双侧先天性小耳畸形并外耳道闭锁婴幼儿软带Ponto疗效初步分析  

Efficacy of softband Ponto in young children with bilateral congenital microtia with aural atresia

作　　者：王艺贝 陈晓巍[1] 樊悦[1] 王珍[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京100730

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第4期291-294,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：“十二五”国家科技支撑计划资助项目(No:2012BAI12B01);国家自然科学基金(No:81450026)

摘　　要：目的：评估双侧先天性小耳畸形并外耳道闭锁婴幼儿佩戴软带Ponto的疗效及听觉发育情况。方法：双侧先天性小耳畸形并外耳道闭锁患儿20例（年龄3~21个月）,听性脑干反应（ABR）骨导反应阈均小于25dBnHL,气导反应阈大于45dBnHL。佩戴软带Ponto,每天佩戴2.5~8.0h,随访3~6个月。通过视觉强化测听（VRA）评估1岁以上患儿佩戴软带Ponto后行为反应阈。应用婴幼儿有意义听觉整合量表（IT-MAIS）评估其佩戴当日、佩戴3个月及佩戴6个月时的听觉发育情况。结果：患儿ABR骨导反应阈平均值为（17.5±5.9）dBnHL,气导反应阈平均值为（72.5±9.3）dBnHL。其中5例年龄满1岁患儿佩戴软带Ponto后测VRA500~4 000Hz平均听阈为（30.5±5.9）dB HL。患儿佩戴软带Ponto前听觉发育均低于正常水平,佩戴3个月及6个月后IT-MAIS评分显著提高,且逐渐接近正常水平。结论：软带Ponto有助于双侧先天性耳廓畸形合并外耳道闭锁婴幼儿的听觉发育,可作为手术植入助听装置前的过渡治疗,尽早应用于临床。Objective：To evaluate auditory developments and the effectiveness of children with congenital bilateral aural atresia after using softband Ponto and to compare them with children with normal hearing.Method：Twenty patients（age ranging from 3months to 21months）with bilateral aural atresia were studied.The air and bone auditory thresholds were assessed by auditory brain stem response（ABR）.The infant-todder meaning auditory integration scale（IT-MAIS）was used to evaluate the auditory development at three time levels：baseline,3months and 6months.Result：The average unaided bone conduction hearing thresholds of patients is（17.5±5.9）dB nHL,and the average air conduction hearing thresholds is（72.5±9.3）dB nHL.The average VRA hearing thresholds of 5patients is（30.5±5.9）dB HL.The IT-MAIS total,detection and perception scores are improved specifically after wearing softband Ponto and approaching the normal level.Conclusion：Softband Ponto is suitable for infants with bilateral atresia.Results from these auditory development testing are encouraging.Softband Ponto should be used as a bridge for surgical implantations when temporal bone is thick enough.

关 键 词：小耳畸形 外耳道闭锁 软带Ponto 听觉发育 

分 类 号：R764.7[医药卫生—耳鼻咽喉科]