VEMP檢查評估鞭炮造成的內耳損傷 Inner ear damage from firecracker assessed by VEMP testing 廖予昊 楊怡和 台大醫院耳鼻喉部
鞭炮起源於中國漢朝 (200 B.C.)
Patients (1997-2017) N= 30 (40 ears) Age: 22 - 58 (32) Y Gender: M / F = 22 / 8 R / L / B = 10 / 10 / 10
Methods Otoscopy Audiometry Caloric test cVEMP test (after 2000) oVEMP test (after 2008)
Clinical manifestation (N=30) 100 (%) Hearing loss Tinnitus Vertigo / Dizziness Headache
Pure tone average (n=40 ears) Hearing Level (dB) -10 10 20 30 40 50 60 70 80 90 100 110 : abnormal : normal 30% 70% 0.5 1.0 2.0 3.0 Frequency ( kHz ) 6
Types of audiogram (N=40 ears) 31 6 2 1
Mean hearing levels * * * * * * * (dBHL) : unaffected : affected : p<0.001 * * * (Hz)
Re-establishing a noise event Part II. Re-establishing a noise event 電光炮 長壽炮 單響炮 水鴛鴦 沖天炮 甩 炮
Measuring the noise levels Real-time noise level was measured outdoors by a sound level meter at 2, 4 and 6 m away. 2 m 4 m 6 m
Noise levels in 6 kinds of firecrackers (dBA) 2m 130 4m 6m 110 dBA 90 電光炮 長壽炮 單響炮 水鴛鴦 沖天炮 甩炮
Inner ear deficits by firecrackers : normal : abnormal 100% 60% 80% 8% p = 0.194
Firecracker trauma vs. Noise trauma Blast injury Noise exposure Noise exposure
Metabolic alteration Mechanical injury Membrane limitans
Conclusion Most firecrackers exhibited noise level >110 dBA even at a distance of 6 m. The blast injury damaged the cochlea, saccule and utricle, but spared the semicircular canals. (Audiol Neurotol, 2018)
世界文化遺產: 成都 都江堰 Membrane limitans SCC saccule utricle cochlea