摘要
目的探讨婴幼儿听力评估中多种客观听力测试方法联合应用的价值。方法回顾性分析2004年1月至2006年12月进行听力学诊断的350例婴幼儿病历资料，其诊断年龄为46天～3岁．平均为1岁7个月。350例患儿进行了听性脑干反应（auditory brainstem response，ABR）、40Hz听觉相关电位（40 Hz auditory event related potential，40Hz—AERP）、听性稳态反应（auditory steady--state response，ASSR）、畸变产物耳声发射（distortion product otoacoustic emission，DPOAE）及鼓室导抗图测试（tympanometry）。结果350例（700耳）婴幼儿中听力损失总耳数为648耳（92．57％）．其中感音神经性听力损失600耳（85．71％），传导性听力损失或混合性听力损失18耳（6．86％）。听力损失的648耳中．各项检查的检出耳数分别为：ABR 605耳（93．36％），40 Hz—AERP 596耳（91．98％）．ASSR622耳（95．99％）．DPOAE 601耳（92．75％），226Hz鼓室导抗图268耳（41．36％）。DPOAE固定正常的99耳中．ABR各波消失或严重异常22耳。ABR测试中记录到声诱发短潜伏期负反应53例（93耳）。完成1000Hz鼓窄导抗图测试的103耳中存在异常的耳数为40耳。经检查诊断小儿听神经病22耳（12例）．辅助诊断大前庭水管综合征53例．初步诊断婴幼儿中耳炎40耳。350例患儿的ABR的波V反应阈为：≤30dB nHL占13．57％．31～50 dB nHL占7.43％，51～70dBnHL占8．57％．71～90dBnHL占13．14％，≥91 dB nHL。占57．29％。结论婴幼儿听力评估中，联合应用多种客观听力测试方法可以提高检出率。结合应用DPOAE和ABR对早期诊断听神经病有重要意义，观察ABR声诱发短潜伏期负反应有助于临床诊断大前庭水管综合征．1000Hz鼓室导抗图有助于婴幼儿中耳病变的诊断。
Objective To understand the significance of using electrophysiological audiologic battery to evaluate the bearing loss in infants. Methods 350 infants, with an average age of 19 months from 46 days to 3 years, received a full eleetrophysiological battery consisting of auditory brainstem responses （ABRs）, 40 Hz auditory event related potential （10 Hz--AERP）, auditory steady--state responses （ASSRs）, distortion product otoaeoustic emissions （DPOAEs） and tympanometry. Results 648 of the 700 ears were found with hearing loss. Of the 648 ears, the ABR showed abnormal results in 605 ears （93.36%）, the 40 Hz--AERP in 596 ears（91.98%） , ASSR in 622 ears （95.99 %）. DPOAE in 601 ears （92.75% ） and tympanometry of 226 Hz in 268 ears （41.36% ）. It was worthy noted that in 99 ears witb normal DPOAEs, 22 had abnormal ABR responses. 93 ears in 53 patients showed acoustically evoked short latency negative response （ASNR） in ABR, and 40 ears had abnormal results in 1 000 Hz tympa nometry. The results indicate tbat from 350 infants, 22 ears （12 cases） were associated with auditory neuropathy （AN）. 53 were diagnosed as having enlarged vestibular aqueduct syndrome （EVAS）, and 40 ears as having otitis media with effusion. Conclusion In infant hearing evaluations, a full battery of electrophysiological measures can be an effective approach to identifying the hearing loss.
出处
《听力学及言语疾病杂志》
CAS
CSCD
2008年第5期379-382,共4页
Journal of Audiology and Speech Pathology
基金
国家863项目(编号2006AA02Z181)
国家自然基金面上项目(编号30470956
30572016&30672310)
高等学校全国优秀博士学位论文作者专项资金资助项目(编号200463)
军队"十一五"杰出人才项目(编号06J018)
北京市重大专项课题项目(编号7070002)联合资助
关键词
客观听力测试
听力损失
婴幼儿
Electrophysiological measures
Hearing loss
Infant
