耳聲傳射具有對於同一人、同側耳可重複量測，作為生物特徵辨識的特性，過去主要是在良好的聽力檢測室、無響室做測量，在臨床上的應用僅作為新生兒的聽力檢測。在成人聽力疾病的應用上，僅作為檢測內耳表現是否正常的一個指標。因此本論文中實際開發在醫院針對罹患梅尼爾氏症的患者，進行瞬態誘發耳聲傳射的量測，其平均訊噪比為13.72 dB SPL，進一步探討耳聲傳射與病情之間的關係。文獻中可知道在健康人耳中，耳聲傳射在接受短聲刺激後各頻率的延遲，1 kHz、2 kHz、4 kHz延遲時間分別約為11 ms、7.1 ms、 4.6 ms。將對應片段的量測結果與受試者的就醫紀錄中，純音聽力檢測、變頻耳聲傳射的量測資料做對照。總共於台北國泰綜合醫院蒐集23位病情程度(分成確診罹患、應已罹患、疑似罹患、病情第一階段到第三階段)不同的梅尼爾氏症患者與9位聽力健康的病人，患病耳測量資料78筆、異側耳129筆、對照組18筆。發現純音聽力檢測大於25 dB被視為聽力損傷的資料中，不論是變頻耳聲傳射、瞬態誘發耳聲傳射其能量強度皆有下降，且純音聽力檢測結果超過40dB、中度聽損的資料中，耳聲傳射的特徵幾近消失無法被觀測、同時也喪失原本個體所具有的耳聲傳射的個體獨特性。而梅尼爾氏症主要病因來自於內耳淋巴的腫脹壓迫導致，除了聽力損傷、浮動之外，也有耳鳴、暈眩等症狀。在聽損不嚴重、甚至沒有聽損的梅尼爾氏患者身上，發現其依然保留某種程度的特徵性，但其耳聲傳射的能量強度皆有受到病情的影響，能量的強度降低，僅有3.86 × 10 ^ (-10) Pa^2。與健康的對照組的平均能量結果1.33 × 10 ^(-9) Pa^2有所區別。未來可以持續釐清，耳聲傳射與病情程度之間的關係，協助醫生在患者初診時作為診斷的依據之一。

Otoacoustic emission (OAE) has the property for personal biometric identification. It can be measured in human's ear anytime, anywhere, and similar results can be got from the same ear. In the past, OAE usually measured at audiometer testing room and rather stable results would be obtained. In this study, we developed a system for transient evoked otoacoustic emission (TEOAE) measurement for the patients of Ménière disease (MD) at the hospital. TEOAE data were measured in a normal room, and the signal-to-noise ratio was 13.72 dB SPL in average. After giving an acoustic impulse, OAE components occur sequentially from higher to lower frequencies; for example, the delay time of the 1 kHz, 2 kHz and 4 kHz components are 11 ms, 7.1 ms and 4.6 ms, respectively. To find the relation between TEOAE and disease, we compared the data with patient's pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAEs). We cooperated with Cathay general hospital and collected 23 MD patients with different illness degrees: certain, possible, probable, stage I, stage II and stage III. Totally, 78 cases of MD ears, 129 cases of non-MD ears and 18 cases of normal hearing ears were recorded. For objects with hearing loss, which means the PTA is greater than 25 dB SPL, the energy of both TEOAE and DPOAE is less than that for normal hearing objects. If the PTA is over 40 dB SPL, almost no OAE signal can be found in those cases. For those MD objects with normal hearing or mild hearing loss, the energy of TEOAE is 3.86 × 10 ^(-10) Pa ^2 in average and is still weaker than that for health hearing objects, which is 1.33 × 10 ^(-9) Pa ^2 in average.

摘要 I
Abstract II
第一章 緒論 1
1.1 耳聲傳射簡介 1
1.2 研究動機與文獻回顧 3
1.3 研究方法及目標 4
1.4 章節介紹 5
第二章 實驗器材與訊號擷取流程 6
2.1 實驗器材與設計 6
2.2 實驗方法與流程 6
2.3 實驗器材性能確認 7
第三章 訊號分析方法與結果 10
3.1 訊號分析之前處理 10
3.2 計算TEOAE作為生物辨識的方法 14
3.3 排除SOAE在SNR上的影響 15
第四章 結果分析與討論 17
4.1 將實際病歷TEOAE與PTA和DPOAE做比較 17
4.2 TEOAE在個人同側耳上的生物辨識 23
第五章 結論與未來發展27
參考文獻 28
附錄 31

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