小儿听神经病神经生理学特点及意义  

Neurophysiological characteristics of infants and young children with auditory neuropathy

作　　者：王登元[1] 卜行宽[1] 邢光前[1] 陆玲[1] 

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,210029

出　　处：《中华医学杂志》2003年第4期281-284,共4页National Medical Journal of China

摘　　要：目的 分析小儿听神经病(AN)神经生理学特点,探讨其在诊断和治疗方面的意义。方法 对13例小儿患者在采集病史和耳科检查的基础上,行系统的听力学检查,包括声导抗、听性脑干反应(ABR)、耳蜗微音电位(CM)、诱发耳声发射(EOAEs)、中潜伏期反应(MLR)和事件相关电位(ERP)以及影像学(CT和/或MRI)和周围神经系统检查。结果 13例患儿鼓室图均呈“A”型、镫骨肌反射及ABR均引不出或明显异常,但CM均正常。除1例有新生儿缺血缺氧史的患儿EOAEs未引出,其余12例皆正常引出。8例患儿记录到MLR,6例可记录到ERP。6例患儿影像学和周围神经系统未见异常。结论 对小儿AN的诊断应着重分析其神经生理学特点。对高危新生儿的听力筛查推荐联合应用EOAEs、ABR和CM,以免漏诊、误诊。Objective To analyze the neurophysiological characteristics of infants and young children with auditory neuropathy ( AN) and explore their clinical significance. Methods Audiological measurements (acoustic immittance, EOAEs, ABR, CM,MLR and ERP) and peripheral neurological tests were conducted and evaluated in 13 infants and young children with AN. 6 AN patients received CT scan and/or MRI examination. Results All patients had type 'A' tympanogram and normal CM. Normal EOAEs were elicited in 12 patients. 8 cases had normal MLR recording and 6 cases had normal ERP (P300 and MMN) . Peripheral neurological tests and CT and/or MRI showed normal results. Conclusion The diagnosis of AN in infants and young children should focus on analyzing their neurophysiological characteristics. Combined use of EOAEs, ABR and CM was recommended for hearing screening on newborns with high risk factors

关 键 词：儿童 听力检查 前庭耳蜗神经疾病 诱发性耳声发射 耳蜗微音电位 

分 类 号：R764[医药卫生—耳鼻咽喉科]