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说明：
关键词： 耳鸣,机制,检测,治疗
耳鸣为一常见的临床症状，人群中约17％的个体有过耳鸣的感觉，(4～5)％的人因此而就诊［1］。耳鸣通常伴有烦恼、睡眠困难、注意力不集中，严重者可影响工作、娱乐和社会交往。耳鸣可因听觉通路上任一部分的异常活动引起，而持续存在的、令人非常烦恼的耳鸣常受心理因素的影响。由于耳鸣的主观性特征，有关耳鸣的研究和治疗至今尚未取得突破性进展。但目前从各个角度进行的探索有助于了解与耳鸣相关的各个侧面。现就以下3方面进行综述。
耳鸣形成的机制
有关耳鸣形成机制的假说很多，但均不能解释所有的耳鸣现象。
一、耳鸣产生的解剖部位
Meikle［2］及其同事比较了大宗耳鸣病例的纯音测听和耳鸣音调匹配的数据后，发现听觉损失的频率范围与耳鸣音调相关，但并不完全一致，推测耳蜗病变区域并不是决定耳鸣音调的唯一因素，耳鸣是外周和中枢病变共同影响的结果。许多临床现象显示仅中枢病变即可能产生耳鸣，如：一侧耳鸣会逐渐变为双侧耳鸣，且双侧耳鸣音调相同；切断或破坏耳鸣侧的耳蜗神经，耳鸣的感觉仍然存在；几乎无听觉的聋耳亦可有耳鸣；耳鸣者的听性脑干反应（auditory brainstem response，ABR）和自发性耳声发射（spontaneous otoacoustic emissions）与耳鸣无直接相关；在微血管减压术中，从严重耳鸣患者颅内暴露的第Ⅷ脑神经上也没有记录到复合动作电位（compound action potential，CAP）的明显变化［3］。Lockwood等［4］观察了4例能通过口、面部动作来改变耳鸣响度的患者，用正电子发射计算机断层（positron emission tomography）技术测定了静息状态，口、面部活动期间及给予声音信号时的脑血流变化，发现耳鸣响度的改变仅引起耳鸣耳对侧脑血流变化，推测这些患者的耳鸣是由于蜗后某些部位的病变引起，而且声音信号在耳鸣者脑内引起变化的范围大于对照组，同时观察到听觉系统和海马（边缘系统的一个组成部分）之间的异常联系，为边缘系统参与耳鸣感觉形成的推论提供了依据。
目录：
一、耳鸣产生的解剖部位
二、耳鸣形成的病理生理过程
参考文献：
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