声导抗基础知识Soundtravel声音传导Gettingsoundintoadifferentmedium声音在不同媒介中的传导Theroleofthemiddleear中耳的作用TheOssicles听小骨TheMiddleearanatomy中耳解剖Gettingsoundintoadifferentmedium声音在不同媒介中的传导Howdowetestthemiddleear?如何检测中耳功能中耳测试Partoftheprobetoneisreflected,andsomeisadmittedintothemiddleear一部分探测音被反射回来，另一部分则进入中耳Theadmittanceiscontinuouslymeasuredbyamicrophone声导纳通过麦克风持续测量计算出来鼓室图-200SA226Hz:Differentconfigurationsoftympanometricresults226Hz鼓室声导抗测试结果与疾病的关系Thetwomiddleearmuscles中耳肌TheAcousticReflex声反射Stapediusmusclecontrolledbyfacialnerve(CNVII)镫骨肌由第七对颅神经－面神经支配Networkinbrainstemconsistsofipsilateralandcontralateralpaths脑干层面由同侧和对侧神经通路组成Reflexactivatedonbothears,evenwhenstimulationonlyoccursinoneear一侧耳受到刺激时，双侧镫骨肌都会收缩Comparisonofipsilateralvs.contralateralacousticreflexeshelpstodeterminesiteoflesion对比同侧和对侧声反射有助于判断病变部位声反射0.00声反射测试–高精度的挑战Threshold+10dB,10secondsstimulustime声反射阈上10dB给声，刺激时程10sThereflexshouldbeactivatedinbothearsevenifstimulatedinonlyoneear单耳刺激声可激活双耳声反射Theuppernormalintensitylimitforreflexthresholdsinadultsis95-100dBHL正常成人声反射阈上限是95－100dBHLReflexthresholdscannotbedeterminedifthereisaproblemwiththemiddleear中耳疾病时不能测出声反射阈BroadBandNoiseprovokesareflexatabout10-15dBlowerthanpuretonestimuli宽带噪声声反射阈较纯音刺激声低10－15dBDeterminestypeofhearinglosswhencomparedwiththeaudiogram声反射阈与听力图比较可帮助判断耳聋类型Decayswithneuralfatigue(typically8thnervetumour)衰减提示听神经疲劳，是听神经肿瘤的典型表现DifferentconfigurationsofAcousticReflexresults声反射结果与疾病的关系226Hzprobetone:Normaltympanograminabnormalear!226Hz探测音：异常中耳显示正常鼓室导抗图Tympanometryininfants婴儿鼓室声导抗HoweasilycanImovethisme－chanicalsystem?怎样轻而易举的推动这个机械系统？B/Gcomponenttympanogram声纳/声导成分鼓室导抗图NowIcanseenotonlyhoweasilyIcanmovethesystem,butIcanactuallyfindoutwhy!现在我不仅能轻而易举的推动它，而且还明白了其中的原因！TraditionalbaselinecompensationMiddleearassessmentininfants,recommendations婴儿中耳评估的推荐方法