气、骨导ABR和窄带CE-Chirp ASSR在先天性外耳畸形婴儿听力评估中的应用  

Application of Air and Bone Conduction ABRs and Narrowband CE-Chirp ASSRs in Hearing Assessment of Infants with Congenital External Ear Malformation

作　　者：丁璐 王梅红 张英慧 施泓 杨一晖[1] 张新钢 郑周数 DING Lu;WANG Meihong;ZHANG Yinghui;SHI Hong;YANG Yihui;ZHANG Xingang;ZHENG Zhoushu(Ningbo Women and Children's Hospital;Cixi Traditional Chinese Medicine Hospital,Ningbo)

机构地区：[1]宁波市妇女儿童医院 [2]宁波市慈溪市中医医院

出　　处：《中华耳科学杂志》2021年第5期759-763,共5页Chinese Journal of Otology

基　　金：浙江省医药卫生科技计划项目(2020KY882);宁波市创新团队项目(2014B82003)。

摘　　要：目的评估先天性外耳畸形婴儿的听力学特点,探讨气、骨导ABR和窄带CE-Chirp ASSR评估先天性外耳畸形婴儿听力的价值。方法对32例(35耳)先天性外耳畸形婴儿和28例(30耳)正常婴儿分别行气、骨导ABR和窄带CE-Chirp ASSR测试,分析畸形组与正常组气、骨导ABR反应阈和潜伏期之间的相关性,以及畸形组窄带CE-ChirpASSR各频率之间的相关性。结果畸形组32例(35耳)中,3耳(8.57%)为轻度听力障碍,26耳(74.29%)为中度听力障碍,5耳(14.29%)为重度听力障碍,1耳(2.86%)为极重度听力障碍。气导ABR测试,畸形组的反应阈为64.86±10.18dBnHL,Ⅴ波潜伏期为8.37±0.73ms,畸形组与正常组反应阈存在显著统计学差异(P=0.00<0.05),两者潜伏期无统计学差异。骨导ABR测试,畸形组反应阈为14.71±7.57dBnHL,Ⅴ波潜伏期为9.40±0.91ms,畸形组与正常组反应阈及潜伏期均无统计学差异。畸形组的ChirpASSR 0.5、1、2与4 kHz的结果分别为51.29±17.38dBcorHL、56.71±14.29 dBcorHL、55±12.66 dBcorHL与51.14±12.13 dBcorHL,各频率之间没有统计学差异。结论多数先天性外耳畸形婴儿为中、重度传导性听力损失,常合并中耳畸形,并且听力结构图为平坦型。气、骨导ABR和窄带CE-ChirpASSR能较好地评估先天性外耳畸形婴儿听力特征。Objective To report audiological characteristics of infants with congenital external ear malformation and to investigate the value of air and bone conduction ABRs and NB CE-Chirp ASSRs in evaluating hearing in these in-fants.Methods Air and bone conduction ABRs and NB CE-Chirp ASSRs were tested in 32 infants(35 ears)with con-genital external ear malformation and 28 normal infants(30 ears).Response thresholds and latencies of ABRs were com-pared between the malformation and normal groups and correlation of NB CE-Chirp ASSR frequencies to external ear malformation was analyzed.Results Of the 35 ears with malformation,26(74.29%)showed moderate hearing impair-ment,and 5(14.29%)showed severe hearing impairment.Air conduction ABR response threshold was 64.86±10.18 dB nHL in the malformation group,higher than that in the normal groups(P=0.00<0.05),with waveⅤlatency at 8.37±0.73 ms and not significantly different from that in the normal group.Bone conduction ABR threshold was 14.71±7.57 dB nHL with theⅤlatency at 9.40±0.91 ms in the malformation group,and not significantly different from the normal group.Chirp ASSR thresholds at 0.5,1,2 and 4 kHz in the malformation group were 51.29±17.38dB corHL,56.71±14.29dB corHL,55±12.66dB corHL and 51.14±12.13dB corHL,respectively,with no significant difference among the frequencies.Conclusion Most infants with congenital external ear malformation showe moderate to severe conductive hearing loss of flat patterns,often with middle ear malformation.Air and bone conduction ABRs and NB CE Chirp ASSRs can improve evaluation of hearing in infants with congenital external ear malformations.

关 键 词：ABR 气导 骨导 ChirpASSR 先天性外耳畸形 

分 类 号：R764[医药卫生—耳鼻咽喉科]