听性脑干反应消失婴幼儿252例听力学结果分析  

Analyses of audiological examination in children without auditory brainstem response

作　　者：张慧[1] 耿曼英[1] 米彦芳[1] 单子丽[1] 汤建芬[1] 郭小艳[1] Zhang Hui;Geng Manying;Mi Yanfang;Shan Zili;Tang Jianfen;Guo Xiaoyan(Department of Otorhinolaryngology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院耳鼻咽喉科,450014

出　　处：《中华耳鼻咽喉头颈外科杂志》2019年第7期540-543,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：河南省科技攻关计划项目(20130384).

摘　　要：目的通过多种客观听力测试方法应用,了解听性脑干反应(auditory brainstem response,ABR)最大强度波形消失耳聋婴幼儿的残余听力情况。方法回顾性分析2015年1月至2018年4月在郑州大学第二附属医院行听力诊断的252例(504耳)婴幼儿患者的病例资料,其中男159例(318耳),女93例(186耳);诊断年龄为72 d到4岁,平均年龄为1岁8个月。252例婴幼儿均进行了ABR、40 Hz听觉相关电位(40 Hz auditory event related potential,40 HzAERP)、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),且满足ABR最大强度未引出,DPOAE各频率未引出,鼓室图为A型或单峰。以SPSS16.0软件对数据进行统计学分析。结果40 HzAERP、ASSR测试均引出444耳(88.1%),均未引出60耳(11.9%);ASSR测试0.5、1、2 kHz引出率较高,分别为84.1%、87.5%、79.8%,明显高于4 kHz引出率(58.7%),差异有统计学意义(Z值分别为2.01、2.20、2.57,P值均<0.05);38例72耳(14.3%)检测到耳蜗微音电位(cochlear microphonic potentials,CM)。结论ABR最大强度各波消失的婴幼儿联合40 HzAERP、ASSR测试可全面评估婴幼儿的残余听力;当ABR最大强度各波消失时,常规检测CM波,有助于听神经病的诊断。Objective To investigate residual hearing of children severe and profound sensorineural deafness in whom wave V was not found in auditory brainstem response(ABR) testing, and to emphasize the importance of objective audiological tests. Methods Two hundred and fifty-two children who were admitted to the Second Affiliated Hospital of Zhengzhou University between January 2015 and April 2018, with an average age of 20 months from 72 days to 4 years, received a full battery of objective audiological tests consisting of distortion product otoacoustic emission(DPOAEs), tympanometry, auditory brainstem responses(ABRs), 40 Hz auditory event related potential(40 HzAERP) and auditory steady-state response(ASSRs).There were 159 males(318 ears) and 93 females(186 ears). Residual hearing obtained by 40 HzAERP、ASSR of 252 children with sensorineural deafness was studied in relation to the absence of wave V in click ABR. SPSS 16.0 software was used to analyze the data. Results Four hundred and forty-four ears of 504 ears have residual hearing of different degrees at different frequencies(88.1%),60 ears (11.9%) were found in whom responses was not found in 40 HzAERP、ASSR testing;Seventy-two ears(14.3%) in 38 patients were tested cochlear microphonic potentials (CMs). Conclusion In children hearing evaluations,a full battery of objective audiological tests could better investigate residual hearing;The CMs were tested could provide the Audiotery Neuropathy diagnosis in infants with OAEs and ABR absent.

关 键 词：听性脑干反应 残余听力 耳蜗微音电位 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]