29例伴智力运动发育缺陷的听障儿童听力评估  

Hearing Assessment in 29 Hearing-impaired Children with Mental and Motor Development Deficits

作　　者：王月琪 张燕梅[1] 宗雅静 秦瑶[1] 曾镇罡[1] 刘玉和[1] WANG Yueqi;ZHANG Yanmei;ZHONG Yajing;QIN Yao;ZENG Zhengang;LIU Yuhe(Department of Otorhinolaryngology Head and Neck Surgery,Peking University First Hospital,Beijing 100034,PR China)

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,北京100034

出　　处：《中华耳科学杂志》2021年第4期706-710,共5页Chinese Journal of Otology

基　　金：北京市科学技术委员会资助课题,项目编号:Z191100006619027;国家自然科学基金面上项目资助课题,项目编号:82071070。

摘　　要：目的探讨伴智力运动发育缺陷的听障儿童的听力评估方法和听力学特点。方法回顾性分析29例伴有智力运动缺陷的听力障碍儿童临床资料,总结伴智力运动发育缺陷的听障儿童听力综合评估流程和方法,采用智力运动发育缺陷儿童听觉发展父母问卷结合儿童行为测听以及听觉电生理检查等,综合评估,判断听力损失的性质和程度,分析各听力检测方法在伴智力运动发育缺陷的听障儿童听力评估的可靠性,以及伴智力运动发育缺陷听障儿童的听力学特点。结果29例伴有智力运动发育缺陷儿童中,12例完成行为测听,获得可靠结果,轻度6例10耳,中度7例9耳,中重度1例1耳,重度2例2耳,极重度1例2耳。4例8耳为全聋型听力损失。8例通过ABR V波判断听力损失程度,轻度3例5耳,中度3例6耳,中重度3例3耳,重度1例1耳,极重度1例1耳。5例不能完成行为测听,父母问卷结果显示无听觉反应,ABR阈值为20-65dBnHL,提示中枢性听力损失,无法判断听力损失程度。29例儿童中11例存在两种性质的听力损失,18例为单一性质的听力损失。其中5例合并传导性听力损失,16例为耳蜗性听力损失,10例存在神经性听力损失,8例诊断为中枢性听力损失。结论智力运动发育缺陷患儿儿童行为测听有时难以获得可靠结果。以听觉发展父母问卷为主导,结合儿童行为测听和听觉电生理检查,综合评估伴智力运动发育缺陷儿童的听力损失性质与程度。神经性和中枢性听力损失在智力运动发育缺陷儿童中常见。Objective To study methods of hearing assessment for children with mental motor development defects.Methods This retrospective study included 29 children with mental motor development defects.The Auditory Development Parent Questionnaire for Children with Mental Motor Development Defects,behavior hearing tests and auditory electrophysiological tests were administered and audiology characteristics analyzed.Results Behavioral audiometry was completed in 12 patients with reliable results.Hearing loss was mild in 6 patients(10 ears),moderate in 7 patients(9 ears),moderate/severe in 1 patient(1 ear),severe in 2 patients(2 ears)and profound in 1 patient(2 ears).Four patients(8 ears)had total deafness.ABR wave V was used to determine the severity of hearing loss in 8 cases,showing mild loss in 5 ears,moderate loss in 6 ears,moderate/severe loss in 3 ears,in 1 severe loss in 1 ear and profound loss in 1 ear.Behavior audiometric test could not be completed in 5 cases,in which parental questionnaire answers suggested no auditory responses and ABR thresholds were at 20-65 dB nHL,suggesting central hearing loss with no information on the degree hearing loss.Of the 29 children,11 had more than one type of hearing loss.Conductive hearing loss was seen in 5 cases,cochlear loss in 16 cases,neural loss in 10 cases and central loss in 8 cases.Conclusion Behavioral audiometry can be difficult in children with mental motor development defects.Parents'questionnaire is the first choice for hearing assessment in hearing-impaired infants with mental retardation,which can be combined with behavioral and electrophysiological audiometry to achieve comprehensive evaluation of hearing status in these children to help formulate corresponding intervention strategies and promote intellectual development and hearing rehabilitation.

关 键 词：儿童 智力运动缺陷 听力损失 听力评估 

分 类 号：R764[医药卫生—耳鼻咽喉科]