前庭水管扩大患儿纯音听力特征性表现——低频骨气导差  

The characteristic of enlarged vestibular aqueducts syndrome in pure tone audiometry:low frequency air-bone gap

作　　者：兰兰[1] 王秋菊[1] 陈之慧[1] 丁海娜[1] 赵建东[1] 郭明丽[1] 于黎明[1] 

机构地区：[1]解放军总医院耳鼻咽喉-头颈外科解放军耳鼻咽喉科研究所,北京100853

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第7期309-311,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金面上项目(No:30370782;30470956);北京市重大科技项目课题(No:H020220020610);高等学校全国优秀博士学位论文作者专项资金资助项目(No:200463)

摘　　要：目的：分析前庭水管扩大（EVA）患儿行纯音测听检查时出现低频骨气导差的比例，探讨纯音测听检查辅助临床诊断EVA的意义。方法：所有患儿均经小儿行为测听或纯音测听、声导抗检查，并行颞骨CT扫描或耳蜗磁共振水成像检查了解中耳及内耳的发育情况。结果：声导抗检查：78例（154耳）中耳鼓室声导抗曲线均为A型，其中单纯A型126耳，As型25耳，Ad型3耳；15耳引出声反射。纯音测听检查：在250Hz处，126耳（81．8oA）存在骨气导差，按听力损失程度分类：轻度1耳，中度12耳，中重度18耳，重度38耳，极重度57耳；在500Hz处，102耳（66．2％）存在骨气导差，按听力损失程度分类：轻度0耳，中度9耳，中重度17耳．重度35耳，极重度41耳。结论：进行纯音测听检查时，在中耳功能正常（中耳声导抗鼓室图为A型）情况下，若发现明显的低频骨气导差，可有66．2％～81．8％的概率提示患儿存在EVA。Objective：The purposes of this study was to analyse the significant of low frequency air-bone gap in enlarged vestibular aqudeduct（EVA） patients according to the pure tone audiogram and the benefit for clinic diagnosis of the EVA. Method：The audiology testing include ①play audiometry or pure tone audiometry, tympanometry, middle ear muscle reflex thresholds and stapedius muscle reflex; ②High-resolution computed tomography （CT） scan of the temporal bone and magnetic resonance imaging was used for diagnoses the EVA. Result： All the 78 patients（154 ears） were diagnosed as the typical EVA by CT or MRI. Inner ear malformations were found in 3 ears otherwise the structures of middle ear in all the patients were absolutely normal. The audiology analysis showed 154 ears were type A tympanogram including 126 ears with typical A, 25 ears with As, 3 ears with Ad type. In the 250 Hz pure-tone test：A-B gap were observed in 126 ears（126/154,81.8%） with the different hearing loss degree： 1 ear mild, 11 ears moderate, 19 ears moderate severe, 40 ears severe and 53 ears profound. In the 500 Hz pure-tone test： A-B gap were found in 102 ears（102/154, 66.2%） with the different hearing loss degree： 9 ears moderate, 17 ears moderate severe, 35 ears severe and 41 ears profound. Conclusion：Our study suggested a 66.2%-81.8% possibilities to find the EVA through the pure-tone audiometry firstly in the basis of the normal tympanograms with the significant A-B gap.

关 键 词：前庭水管扩大 测听法 纯音 声导抗检查 儿童 

分 类 号：R764[医药卫生—耳鼻咽喉科]