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感音神经性听力损失儿童的球囊功能评估。

Assessment of saccular function in children with sensorineural hearing loss.

作者信息

Zhou Guangwei, Kenna Margaret A, Stevens Katelyn, Licameli Greg

机构信息

Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, Boston, Massachusetts 02115, USA.

出版信息

Arch Otolaryngol Head Neck Surg. 2009 Jan;135(1):40-4. doi: 10.1001/archoto.2008.508.

Abstract

OBJECTIVE

To investigate saccular function using vestibular evoked myogenic potentials in children with congenital or early acquired sensorineural hearing loss.

DESIGN

Retrospective cohort study.

SETTING

Pediatric tertiary referral center.

PATIENTS

Twenty-three children with bilateral sensorineural hearing loss (severe to profound in 22 cases, moderate in 1 case) underwent evaluation of saccular function. Twelve pediatric subjects with normal hearing were included in the study as the control group.

INTERVENTIONS

Otologic examination, computed tomography of the temporal bone, audiometry, tympanometry, and vestibular evoked myogenic potential testing.

MAIN OUTCOME MEASURE

Differences in threshold, amplitude, and P1 and N1 latencies of vestibular evoked myogenic potentials between children with normal-hearing and hearing-impaired children.

RESULTS

Abnormal vestibular evoked myogenic potentials were found in 21 of 23 children (91%) with sensorineural hearing loss. The thresholds of vestibular evoked myogenic potential were significantly higher (P <.001) and the amplitudes were lower in children with sensorineural hearing loss than those in children with normal hearing. There were no differences in the P1 and N1 latencies between the 2 groups.

CONCLUSIONS

The impairment of saccular function, indicated by the abnormal findings in the vestibular evoked myogenic potential, is often associated with sensorineural hearing loss in the pediatric population. Although saccular dysfunction may create a vestibular deficit, its manifestations can vary and be easily overlooked in children. Considering the high percentage of abnormal findings in our study, we recommend that deaf and hard-of-hearing children undergo vestibular evaluation. Vestibular evoked myogenic potential testing is an easy and reliable procedure to evaluate saccular function in children.

摘要

目的

利用前庭诱发肌源性电位研究先天性或早期获得性感音神经性听力损失儿童的球囊功能。

设计

回顾性队列研究。

地点

儿科三级转诊中心。

患者

23例双侧感音神经性听力损失儿童(22例为重度至极重度,1例为中度)接受了球囊功能评估。12例听力正常的儿科受试者作为对照组纳入研究。

干预措施

耳科检查、颞骨计算机断层扫描、听力测定、鼓室图检查和前庭诱发肌源性电位测试。

主要观察指标

听力正常儿童与听力受损儿童在前庭诱发肌源性电位的阈值、波幅以及P1和N1潜伏期方面的差异。

结果

23例感音神经性听力损失儿童中有21例(91%)前庭诱发肌源性电位异常。感音神经性听力损失儿童的前庭诱发肌源性电位阈值显著更高(P<.001),波幅更低。两组之间的P1和N1潜伏期无差异。

结论

前庭诱发肌源性电位异常结果表明球囊功能受损,这在儿科人群中常与感音神经性听力损失相关。尽管球囊功能障碍可能导致前庭功能缺陷,但其表现可能各异,在儿童中容易被忽视。鉴于我们研究中异常结果的高比例,我们建议聋儿和听力障碍儿童接受前庭评估。前庭诱发肌源性电位测试是评估儿童球囊功能的一种简便可靠的方法。

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