Baumann U, Schorn K
Universitäts-HNO-Klinik, Klinikum Grosshadern, Marchioninistrasse 15, 81377 München.
HNO. 2001 Feb;49(2):118-25. doi: 10.1007/s001060050720.
The recording of otoacoustic emissions is suitable for the detection of hearing loss in small children. The test meets the following requirements for hearing screening: it is carried out in a few minutes, specialized personnel is not necessary, the results do not depend on the vigilance of the child, and total costs are comparably low. However, the choice of a suitable device is quite essential. A test of the ILO88, ILO92, Echosensor (Otodynamics Ltd.), and Echoscreen (Madsen) devices was performed with 102 children (aged < 1 year). Additionally, a software package (Otoclass) for offline analysis of ILO88 data files was tested. The results indicate that all devices applying OAE as a screening measure was able to detect every ear (n = 25) with a hearing loss indicated by the outcome of a control BERA (stimulus level 35 dB nHL), thus reaching a sensitivity equal to 100%. The specificity of the different OAE devices depends on the underlying detection strategy. The best results were achieved with the automated Echoscreen device (95.9%) followed by the Otoclass analysis software (94.2%). The Echosensor device failed in our study to provide good specificity (77.3%). Reflex audiometry, which is favored by pediatricians in Germany, when used alone is completely inadequate as a screening method, even if conducted by a well-trained investigator. In our study, only 61.5% of the children with hearing loss were detected with reflex audiometry, and 42.7% of the children with normal hearing were misclassified. These results deviated from the results presented in ref. 13 to a large extent, as the Hanover group attested sensitivity and specificity of 100% for reflex audiometry (HNO 43, Reuter et al.). The deviating results are discussed in detail.
耳声发射记录适用于检测幼儿听力损失。该测试满足听力筛查的以下要求：测试在几分钟内即可完成，无需专业人员，结果不依赖于儿童的警觉性，且总成本相对较低。然而，选择合适的设备至关重要。对102名1岁以下儿童使用ILO88、ILO92、回声传感器（Otodynamics有限公司）和回声筛查仪（Madsen）设备进行了测试。此外，还测试了用于离线分析ILO88数据文件的软件包（耳声发射分类软件）。结果表明，所有将耳声发射作为筛查手段的设备都能够检测出每只耳朵（n = 25），这些耳朵经对照脑干听觉诱发电位（刺激强度35 dB nHL）结果显示存在听力损失，因此灵敏度达到100%。不同耳声发射设备的特异性取决于其潜在的检测策略。自动回声筛查仪设备取得了最佳结果（95.9%），其次是耳声发射分类分析软件（94.2%）。在我们的研究中，回声传感器设备未能提供良好的特异性（77.3%）。德国儿科医生青睐的反射测听法，单独使用时作为一种筛查方法是完全不足的，即使由训练有素的检查人员进行操作。在我们的研究中，反射测听法仅检测出61.5%的听力损失儿童，42.7%听力正常的儿童被误分类。这些结果与参考文献13中呈现的结果有很大偏差，因为汉诺威小组证实反射测听法的灵敏度和特异性为100%（《耳鼻喉科文献》43卷，罗伊特等人）。对这些偏差结果进行了详细讨论。
