Lemajić-Komazec Slobodanka, Komazec Zoran, Vlaski Ljiljana, Dankuc Dragan
Klinicki centar Vojvodine, Klinika za bolesti uva, grla i nosa, 21000 Novi Sad, Hajduk Veljkova 1-7.
Med Pregl. 2008;61 Suppl 2:21-5.
Hearing loss in children will cause cognitive deficits in the central areas which are dependent upon hearing and is therefore responsible for delay in the speech development, poor language skills and disorders in psychological and mental behavior. An early identification of educationally significant hearing loss in infants and young children is an essential prerequisite for effective aural rehabilitation and educational intervention. Maturation of the auditory path takes place within the first 18 months of life and is dependant on the adequate acoustic stimulation. To ensure the optimal therapy a definite diagnosis of the hearing impairment should be made until the sixth month of life. Current health care standards recommend the confirmation of the neonatal hearing loss before the age of three months and the appropriate intervention before the age of six months.
The study consisted of the prospective analysis of data collected for 70 children with suspected hearing loss. According to the hearing level determined by the objective diagnostic methods (Brainstem Evoked Response Audiometry) the whole group was divided into three subgroups. We analyzed the average age when the hearing loss was detected, the reasons for the late identification of the hearing loss, as well as the risk-factors for hearing difficulties.
Of 70 children with suspected hearing loss, we found normal hearing or mild hearing loss in 17 cases (group 1), 16 children were suffering from moderate and severe hearing loss (group II), and 37% children were suffering from profound hearing loss (group III). Until the age of 2, the diagnosis was made in 40% of 70 children, most in the group III 58.8%, 25% in the group II and 17.64% of children in the group I. The average age when the hearing loss was suspected was 1.62, 2.38 and 1.41 in the groups I, II and III respectively, whereas the average age when the hearing was examined was 2.83, 3.32 and 2.32 in the groups I, II and III respectively. In 22 children (21.5%) no cause of hearing impairment could be determined Nineteen children (15.7%) had the history of familial hearing loss, 37 (52.8%) children suffered from acquired hearing loss. Risk- factors: the presence of the hearing impaired in the family as well as risk-factors was not the reason for parents to check the hearing status of their child.
The mean age of children diagnosed to have the hearing impairment is still over 2 years in our region. However, the introduction of a universal screening programme would result in significantly earlier detection of the hearing impairment in children.
儿童听力损失会导致依赖听力的中枢区域出现认知缺陷，进而导致言语发育迟缓、语言能力差以及心理和精神行为障碍。尽早识别婴幼儿具有教育意义的听力损失是有效听力康复和教育干预的必要前提。听觉通路在生命的前18个月内发育成熟，且依赖于充足的声音刺激。为确保最佳治疗效果，应在儿童6个月大之前明确诊断听力障碍。当前的医疗保健标准建议在3个月大之前确诊新生儿听力损失，并在6个月大之前进行适当干预。
该研究包括对70例疑似听力损失儿童收集的数据进行前瞻性分析。根据客观诊断方法（脑干诱发反应测听法）确定的听力水平，将整个组分为三个亚组。我们分析了听力损失被发现时的平均年龄、听力损失诊断延迟的原因以及听力困难的风险因素。
在70例疑似听力损失儿童中，我们发现17例听力正常或轻度听力损失（第1组），16例儿童患有中度和重度听力损失（第II组），37%的儿童患有极重度听力损失（第III组）。在70例儿童中，40%在2岁之前得到诊断，其中第III组最多，为58.8%，第II组为25%，第I组为17.64%。第I、II、III组疑似听力损失时的平均年龄分别为1.62、2.38和1.41岁，而第I、II、III组进行听力检查时的平均年龄分别为2.83、3.32和2.32岁。22例儿童（21.5%）无法确定听力障碍的原因。19例儿童（15.7%）有家族性听力损失病史，37例（52.8%）儿童患有后天性听力损失。风险因素：家庭中存在听力受损者以及风险因素并非家长检查孩子听力状况的原因。
在我们地区，被诊断患有听力障碍的儿童平均年龄仍超过2岁。然而，引入普遍筛查计划将显著更早地发现儿童听力障碍。
