窄带CE-Chirp声诱发的ASSR在婴儿听力筛查及诊断中的应用  

NB CE-Chirp ASSR Application in Infant Hearing Screening and Diagnosis

作　　者：史伟[1] 郭维[1] 王秋菊[1] 

机构地区：[1]中国人民解放军总医院耳鼻咽喉-头颈外科,解放军耳鼻咽喉研究所,北京100853

出　　处：《听力学及言语疾病杂志》2011年第1期7-9,共3页Journal of Audiology and Speech Pathology

基　　金：国家863项目(2006AA02Z181);国家自然基金重点项目(30830104),国家自然基金面上项目(30771203);北京市重大专项课题项目(7070002);国家“十一五”科技支撑计划(2007BAI18B12)联合资助

摘　　要：目的探讨窄带CE-Chirp声诱发的听性稳态反应(ASSR)在婴儿听力筛查及诊断中应用的可行性。方法对10例(20耳)耳声发射听力筛查双耳未通过的婴儿(观察组)行ASSR筛查,年龄2～12个月,平均6个月。对照组为10例(20耳)听力正常且耳声发射听力筛查通过的婴儿,年龄为1～11个月,平均6个月。观察组婴儿自然睡眠或测试前口服10%的水合氯醛溶液后进入睡眠,对照组婴儿在自然睡眠下进行测试。应用丹麦国际听力(Inter-acoustics)的EclipseASSR1.02系统,刺激声为窄带(NB)CE-Chirp声,刺激重复率为90次/秒。耳机型号为ER-3A插入式气导耳机。刺激声强度≤80dBnHL时,4个频率双耳同时给声(0.5、1、2、4kHz);刺激声强度>80dBnHL时,单频率双耳给声。初始给声强度为30dBnHL,4个频率都引出反应,判定为ASSR筛查通过;若某个频率未引出,则以20dB一档提高刺激声强度直至引出反应后,再采用降10升5的方法,分别找到每个频率的反应阈。结果观察组10例(20耳)中有2耳(10%)ASSR检查通过,ASSR检查未通过的18耳分别得出500、1000、2000、4000Hz的听阈所用时间为2.4～36.1分钟,平均24.5分钟;对照组10例(20耳)ASSR检查均通过,所用时间为45秒～5.5分钟,平均3.2分钟。结论 NBCE-Chirp ASSR具有快速、特异性高的特点,可用于婴儿听力筛查和频率特异性听力评估。Objective To investigate the probability of using NB CE--Chirp ASSR in infant hearing screening and diagnosis of hearing loss. Methods 10 infants aged from 2 to 12 months with an average age of ca months （20 ears） who referred on OAE test received the NB CE--Chirp ASSR test after sedated by chloridehydrate. While 10 normal hearing infants aged from 1 to ll months with an average age of 6 months （20 ears） received the NB CE--Chirp ASSR test after sleeping. Interacoustics Eclipse ASSR 1.02 system was used in the test, NB CE--Chirp stimulus at a rate of 90/s, and presented by the ER-3A insert earphones. We tested four frequencies on both ears simultaneously when the intensity of stimulus was less than or equal to 80 dB nHL, and tested each frequency on both ears when the intensity was greater than 80 dB nHL. 20 infants were initially tested at 30 dB nilE. We considered ASSR test pass, if all the four frequencies pass, and found out the threshold if they didn＇t pass with the step of 5 dB. Results Of the 20 ears which referred on the OAE test, 2 ears passed the ASSR test, 18 ears received hearing threshold evaluation at 500 Hz, 1 000 Hz, 2 000 Hz and 4 000 Hz. All the normal--hearing infants （20 ears） passed ASSR test. The testing time in OAE refer groups was 2.4-36.1 minutes （average of 24.5 minutes） and while was 0.8-5.5 minutes （average of 3.2 minutes） in normal group. Conclusion NB CE-Chirp ASSR provided shorter detection time, higher sensibility and better frequency characteristic of speech for infant hearing screening and hearing loss diagnosis.

关 键 词：CE—Chirp声 听性稳态反应 听力筛查 婴儿 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]