Kayano K, Suzuki H, Nakano H, Hayashido K, Kimura T, Tatemoto K, Nishiyama A, Fukushima T
Department of Otolaryngology, Kyoto First Red Cross Hospital.
Nihon Jibiinkoka Gakkai Kaiho. 2000 Aug;103(8):885-93. doi: 10.3950/jibiinkoka.103.885.
Natus-ALGO 2e, an automated ABR screener(Natus Medical, Foster City, CA, USA), compares the V wave of ABR evoked by 35-dB-nHL click stimuli by using a template-matching detection algorithm that provides only a pass-refer outcome. The aim of this study was to compare Natus-ALGO 2e with conventional ABR, and to evaluate its usefulness. The Natus-ALGO 2e screener was used to screen 202 ears of 101 neonates in our neonatal intensive care unit. The mean conceptional age at the time of screening was 40.4 +/- 3.0 weeks. 60 ears of 30 infants at high-risk of hearing impairment, including "refer" infants, were tested by the Natus-ALGO 2e and conventional ABR methods, and the results were compared. All neonates were tested with the Natus-ALGO 2e screener in a state of natural sleep, and screening time averaged 2 minutes 58 seconds. There were 97 cases in which both ears were passed, 3 cases in which both ears were referred, and one case in which one ear was referred. In comparison with conventional ABR, 53 of the 60 ears of 30 high-risk infants passed by the Natus-ALGO 2e method, whereas 14 of the 53 ears initially failed the conventional ABR screening. Of these 14 ears disagreements (the results of the Natus-ALGO 2e method passed, but the results of the conventional ABR failed), the results of the ABR screening changed to normal in 11 ears, and ABR showed improved threshold and latency in the other 3 ears after 5 weeks to 12 months. Among those that passed the Natus-ALGO 2e screening, the number of sweeps that failed the ABR screen was significantly greater than with normal ABR. Of the 7 ears of 4 patients that were referred on the basis of the Natus-ALGO 2e screening and failed by the conventional ABR method, 3 ears screened by the ABR method were normal when retested, and one ear passed by the Natus-ALGO 2e screening 12 weeks to 11 months later. In conclusion, Natus-ALGO 2e is useful for screening infant hearing because it can be performed quickly while the patient is sleeping naturally. In infants at high-risk for hearing impairment, the results of Natus-ALGO 2e and conventional ABR screening conflicted in numerous sweeps. Therefore, when there are many sweeps in high-risk infants, a retest should be performed that includes conventional ABR, even if they passed with Natus-ALGO 2e.
Natus-ALGO 2e是一款自动听性脑干反应（ABR）筛查仪（美国加利福尼亚州福斯特城的Natus Medical公司生产），它通过使用模板匹配检测算法，比较由35分贝正常听力级（nHL）短声刺激诱发的ABR的V波，该算法仅提供通过-转诊结果。本研究的目的是将Natus-ALGO 2e与传统ABR进行比较，并评估其效用。在我们的新生儿重症监护病房，使用Natus-ALGO 2e筛查仪对101名新生儿的202只耳朵进行了筛查。筛查时的平均孕龄为40.4±3.0周。对30名有听力障碍高风险的婴儿（包括“转诊”婴儿）的60只耳朵，采用Natus-ALGO 2e和传统ABR方法进行检测，并比较结果。所有新生儿均在自然睡眠状态下使用Natus-ALGO 2e筛查仪进行检测，筛查时间平均为2分58秒。双耳通过的有97例，双耳转诊的有|3例，单耳转诊的有1例。与传统ABR相比，30名高风险婴儿的60只耳朵中，有53只通过了Natus-ALGO 2e方法的检测，而在最初传统ABR筛查未通过的5 |只耳朵中，有14只耳朵出现了差异（Natus-ALGO 2e方法的结果为通过，但传统ABR的结果为未通过）。在这14只存在差异的耳朵中（Natus-ALGO 2e方法的结果为通过，但传统ABR的结果为未通过），5至12个月后，11只耳朵的ABR筛查结果变为正常，另外3只耳朵的ABR阈值和潜伏期有所改善。在通过Natus-ALGO 2e筛查的婴儿中，ABR筛查未通过的扫描次数明显多于正常ABR。在基于Natus-ALGO 2e筛查被转诊且传统ABR方法检测未通过的4名患者的7只耳朵中，3只耳朵再次检测时ABR方法筛查结果正常，1只耳朵在12周后至11个月时通过了Natus-ALGO 2e筛查。总之，Natus-ALGO 2e可在患者自然睡眠时快速进行检测，因此对婴儿听力筛查很有用。在有听力障碍高风险的婴儿中，Natus-ALGO 2e和传统ABR筛查结果在多次扫描中存在冲突。因此，在高风险婴儿中，即使他们通过了Natus-ALGO 2e的检测，也应进行包括传统ABR在内的重新检测。
