34.48(±22.79)㏈이었다. Background & Objectives: This study was performed to investigate the rate of malingering deafness and to predict the degree of exaggerated-hearing loss using pattern of response of pure tone audiometry(PTA), speech audiometry(SA) and auditory brainstem response (ABR) in subjects with a purpose of socioeconomic benefit. Methods: We reviewed the medical records of 54 subjects. The subjects were divided into the malingering group and the control group in accordance with pattern of response. These results were analyzed statistically. Results: The responded-thresholds of ascending and descending methods in 1 kHz between the malingering group and the control group were significantly different. The differences between 2 PTAs(pure tone averages between 0.5 and 1kHz) and SRT(speech reception threshold) (P < .001), ABR threshold and high 3 PTAs(pure tone averages between 0.5, 1 and 2kHz) (P = .002), ABR threshold and SRT (P < .001) were statistically significant. Discussion & Conclusion: It was concluded that the rate of malingering deafness was 84.48%, and the degree of exaggerated-hearing loss was 34.48dB respondedthreshold of ascending method.

순음청력검사에 대한 기본적 이해

민미식 ( Mi Sik Min ),유선우 ( Seon Woo You ) 대한임상검사과학회 2001 대한임상검사과학회지(KJCLS) Vol.33 No.2

Pure-tone audiometry is the most common measure of hearing sensitivity. Stimuli are pure tones at octave frequencies from 250Hz up to 8,αX>Hz and usually two interoctave frequencies(3000Hz and 6000Hz). Pure-tone audiometry should always be carried out with the patient in a double-walled, sound treated room. Test results are graphed on an audiogram. All audiogram include a graph for plotting hearing threshold levels(HTLs). Masking is the audiometric technique used to eliminate participation of the nontest ear whenever air- and bone-conduction stimulation exceeds interaural attenuation. Selection of appropriate masking is difficult, especially when there is bilateral hearing impairment. Type of hearing loss, determined by comparison of the hearing thresholds for air- versus bone-conduction signals, is useful in classifying a hearing loss as sensoryneural(no air-bone gap), conductive(normal bone conduction and a loss by air conduction), or mixed(loss by bone with a superimposed air-bone gap).

소음 특수건강진단에서의 순음청력검사 방법 및 평가의 적정성 : 청력정도관리 순음청력검사 자료를 중심으로

김규상,김소연,조영숙,정호근 대한산업의학회 2001 대한직업환경의학회지 Vol.13 No.3

목적 : 이 연구는 각 특수건강진단기관의 소음 특수건강진단에서 소음성 난청을 판단하는데 가장 중요한 청각도(audiogram) 등의 자료를 통해 2차 소음 특수건강진단 대상자 선정의 적정설, 순음청력검사방법의 적정성 및 판정의 적정성을 평가하였다. 방법 : 1997년의 청력전도관리의 소음 특수건강진단의 자료 평가 대상기관인 48개 특수건강진단기관에서 1998년 하반기에 특수건강진단을 실시한 근로자수 100-500인 규모의 특수건강진단기관당 사업장 1곳의 특수건강진단 결과표, 소음 특수건강진단 개인표, 2차(정밀) 소음 특수건강진단 대상자의 순음청력검사 자료를 제출받아 2차 소음 특수건강진단 대상자 선정의 적정성, 순음청력검사방법의 적정성 및 판정의 적정성을 분석 평가하였다. 대상자 선정의 적정성은 1999년 현재 2차 건강진단 대상자 건별기준을 적용한 2차 건강진단의 실시 여부, 순음청력 검사방법의 적정성은 주파수별 기도 및 골도 검사 실시, 표준표기방법에 따른 역치 표기, 기도 및 골도 검사 결과의 차이, 적정한 기도 및 골도 음차폐 실시 여부의 평가를 통해 간접적으로 판단하였다. 소음 특수건강진단 판정의 적절성은 특수건강진단기관에서 판정한 구분을 ISO 기준(1964)적응에 의한 역치에 따른 청력장애 정도와 소음성 난청 유소견자 진단기준인 3분법에 의한 청력손실치, 4000 Hz에서의 역치 및 난청의 유형의 적용에 따라 각각 비교하여 적정성을 살펴보았다. 결과 : 2차 건강진단 대상자 선별기준에 따른 2차 건강진단 대상자는 기관 평균 사업장당 34.3명이었으나 18.4명만을 대상으로 2차 건강진단을 실시하여 선별기준 적용의 실시율이 67.7 %로 1/3의 대상이 2차 건강진단에서 누락되었다. 2차건강진단 대상자에 대해 각 주파수별 기도 골도 검사율은 75.7 %로 24.3 %가 골도검사를 시행하지 않고 기도검사만으로 평가 판단하였다. 표준표기방법(오른쪽, 왼쪽 - 비차폐 기도, 차폐 기도, 비차폐 골도, 차폐 골도검사)에 따른 표기에서 70.4 %에서 제대로 표기되고 있으며, 기도 및 골도청력검사의 적정성으로 기도청력역치는 골도청력역치보다 같거나 크게 나와야 하는데 골도청력역치가 기도청력역치보다 크게 나오는 경우(골도-기도청력역치>10)에는 잘못 측정하였다고 볼 수 있는바 이 기준의 적용시 75.5 %만이 검사결과가 적정하였으며, 기도 및 골도 음차폐 검사는 각각 실시 대상자의 15.0 %. 26.2 %만 실시하고 있었다. 48개 기관 중 7개 기관(14.6 %)이 2차 검진을 기도순음청력검사만으로 판정하고 있었으며, 기도 및 골도 음차폐검사는 각각 7개 기관(14.6 %), 13개 기관(27.2 %)에서만 실시하였다. 난청의 유형과 역치에 따른 청력장애의 평가는 소음 특수건강진단 결과 평가의 적정성(ISO 기준(1964)적용에 의한 청력손실 비교)과 판정의 적정성 (소음성 난청 유소견자 진단기준의 적용에 따른 비교)을 특수건강진단기관이 최종 판정한 결과와 비교하였을 때 질환자(D1, D2)의 판정이 과소평가되어 있었다. 결론 : 특수건강진단기관에 대한 청력정도관리와 청력검사자의 질관리가 지속적으로 필요하며 판정에서의 여러 장애 요인을 검토하여 적정하게 판정하여 관리될 수 있게끔 하여야 할 것이다. 그리고 순음청력검사의 정확성과 신뢰성을 확보할 수 있는 제반기준을 설정하여 검사자간, 검사자내 피검자의 역치결과의 오차를 줄여 나가야 할 것이다. Objeotive : This study was undertaken to evaluate that noise-exposed workers have been appropriately selected for the special periodic health examination and that pure-tone audiometry has been correctly applied and the results of these have been properly analyzed. Methods : We obtained health examination data of noise-exposed workers from 48 special periodic health examination agencies. The data consisted of special periodic health examination results and audiograms that had performed examination during the latter half of 1998. We analysed the appropriateness of the subject selection for the second special periodic health examination of noise-exposed workers, the method of pure-tone audiometry, and the evaluation of audiogram. Results : The screening performance rate is 67.65% in the special periodic health examination of noise-exposed workers. Although 34.29 persons per agency should have had a secthird of subjects were omitted. The air and bone conduction performance rate by each frequency is 75.71%. 24.29% persons did not have a bone conduction and were evaluated only by air conduction. The correct use rate of symbols(right, left-unmasked AC, masked AC, unmasked BC, and masked BC) recommended by ASHA(American Speech-Language-Hearing Association) was 70.36%, Generally air conduction threshold is equal to or higher than bone conduction threshold. In the reverse case, especially if the gap is more than 10 dB(BC-AC>10), this is considered to be incorrect. When we applied this criteria, the result indicated that it was correct in 75.46%. The performance rate of air masking was 15.03%, and bone masking was 26.21%. 7 among 48 agencies diagnosed NIHL(Noise-Induced Hearing Loss) only by air conduction, 8 performed air masking and 13 did bone masking. When compared with ISO Standard(1964) and Ministry of Labor Standard, the results of evaluation(D1, D2) on hearing loss according to hearing loss type and threshold were rather low. Conclusions : Hearing Quality Assurance Program about periodic special examination agencies and examiners will continue to be needed and also the evaluation of hearing loss should be performed and controlled using accurate criteria. This will reduce the error among examiners and results in individuals by means of a standard that is capable of being accurate and reliable.

급성 저주파 감각신경성 난청에서 125 Hz 순음 역치의 중요성

안용휘,이은섭,김효정,강용경,오현식,심현준 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.8

Background and Objectives To analyze the 125 Hz pure-tone thresholds in patients with acute low frequency sensorineural hearing loss (LFHL) and to investigate the value of 125 Hz thresholds for the assessment of LFHL. Subjects and Method Hearing tests including 125 Hz pure-tone were performed in 91 patients with acute LFHL ≤500 Hz and in 46 subjects with normal hearing. Patients with sudden sensorineural hearing loss or Meniere’s disease were excluded. Inter-group and intra-group comparison of 125 Hz was made between LFHL and the control groups. Results There was a significant difference of mean pure-tone thresholds at 125 Hz between the acute LFHL and the normal groups (39.8±8.9 vs. 14.3±6.7 dB). Eight (8.8%) patients in the LFHL group showed normal thresholds at 125 Hz, but all other subjects were normal at 125 Hz in the control group. None with the average hearing thresholds at 250 and 500 Hz ≥40 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in the LFHL group (250 Hz; r=0.81, 500 Hz; r=0.63). Conclusion Not all patients with acute LFHL show abnormal hearing threshold at 125 Hz although every subject with normal hearing is within the normal limits at 125 Hz. Threshold assessment should be made at 125 Hz when a mild LFHL exists in the conventional pure tone audiometry. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(8):583-7

치과기공 소음 노출이 치기공과 학생의 스트레스와 순음청력에 미치는 영향

연정민,이주희,김대현,이옥경 한국디지털정책학회 2016 디지털융복합연구 Vol.14 No.4

Noise is unwanted sound that is the reason of the stress and hearing loss. The current study attempted to estimate whether the noise of dental laboratory affected stress and pure tone audiometry (PTA) of dental laboratory technicians (DLTs) using heart rate variability, air and bone conduction audiometry. The age, heights, and weights of DLTs were resembled control. Standard deviation of normal to normal interval such as stress resistance and normalized HF of DLTs were significantly decreased, but heart rates, normalized LF, and LF/HF ratio of DLTs were significantly increased compared with control. In air conduction audiometry of DLTs, significant increments of thresholds encountered in 125, 250, 500, 1000, 2000, 3000, 4000, and 6000 Hz in the right ears and 125, 250, 500, 1000, and 2000 Hz in the left ears. Thresholds of bone conduction audiometry in both ears were significantly increased in 250, 500, 1000, 2000, and 4000 Hz. The findings in this study provide that stress and hearing loss observed in noise-exposed DLTs at dental laboratory. Therefore, proper safety precautions should be carried out at dental laboratory. 소음은 원하지 않는 소리로서 소음의 노출은 스트레스와 난청의 원인이 된다. 본 연구에서는 치기공과 학생의 치과기공 소음 노출에 의하여 스트레스와 순음청력에 미치는 영향을 파악하기 위하여 심박변이도와, 공기전도검사와 골전도검사를 실시하였다. 치기공과 학생의 나이, 키와 체중은 대조군과 유사한 결과를 나타냈다. 스트레스의 저항도를 나타내는 심박 표준편차와 부교감신경의 활성과 관련 있는 norm HF는 유의적으로 감소하였으며, 심박수, 교감신경의 지표인 norm LF, 교감신경과 부교감신경의 비율은 유의적으로 증가하였다. 공기전도검사 결과 치기공과 학생의 오른쪽 귀의 125, 250, 500, 1000, 2000, 3000, 4000, 6000 Hz와 왼쪽 귀의 125, 250, 500, 1000, 2000 Hz에서 역치와 골전도검사 결과 오른쪽과 왼쪽 모두 250, 500, 1000, 2000, 4000 Hz에서 역치가 유의적으로 증가하였다. 또한, 순음청력검사 결과를 4분법을 이용하여 어음영역의 평균을 비교한 결과 치기공학과 학생에서의 역치가 모두 유의적인 증가를 보였다. 이와 같은 결과를 종합해 보면, 치기공학과 학생들에게 노출된 치과기공 소음에 의해서도 스트레스의 증가와 청력소실이 유발될 수 있으므로 적절한 예방책을 찾아야 할 것이다.

저주파 감각신경성 난청을 동반한 어지럼 환자에서 125 Hz 순음 역치의 중요성

안용휘,심현준 대한평형의학회 2017 Research in Vestibular Science Vol.16 No.4

Objectives: To measure 125 Hz pure-tone thresholds in patients with low frequency sensorineural hearing loss (LFHL) and vertigo and to evaluate the necessity of 125 Hz thresholds for assessment of LFHL with vertigo.Methods: Pure tone audiometry including 125 Hz was performed in 25 dizzy patients with LFHL ≤500 Hz and 25 age-matched subjects with normal hearing. Patients with sudden sensorineural hearing loss and vertigo were excluded. Comparison of 125 Hz between LFHL and control groups, and comparison of 125 Hz and other frequencies in LFHL group was made.Results: Mean pure-tone thresholds at 125 Hz in LFHL group (41.7±7.5 dB) was higher than that in normal controls (12.8±6.4 dB). Three (12%) patients had normal thresholds at 125 Hz in LFHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing thresholds at 250 and 500 Hz ≥35 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in LFHL group (250 Hz; r=0.79, 500 Hz; r=0.66).Conclusions: Not every patient of LFHL with vertigo has abnormal hearing threshold at 125 Hz, although all subjects with normal hearing is within normal limits at 125 Hz. Measurement of 125 Hz pure-tone threshold is highly recommended when a mild LFHL exists.

청신경병증이 아닌 성인의 순음청력검사와 청성지속반응검사의 역치값 불일치

노혜일,이혜숙 대한이비인후과학회 2020 대한이비인후과학회지 두경부외과학 Vol.63 No.8

Background and Objectives To evaluate mismatches between pure-tone audiometry (PTA)and auditory steady-state response (ASSR) tests in non-auditory neuropathy adults and investigatebrain lesions that may explain the mismatches, especially in cases where the ASSR thresholdwas worse than the estimated PTA threshold. Subjects and Method PTA, speech audiometry, auditory brainstem response, ASSR, andneuroimaging tests were carried out on individuals selected. Among them, medical records of30 subjects (16 males, 14 females; mean age=54.4±13.2 years) with significant mismatches betweenPTA and estimated ASSR thresholds were analyzed retrospectively. All neuroimagingtests were reviewed to identify any neurologic abnormalities. Results Pathologic brain lesions were found in 19 cases (63.3%) in the study group, all of whichshowed significant mismatch in hearing threshold between PTA and ASSR. Seven case of ischemicbrain lesions (23.3%), five tumorous lesions (16.6%), and four brain vessel anomalies (13.3%)were found. Brain hemorrhage due to trauma were found in two cases (6.6%) as well as one case(3.3%) of unruptured aneurysm. Central auditory pathway disorder was suspected in two cases. The 11 cases showing normal results in the imaging studies included one mental retardation, onebrain concussion, and seven cases (23.3%) with no specific causes. Six tinnitus cases includedtwo subjects showing discrepancies between frequency matching in the tinnitogram. Conclusion In adults with a mismatch between PTA thresholds and estimated ASSR thresholds,especially for those with moderate to profound hearing loss, additional neuroimaging testsand other audiologic tests may reveal other possible causes of hearing loss.

어지럼을 동반한 돌발성감각신경난청 환자에서 125 Hz 순음 역치는 예후적 가치가 있는가?

안용휘,심현준 대한평형의학회 2020 Research in Vestibular Science Vol.19 No.1

Objectives: To analyze 125-Hz pure-tone thresholds in dizzy patients with sudden sensorineural hearing loss (SSNHL) and to investigate the relationship between 125-Hz thresholds and the prognosis of SSNHL with vertigo. Methods: Hearing and vestibular function tests including 125-Hz pure-tone were performed in 132 patients with SSNHL and 65 subjects with normal hearing. Audiometric follow-up was performed at 6 months after initial visit. Intergroup and intragroup comparison of 125 Hz was made between SSNHL and control groups. Results: Twenty-four patients (18.2%) had normal thresholds at 125 Hz in SSNHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing threshold at 250 and 500 Hz≥30 dB had normal threshold at 125 Hz. There was no significant relationship between 125-Hz threshold and results of vestibular function test. There was no correlation between 125-Hz threshold and hearing recovery in SSNHL group. Conclusions: There might be no need to assess 125-Hz pure-tone threshold in patients with SSNHL, because it is enough to evaluate thresholds of 250 and 500 Hz for low frequency.

음압 보정을 통한 이동형 청력 검사 시스템 구현

辛承元(Seung-Won Shin),金敬燮(Kyeong-Seop Kim),尹泰晧(Tae-Ho Yoon),李相旻(Sang-Min Lee),宋哲奎(Chul-Gyu Song) 대한전기학회 2007 전기학회논문지 Vol.56 No.6

In this paper, we implement a PDA(Personal Digital Assistant)-based audiometric system in order to estimate hearing threshold by adopting both pure-tone sound and speech audiometric test system. To estimate a subject's hearing threshold in an ambulatory audiometric test environment, an efficient sound calibration scheme between a PDA and a headphone device is proposed by appling polynomial fitting algorithms in 8-banded frequency ranges.