Georgalas C, Xenellis J, Davilis D, Tzangaroulakis A, Ferekidis E
Department of Otolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
J Laryngol Otol. 2008 Dec;122(12):1299-304. doi: 10.1017/S0022215108002156. Epub 2008 Apr 21.
The characteristics of otoacoustic emissions that make them ideally suited for universal newborn hearing loss screening could potentially be useful for the screening of older children. This study was performed in order to assess the role of otoacoustic emissions in a screening programme for middle-ear disorders and hearing loss in school-age children.
Cross-sectional, preliminary screening study.
Primary schools of Argolida municipality, south-east Greece, between December 2004 and March 2005. PATIENT SELECTION AND RECRUITMENT: All the primary school students of Argolida were invited, by press releases and individually by their teachers, to attend a session of otological and audiological screening.
One hundred and ninety-six children were evaluated using transient evoked otoacoustic emissions. Twenty per cent failed in both ears, while in 32 per cent otoacoustic emissions could not be produced in at least one ear. Younger children had higher rates of absent transient evoked otoacoustic emissions. The absence of otoacoustic emissions was highly correlated with tympanic membrane changes seen on otoscopy and the presence of a type B tympanogram. As a single screening modality, otoacoustic emissions had a 100 per cent sensitivity in diagnosing hearing loss worse than 30 dB, and a 90 per cent sensitivity and 64 per cent specificity in diagnosing hearing loss worse than 25 dB, which did not improve by adding tympanometry to the screening protocol.
These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.
耳声发射的特性使其非常适合用于新生儿听力损失的普遍筛查,这可能对大龄儿童的筛查也有用。进行本研究是为了评估耳声发射在学龄儿童中耳疾病和听力损失筛查项目中的作用。
横断面初步筛查研究。
2004年12月至2005年3月期间,希腊东南部阿尔戈利达市的小学。
通过新闻稿并由教师逐个邀请阿尔戈利达市所有小学生参加耳科和听力筛查。
使用瞬态诱发耳声发射对196名儿童进行了评估。20%的儿童双耳筛查失败,32%的儿童至少有一只耳朵无法引出耳声发射。年龄较小的儿童瞬态诱发耳声发射缺失率较高。耳声发射缺失与耳镜检查所见鼓膜变化及B型鼓室图的存在高度相关。作为单一筛查方式,耳声发射在诊断听力损失大于30 dB时敏感性为100%,在诊断听力损失大于25 dB时敏感性为90%,特异性为64%,在筛查方案中增加鼓室导抗图检查后并无改善。
这些结果强烈提示耳声发射测试在筛查学龄儿童听力损失方面具有潜在用途。建议进一步开展考虑成本效益问题的研究。