婴幼儿单侧听力损失的听力学特征分析  

Analysis of audiological features in infants with unilateral hearing loss

作　　者：熊芬[1] 谢林怡[1] 史伟[1] 兰兰[1] 丁海娜[1] 张娇[2] 王秋菊[2] XIONG Fen;XIE Linyi;SHI Wei;LAN Lan;DING Haina;ZHANG Jiao;WANG Qiuju(Department of Otolaryngology Head and Neck Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing,100853,China;Department of Audiology and Vestibular Medicine,Institute of Otolaryngology,Senior Department of Otolaryngology Head and Neck Surgery,the Sixth Medical Center of Chinese PLA General Hospital,National Clinical Research Center for Otolaryngologic Diseases)

机构地区：[1]解放军总医院第一医学中心耳鼻咽喉头颈外科,北京100853 [2]解放军总医院第六医学中心耳鼻咽喉头颈外科医学部耳鼻咽喉内科、耳鼻咽喉研究所、国家耳鼻咽喉疾病临床医学研究中心

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第3期169-173,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金重点项目(No:81830028);国家自然科学基金优秀青年基金项目(No:82222016);国家自然科学基金面上项目(No:82271189、82271171、82171130);军队后勤科研计生专项(No:19JSZ14);解放军总医院医疗大数据分析及应用研究(No:2019MBD-005)联合资助。

摘　　要：目的:探讨婴幼儿单侧听力损失的听力学特征及可能的病因。方法:在北京妇幼保健机构新生儿听力筛查未通过而上转到解放军总医院儿童听力诊断中心进行听力诊断,确诊为单侧听力损失的婴幼儿105例,采集临床资料,进行全套听力学检查,包括听性脑干反应、40 Hz听觉相关电位、多频稳态反应、畸变产物耳声发射、鼓室声导抗测试。结果:(1)105例患儿初诊时,轻度听力损失45例(42.86%),中度听力损失19例(18.10%),重度听力损失14例(13.33%),极重度听力损失27例(25.71%);其中,传导性/混合性听力损失65例(61.90%),感音神经性听力损失40例(38.10%)。(2)105例患儿中83例进行了随访复诊,最后正常24例,轻度听力损失15例,中度听力损失4例,重度听力损失12例,极重度听力损失26例,单耳转双耳听力下降2例。(3)从初诊到随访复诊,单侧轻度听力损失患儿听力变化最大,单侧中度听力损失次之,单侧重、极重度听力损失患儿例数基本无变化;单侧轻、中度的传导性听力损失患儿恢复正常或改善最多,感音神经性听力损失患儿听力变化的例数较少。结论:新生儿听力筛查未通过而后诊断为单侧听力损失的患儿,以轻、中度传导性听力损失和重、极重度感音神经性听力损失为主,随着年龄增长,轻、中度听力损失患儿听力逐渐改善,重、极重度感音神经性听力损失无变化。Objective: To investigate the audiological characteristics and possible causes of unilateral hearing loss in infants and young children. Methods: 105 infants from Beijing Maternal and Child Health Care Institution who failed the newborn hearing screening and were referred to the Children’s Hearing Diagnosis Center of PLA General Hospital for hearing diagnosis. They were diagnosed with unilateral hearing loss and underwent clinical data collection. A full set of audiological examinations included ABR, 40 Hz auditory event related potential, ASSR, DPOAE, tympanometry. Results:(1)In initial diagnosis, 45 cases(42.86%) had mild hearing loss, 19 cases(18.10%) had moderate hearing loss, 14 cases(13.33%) had severe hearing loss, and 27 cases(25.71%) had severe hearing loss;Among them, 65 cases(61.90%) were conductive hearing loss or mixed hearing loss, and 40 cases(38.10%) were sensorineural hearing loss.(2)83 of 105 cases had follow-up visits: 24 cases were normal, 15 cases with mild hearing loss, 4 cases with moderate hearing loss, 12 cases with severe hearing loss, and 26 cases with extremely severe hearing loss, 2 cases of hearing loss in both ears.(3)From the initial diagnosis to the follow-up diagnosis, the change of mild hearing loss was the largest, followed by moderate hearing loss, severe and extremely severe hearing loss basically did not change;the number of mild and severe conductive hearing loss which recovered to normal hearing was most, the number of sensorineural hearing loss changed little. Conclusion: The infants who failed the newborn hearing screening and were diagnosed with unilateral hearing loss were mainly mild to moderate conductive hearing loss and severe to extremely severe sensorineural hearing loss. The hearing of children with hearing loss gradually improved, and severe and extremely severe sensorineural hearing loss remained unchanged.

关 键 词：听力筛查 婴幼儿 听力损失 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]