Xu Zheng-Min
Department of Otorhinolaryngology, Children's Hospital of Fudan University, Shanghai, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005 Sep;40(9):648-52.
To investigate the correlation between the auditory steady-state response (ASSR) thresholds and the vision reinforcement audiometry (VRA) thresholds in infants with auditory neuropathy.
Ten cases in control group were measured by the ASSR and VRA. Based upon the ABR, DPOAE, and impedance data, as well as the aetiology (infection of the early pregnancy, defect of oxygen in birth and jaundice after birth), the 16 cases with hearing losses were divided into three groups (I , II and III). ASSR and VRA were examined.
From the analysis of ABR, DPOAE, and impedance data, the patients with the infection of early pregnancy in group I (5 cases/8 ears) had that the DPOAE were absent (5 cases/8 ears), the latency of wave I of ABR was delay and the interpeak latency of wave I - V of ABR was short (4 cases/6 ears), as well as the acoustic reflect thresholds in 500 Hz and 1000 Hz were normal (3 cases/6 ears) and high (2 cases/2 ears). They were deduced in cochlear lesion. The patients of group II with defect of oxygen in birth (5 cases/10 ears) showed that the DPOAEs were absent, the wave I of ABR was absent (3 cases/5 ears), and the interpeak latency of wave I - III of ABR was delay (2 cases/3 ears) They were deduced in auditory neuropathy (lesion from the cochlea to the brain-stem). The patients of group III had that the DPOAEs were present (6 cases/8 ears), the wave I/III/V of ABR and acoustic reflect were absent(4 cases/5 ears), and the interpeak latency of wave I -V of ABR was delay (2 cases/3 ears) who were deduced in auditory neuropathy(from the brain-stem to the subcortical lesion). Our results showed that the correlation coefficient-ranges between the ASSR thresholds and the VRA thresholds were the 0. 95 - 0. 98 in group I, the 0. 72 - 0. 84 in group II, and the 0.43 - 0.64 in group III. Comparison of the mean threshold-differences between the ASSR VRA thresholds for group I, group II, and group III for each frequency revealed significant difference (F test, P < 0.05, P < 0.01, P < 0.01, P < 0.05, P < 0.05).
The correlation technique between the ASSR thresholds and the VRA thresholds could provide the auditory neuropathy diagnosis and differential diagnosis in infants.
探讨听神经病患儿听觉稳态反应（ASSR）阈值与视觉强化测听（VRA）阈值之间的相关性。
对10例对照组患儿进行ASSR和VRA检测。根据听性脑干反应（ABR）、畸变产物耳声发射（DPOAE）、声导抗数据以及病因（孕早期感染、出生时缺氧、出生后黄疸），将16例听力损失患儿分为三组（I组、II组和III组），进行ASSR和VRA检测。
通过对ABR、DPOAE和声导抗数据的分析，I组（5例/8耳）孕早期感染患儿中，DPOAE缺失（5例/8耳），ABR I波潜伏期延长，ABR I - V波间期缩短（4例/6耳），500 Hz和1000 Hz声反射阈值正常（3例/6耳）及升高（2例/2耳），推断为耳蜗病变。II组出生时缺氧患儿（5例/10耳）显示DPOAE缺失，ABR I波缺失（3例/5耳），ABR I - III波间期延长（2例/3耳），推断为听神经病（从耳蜗到脑干病变）。III组患儿DPOAE引出（6例/8耳），ABR I/III/V波及声反射缺失（4例/5耳），ABR I - V波间期延长（2例/3耳），推断为听神经病（从脑干到皮层下病变）。结果显示，I组ASSR阈值与VRA阈值之间的相关系数范围为0.95 - 0.98，II组为0.72 - 0.84，III组为0.43 - 0.64。对I组、II组和III组各频率ASSR与VRA阈值的平均差值比较显示差异有统计学意义（F检验，P < 0.05，P < 0.01，P < 0.01，P < 0.05，P < 0.05）。
ASSR阈值与VRA阈值的相关性技术可为婴幼儿听神经病的诊断及鉴别诊断提供依据。
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