Schmidt C-M, Bohlender J E, Deuster D, Knief A, Matulat P, Dinnesen A G
Universitätsklinikum Münster, Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Kardinal-von-Galen-Ring 10, 48149 Münster. michael.schmidt@uni-muenster
Laryngorhinootologie. 2004 Aug;83(8):523-8. doi: 10.1055/s-2004-814471.
Though one of the most important investigations in paediatric audiology, brainstem evoked response audiometry (BERA) often necessitates sedation or general anaesthetics, especially in newborn and infants. In paediatric neurology, melatonin has been successfully used for some years to induce sleep prior to EEG investigations. Melatonin as a hormone regulating the circadian rhythm induces natural sleep without the risks of sedation. Side effects are not known.
Click-induced BERA was first performed in 10 adults with normal hearing with and without previous melatonin administration, and click thresholds and latencies of evoked potentials were compared. 50 children then underwent BERA in melatonin-induced sleep.
Click thresholds in adults were mostly identical (r = 0,88), while the mean latencies of evoked potentials seemed to be minimally prolonged (r from 0,82 to 0,95). Click-induced BERA was successful in 45 of the 50 children, and notched-noise BERA in at least 2 frequencies in 38 of 43 children.
Offering a high success rate with no side effects, melatonin-induced sleep seems to be a good alternative to sedation. This method is widely accepted by parents and permits earlier diagnosis of hearing impairment in the routine clinical setting.
虽然脑干诱发电位听力测定（BERA）是小儿听力学中最重要的检查之一，但通常需要镇静或全身麻醉，尤其是在新生儿和婴儿中。在小儿神经病学中，褪黑素已成功用于脑电图检查前诱导睡眠数年。褪黑素作为一种调节昼夜节律的激素，可诱导自然睡眠，无镇静风险。目前尚不清楚其副作用。
首先对10名听力正常的成年人进行了有无服用褪黑素的短声诱发BERA检查，并比较了短声阈值和诱发电位潜伏期。然后，50名儿童在褪黑素诱导的睡眠状态下接受了BERA检查。
成年人的短声阈值大多相同（r = 0.88），而诱发电位的平均潜伏期似乎略有延长（r从0.82至0.95）。50名儿童中有45名短声诱发BERA检查成功，43名儿童中有38名至少在2个频率上进行了短纯音BERA检查成功。
褪黑素诱导睡眠成功率高且无副作用，似乎是镇静的良好替代方法。该方法被家长广泛接受，并允许在常规临床环境中更早地诊断听力障碍。
