Wen Ruijin, Li Yan, Luo Renzhong, Wang Xiaoya
Department of Otolaryngology, Guangzhou Children's Hospital, Guangzhou Medical College, Guangzhou, 510120, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Oct;23(19):865-8, 871.
To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.
802 infants (1,179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE). However, they failed in the first or and second hearing screening. Auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.
Among 802 cases (1,179 ears), the ratio of single-ear (53.2%) is higher than both-ears (39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation; 25.8% infants once suffered from hypercholesterolemia failed in the hearing screening,which was higher than the other known risk factors. P<0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk factors group (10.8%); 56.9% of the infancy who did not pass the hearing screening were found none risk factors, 42.3% of the infancy who had high risk factors was normal hearing level; 96 cases (138 ears) undergone twice assessment, in moderate disorder group, more cases (74.3%) changed better, and less disorder group (40.9%), severe disorder group (33.3%). Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases (12 ears) diagnosis auditory neuropathy.
The important factors make the follow-up decision including perinatal history, hearing level and age. Maybe some high-factors we did not realized. Gene screening should be paid more attention in the future work.
探讨听力筛查未通过婴儿的特点及听阈变化情况。
本研究回顾了802例有听力筛查记录的婴儿（1179耳）。他们均接受了耳声发射（OAE）听力筛查，但首次或第二次听力筛查未通过。对其进行了听性脑干反应（ABR）、畸变产物耳声发射（DPOAE）及声导抗测试。对听力评估异常的受试者在接下来的1 - 3个月（6个月龄前）进行复查，以分析测试的听阈特点及听力变化情况。
在802例（1179耳）中，单耳比例（53.2%）高于双耳比例（39.5%），P<0.05。两组在重度听力评估异常比例上无显著差异；曾患高胆固醇血症的婴儿中25.8%听力筛查未通过，高于其他已知危险因素，P<0.05；先兆流产组未发现重度听力异常病例；家族性听力损失组重度听力评估异常比例（40.9%）高于其他高危因素组，其次为两种或以上危险因素组（10.8%）；听力筛查未通过的婴儿中56.9%无危险因素，有高危因素的婴儿中42.3%听力水平正常；96例（138耳）进行了两次评估，中度异常组中更多病例（74.3%）情况好转，轻度异常组（40.9%）、重度异常组（33.3%）。7耳情况变差；在不同高危因素导致的听力异常中，中度听力异常儿童听力改善比例高于轻度听力异常儿童。10例（12耳）诊断为听神经病。
做出随访决定的重要因素包括围产期病史、听力水平和年龄。可能还有一些我们未意识到的高危因素。基因筛查在未来工作中应得到更多关注。
