Widen Judith E, Johnson Jean L, White Karl R, Gravel Judith S, Vohr Betty R, James Michele, Kennalley Teresa, Maxon Antonia B, Spivak Lynn, Sullivan-Mahoney Maureen, Weirather Yusnita, Meyer Sally
Department of Hearing and Speech, University of Kansas Medical Center, Kansas City 66160, USA.
Am J Audiol. 2005 Dec;14(2):S200-16. doi: 10.1044/1059-0889(2005/022).
This 3rd of 4 articles on a study of the efficacy of the 2-stage otoacoustic emission/automated auditory brainstem response (OAE/A-ABR) newborn hearing screening protocol describes (a) the behavioral audiometric protocol used to validate hearing status at 8-12 months of age, (b) the hearing status of the sample, and (c) the success of the visual reinforcement audiometry (VRA) protocol across 7 sites.
A total of 973 infants who failed OAE but passed A-ABR, in one or both ears, during newborn screening were tested with a VRA protocol, supplemented by tympanometry and OAE screening at age 8-12 months.
VRA audiograms (1.0, 2.0, and 4.0 kHz) were obtained for 1,184 (82.7%) of the 1,432 study ears. Hearing loss was ruled out in another 100 ears by VRA in combination with OAE, for a total of 88.7% of the study sample. Permanent hearing loss was identified in 30 ears of 21 infants. Sites differed in their success with the VRA protocol.
Continued monitoring of hearing beyond the newborn period is an important component of early detection of hearing loss. Using a structured protocol, VRA is an appropriate test method for most, but not all, infants. A battery of test procedures is often needed to adequately delineate hearing loss in infants. Examiner experience appears to be a factor in successful VRA.
本系列4篇关于两阶段耳声发射/自动听性脑干反应（OAE/A-ABR）新生儿听力筛查方案疗效研究的第3篇文章描述了：（a）用于验证8至12个月龄听力状况的行为测听方案；（b）样本的听力状况；（c）7个地点视觉强化测听（VRA）方案的成功率。
共有973名在新生儿筛查期间一耳或双耳OAE筛查未通过但A-ABR筛查通过的婴儿接受了VRA方案测试，并在8至12个月龄时辅以鼓室图和OAE筛查。
1432只研究耳中的1184只（82.7%）获得了VRA听力图（1.0、2.0和4.0 kHz）。通过VRA结合OAE在另外100只耳中排除了听力损失，占研究样本总数的88.7%。在21名婴儿的30只耳中发现了永久性听力损失。各地点在VRA方案的成功率方面存在差异。
新生儿期过后持续监测听力是早期发现听力损失的重要组成部分。使用结构化方案，VRA对大多数但并非所有婴儿来说是一种合适的测试方法。通常需要一系列测试程序来充分界定婴儿的听力损失。检查者的经验似乎是VRA成功的一个因素。
