中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
3期
195-200
,共6页
黄丽辉%邓学倩%杨宜林%王士杰%唐小青%郭连生%韩德民
黃麗輝%鄧學倩%楊宜林%王士傑%唐小青%郭連生%韓德民
황려휘%산학천%양의림%왕사걸%당소청%곽련생%한덕민
新生儿筛查%听力检查%诱发电位,听觉,脑干%耳声发射,自发性
新生兒篩查%聽力檢查%誘髮電位,聽覺,腦榦%耳聲髮射,自髮性
신생인사사%은력검사%유발전위,은각,뇌간%이성발사,자발성
Neonatal screening%Hearing tests%Evoked potentials,auditory,brain stem%Otoacoustic emissions,spontaneous
目的 探讨听力筛查未通过而短声(click)诱发听性脑干反应阈值正常婴幼儿的听力学特点,进一步分析畸变产物耳声发射(DPOAE)不同频率异常与其他客观听力检查异常之间的关系.方法 瞬态声诱发耳声发射(TEOAE)听力筛查未通过而接受包括DPOAE、短声ABR、40 Hz听觉相关电位、226 Hz声导抗、1000 Hz声导抗和声反射等诊断性听力学检查的患儿共695例,以其中诊断性短声诱发ABR阈值正常的新生儿及婴幼儿89例(123耳)作为研究对象,根据DPOAE频率异常的不同分为A组(全频正常)、B组(低频异常)、C组(高频异常)和D组(全频异常).对比各项听力检查结果,分析DPOAE频率异常各组与其他5项客观听力检查(ABR Ⅰ波潜伏期、40 Hz听觉相关电位、226 Hz鼓室声导抗、1000 Hz鼓室声导抗及声反射)之间的相互关系.结果 123耳中所有6项听力检查均正常者7耳(5.7%);6项听力检查中有一项或一项以上异常者116耳(94.3%).男婴的异常率为93.9%(77/82),女婴的异常率为95.1%(39/41),二者差异无统计学意义(P＞0.05);左耳异常率为93.1%(54/58),右耳异常率为95.4%(62/65),二者差异无统计学意义(P＞0.05).各组耳数所占比例由高到低分别是D组48.0%(59/123)、B组27.6%(34/123)、A组16.3%(20/123)和C组8.2%(10/123).A组、B组和D组中异常率最高的检查项目均为声反射,异常率分别为40.0%,55.9%和66.1%;而C组中异常率最高的项目为ABR Ⅰ波潜伏期(50.0%).各组低频听力损失均以轻度为主,在B组中有1耳为中度听力损失,D组中有6耳为中度听力损失,1耳为重度听力损失.结论 听力筛查未通过而短声ABR反应阈值正常的婴幼儿,如果DPOAE全频异常,需要及时进行全面的听力学评估,而DPOAE全频正常、低频异常或高频异常者,需要进行跟踪随访.
目的 探討聽力篩查未通過而短聲(click)誘髮聽性腦榦反應閾值正常嬰幼兒的聽力學特點,進一步分析畸變產物耳聲髮射(DPOAE)不同頻率異常與其他客觀聽力檢查異常之間的關繫.方法 瞬態聲誘髮耳聲髮射(TEOAE)聽力篩查未通過而接受包括DPOAE、短聲ABR、40 Hz聽覺相關電位、226 Hz聲導抗、1000 Hz聲導抗和聲反射等診斷性聽力學檢查的患兒共695例,以其中診斷性短聲誘髮ABR閾值正常的新生兒及嬰幼兒89例(123耳)作為研究對象,根據DPOAE頻率異常的不同分為A組(全頻正常)、B組(低頻異常)、C組(高頻異常)和D組(全頻異常).對比各項聽力檢查結果,分析DPOAE頻率異常各組與其他5項客觀聽力檢查(ABR Ⅰ波潛伏期、40 Hz聽覺相關電位、226 Hz鼓室聲導抗、1000 Hz鼓室聲導抗及聲反射)之間的相互關繫.結果 123耳中所有6項聽力檢查均正常者7耳(5.7%);6項聽力檢查中有一項或一項以上異常者116耳(94.3%).男嬰的異常率為93.9%(77/82),女嬰的異常率為95.1%(39/41),二者差異無統計學意義(P＞0.05);左耳異常率為93.1%(54/58),右耳異常率為95.4%(62/65),二者差異無統計學意義(P＞0.05).各組耳數所佔比例由高到低分彆是D組48.0%(59/123)、B組27.6%(34/123)、A組16.3%(20/123)和C組8.2%(10/123).A組、B組和D組中異常率最高的檢查項目均為聲反射,異常率分彆為40.0%,55.9%和66.1%;而C組中異常率最高的項目為ABR Ⅰ波潛伏期(50.0%).各組低頻聽力損失均以輕度為主,在B組中有1耳為中度聽力損失,D組中有6耳為中度聽力損失,1耳為重度聽力損失.結論 聽力篩查未通過而短聲ABR反應閾值正常的嬰幼兒,如果DPOAE全頻異常,需要及時進行全麵的聽力學評估,而DPOAE全頻正常、低頻異常或高頻異常者,需要進行跟蹤隨訪.
목적 탐토은력사사미통과이단성(click)유발은성뇌간반응역치정상영유인적은역학특점,진일보분석기변산물이성발사(DPOAE)불동빈솔이상여기타객관은력검사이상지간적관계.방법 순태성유발이성발사(TEOAE)은력사사미통과이접수포괄DPOAE、단성ABR、40 Hz은각상관전위、226 Hz성도항、1000 Hz성도항화성반사등진단성은역학검사적환인공695례,이기중진단성단성유발ABR역치정상적신생인급영유인89례(123이)작위연구대상,근거DPOAE빈솔이상적불동분위A조(전빈정상)、B조(저빈이상)、C조(고빈이상)화D조(전빈이상).대비각항은력검사결과,분석DPOAE빈솔이상각조여기타5항객관은력검사(ABR Ⅰ파잠복기、40 Hz은각상관전위、226 Hz고실성도항、1000 Hz고실성도항급성반사)지간적상호관계.결과 123이중소유6항은력검사균정상자7이(5.7%);6항은력검사중유일항혹일항이상이상자116이(94.3%).남영적이상솔위93.9%(77/82),녀영적이상솔위95.1%(39/41),이자차이무통계학의의(P＞0.05);좌이이상솔위93.1%(54/58),우이이상솔위95.4%(62/65),이자차이무통계학의의(P＞0.05).각조이수소점비례유고도저분별시D조48.0%(59/123)、B조27.6%(34/123)、A조16.3%(20/123)화C조8.2%(10/123).A조、B조화D조중이상솔최고적검사항목균위성반사,이상솔분별위40.0%,55.9%화66.1%;이C조중이상솔최고적항목위ABR Ⅰ파잠복기(50.0%).각조저빈은력손실균이경도위주,재B조중유1이위중도은력손실,D조중유6이위중도은력손실,1이위중도은력손실.결론 은력사사미통과이단성ABR반응역치정상적영유인,여과DPOAE전빈이상,수요급시진행전면적은역학평고,이DPOAE전빈정상、저빈이상혹고빈이상자,수요진행근종수방.
Objective The presnt study was to evaluate the audiological characteristics of infants with normal auditory brainstem response thresholds in click and abnormal transiently evoked otoacoustic emissions. Relationships between test results of distortion product otoacoustic emissions(DPOAE) and other hearing testing methods were also evaluated. Methods The participants consisted of eighty-nine infants,with a total of 123 ears. All participants' TEOAE screening results were abnormal but diagnostic click ABR results were normal. The participants were classified into the following goups based on the test results from distortion product otoacoustic emissions: group A (normal all-frequency ), group B (abnormal lowfrequency), group C (abnormal high-frequency ), and group D (abnormal all-frequency ). Results Obtained from these groups were compared to results of other hearing tests including the latency of ABR wave Ⅰ, 40 Hz auditory event related potential (40 Hz AERP), 226 Hz and 1000 Hz tympanometry, and acoustic reflex. Results In six hearing tests in the 123 ears, seven ears (5.7%) were normal, while 116ears (94. 3% ) were abnormal. No significantly differences were detected between boys (93.9%) and girls (95. 1% ), as well as between left (93. 1% ) and right ears (95.4%). The proportion of abnormal test results ranked as follows: 59 ears in group D (48.0%), 34 ears in group B (27.6%), 20 ears in group A (16. 3% ), and 10 ears in group C (8.2%). The highest abnormal rates in groups A, B and D were acoustic reflex, which were 40. 0% for group A, 55.9% for group B and 66. 1% for group D respectively.The highest abnormal rate in group C was the latency of ABR wave Ⅰ ( 50. 0% ). Distribution of lowfrequency hearing loss in each group was mainly mild. However, one ear in group B was moderate hearing loss, six ears in group D were moderate hearing loss, and one ear in group D was severe hearing loss.Conclusions The present study showed that, of which infants with normal thresholds of ABR failed the hearing screening, comprehensively audiology assessment is needed. And of which infants with normal DPOAE in full frequency or abnormal in high frequency region or low frequency region need to be followed up.
