臺灣博碩士論文加值系統

本研究之目的為使用Nicolet及Integrity™ 兩型聽性誘發反應系統量測一小群正常聽力者以click與500, 1000, 2000及4000 Hz tone bursts作為刺激音時之行為閾值。並測得以click與tone bursts作為刺激音時，正常聽力者之ABR閾值，比較ABR閾值與純音聽閾之差異，分析兩型聽性誘發反應系統用於評估正常聽力者之ABR閾值是否具統計上的差異。記錄每名受測者以兩型聽性誘發反應系統完成ABR閾值測試分別所需時間，比較兩者間差異。
參與研究之個案需純音聽力檢查在500, 1000, 2000及4000 Hz之聽閾優於或等於10 dB HL。各刺激音之0 dB nHL為15名受測者對該刺激音行為聽閾之平均。ABR閾值記錄之杯狀電極置於上前額及刺激耳同側乳突，單頻道記錄。
研究結果顯示Nicolet及Integrity™ 兩型聽性誘發反應系統以click為刺激音時，所測得之ABR閾值與2000及4000 Hz純音聽閾平均值之平均差異分別為0.7及3.3 dB。以tone bursts為刺激音時，Nicolet聽性誘發反應系統所測得之ABR閾值與純音聽閾的平均差異在500, 1000, 2000及4000 Hz分別為11.7, 7.3, 4.0及4.3 dB; Integrity™ 聽性誘發反應系統所測得之ABR閾值與純音聽閾平均差異在500, 1000, 2000及4000 Hz分別為15.7, 8.7, 6.7及6.7 dB。分析Nicolet及Integrity™ 兩型聽性誘發反應系統測得之ABR閾值結果顯示，刺激音為click與1000, 2000及4000 Hz tone bursts時，無統計顯著差異 (p＞.01)，刺激音為500 Hz tone bursts時，呈統計顯著差異 (p＜.01)。平均每名受測者以兩系統完成ABR閾值測試分別所需時間，以Integrity™ 聽性誘發反應系統時間較短 (p＜.01)。
整體而言，本研究顯示，Nicolet及Integrity™ 兩型聽性誘發反應系統以click為刺激音時，測得之ABR閾值與2000及4000 Hz之純音聽閾平均值皆具有良好的一致性。以tone bursts為刺激音所測得之ABR閾值，皆能可靠的預估正常聽力者在500, 1000, 2000及4000 Hz之聽覺敏感度。

The purpose of this study is to obtain the behavioral thresholds in response to the click and tone bursts of 500, 1000, 2000 and 4000 Hz by using the Nicolet and the Integrity™ auditory evoked systems from a small group of normal-hearing subjects. The ABR thresholds were obtained with the click and tone bursts stimuli from subjects with normal hearing sensitivity. The ABR thresholds were compared with the pure tone thresholds, and the results of ABR thresholds from two auditory evoked systems were also compared. The averaged time to complete the ABR threshold test by using two auditory evoked systems was compared.
All participants in this study exhibited pure tone thresholds of 10 dB HL or less at 500, 1000, 2000 and 4000 Hz. The reference level of each stimulus was determined based on the averaged behavioral thresholds of 15 subjects and was designated as 0 dB nHL for the specific stimulus. Single-channel recordings of the ABR were obtained from using cup electrodes placed at the vertex and mastoid ipsilateral to the stimulated ear.
It was found that the mean differences between the ABR thresholds in response to click and the pure tone average of 2000 and 4000 Hz by using Nicolet and Integrity™ auditory evoked systems were 0.7 and 3.3 dB, respectively. The mean differences between the ABR thresholds and pure tone thresholds at 500, 1000, 2000 and 4000 Hz by using the Nicolet auditory evoked system were 11.7, 7.3, 4.0 and 4.3 dB, respectively. The mean differences between the ABR thresholds and pure tone thresholds at 500, 1000, 2000 and 4000 Hz by using the Integrity™ auditory evoked systems were 15.7, 8.7, 6.7 and 6.7 dB, respectively. No significant difference (p＞.01) was found between the ABR thresholds obtained by using the Nicolet and Integrity™ auditory evoked systems when the stimuli were the click and tone bursts of 1000, 2000 and 4000 Hz. The difference in ABR thresholds obtained by using the Nicolet and Integrity™ auditory evoked systems was significant (p＜.01) when using 500 Hz tone burst as stimulus. The averaged time to complete the ABR threshold test by using the Integrity™ auditory evoked system was shorter than that one by using the Nicolet auditory evoked system (p＜.01).
In summary, the present study suggests that by using the Nicolet or Integrity™auditory evoked system, there is consistency between the ABR thresholds in response to the click and the pure tone average of 2000 and 4000 Hz. By using the ABR thresholds to tone bursts, reasonable estimates of 500, 1000, 2000 and 4000 Hz pure tone thresholds were comparable from Nicolet or Integrity™ auditory evoked systems in subjects with normal hearing sensitivity.

致謝 I
中文摘要 II
英文摘要 IV
目 錄 VI
表目次 VIII
圖目次 IX
附錄目次 X
第一章 文獻探討 1
第一節 聽性腦幹反應 1
第二節 頻率特定性ABR 5
第三節 ABR與行為聽力評估 8
第四節 無線ABR 10
第二章 研究目的與方法 13
第一節 研究目的 13
第二節 研究個案 14
第三節 研究設計 15
第四節 統計及分析方法 18
第三章 研究結果 19
第一節 ABR刺激音強度校準之結果 19
第二節 ABR閾值記錄結果 20
第四章 討論 24
第一節 ABR刺激音強度行為校準之研究結果討論 24
第二節 ABR閾值與純音聽閾差異之討論 25
第三節 Nicolet及Integrity™ 兩型聽性誘發反應系統之比較 29
第五章 結論及研究展望 30
參考文獻 31

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