感音神经性聋患儿的听功能综合评估  

Audiologic Comprehensive Evaluation of Sensorineural Deafness in Children

作　　者：蒋璐[1] 冯永[1] 柳炯[1] 梅凌云[1] 贺楚峰[1] 

机构地区：[1]中南大学湘雅医院耳鼻咽喉科教研室,长沙410008

出　　处：《听力学及言语疾病杂志》2010年第2期121-125,共5页Journal of Audiology and Speech Pathology

基　　金：国家863计划(2007AA02Z445);国家自然科学基金(30470954;30671150);"十一五"国家攻关计划(2007BA118B13);高等学校博士学科点专项基金(20060533043)资助

摘　　要：目的探讨听力测试组合（ABR＋ASSR＋声场环境中的行为测听）在感音神经性聋患儿残余听力评估中的应用价值。方法48名（96耳）感音神经性聋患儿中能配合纯音测听的患儿19人（38耳）设为PTA组，进行纯音测听及ASSR检测；不能配合纯音测听的患儿29人（58耳）设为BA组，进行声场环境中的行为测听（behavior audiometry，BA）、ABR及ASSR检测。结果①PTA组0．5、1、2、4kHz各频率ASSR反应阈与纯音听阈显著相关（P〈0．01），各频率相关系数分别为0．75、0．76、0．76、0．83，建立本实验室的ASSR—PTA直线回归方程；②BA组23耳ABR无反应但仍可引出ASSR，而ASSR无反应耳ABR均未能引出；BA组29例患儿中ASSR检测反应较好耳（29耳）在0．5～4kHz四个频率上，ASSR可测得83个反应阈值，行为测听可测得89个反应阈值，综合ASSR和行为测听可以得到96个反应阈值。结论与单项听力测试方法相比，听力测试组合（行为测听＋ABR＋ASSR）能为更小年龄、听力损失更重的患儿进行残余听力的评估，同时能对双侧耳间听力差异、各频率的听力损失程度进行评估，为听力损失病变的定位判断提供参考。Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR, ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children. Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test, and group BA of the children unable to perform on behavioral evaluations. Flesults The analysis of the au- diometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds （P〈0. 01） at various frequencies. The correlation coefficients were 0. 75,0. 76,0. 76, and 0.83 at different frequencies. The ASSR-PTA linear regression was utilized. The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR. Those without ASSR responses also had no ABR. There were 116 tests in total four frequencies for the 29 ears. 83 responses were obtained from ASSR, 89 responses from behavior audiometry and 96 from the use of the both tests. Gonclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe hearing loss children as compared to the pure tone audiometry alone. More detailed data can be obtained thus from children to assist in rehabilitation in a more effective manner.

关 键 词：听性稳态反应 听性脑干反应 行为测听 听力测试组合 

分 类 号：R764.431[医药卫生—耳鼻咽喉科] R764.5[医药卫生—临床医学]