Wen Ruijin, Luo Renzhong, Gao Shengli, Wang Xiaoya
Department of Otolaryngology, Guangzhou Women and Children's Medical Center,Guangzhou Children's Hospital, Guangzhou, 510623, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Aug;24(16):725-9.
To evaluate the characters and hearing changes of the infants failed in hearing screening with high-risk factors for hearing loss.
Two hundred and forty-four infants (488 ears) who failed in the hearing screening or with the different results between the first and second screening, were tested by auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement in this study.
(1) A little proportion results among the three DPOAE screening was variable, the pass rate in the right-ear was higher than that in the left-ear. (2) Forty-five of 184 ears which had passed the third DPOAE evaluation had the abnormal ABR results, the discrepancy rate between the two methods was 24.5% (45/184); 20 of 304 ears which failed in the hearing screening had a normal ABR results, with the discrepancy rate of 6.6% (20/304). (3) The highest proportion of abnormal result of the ABR in each groups was mild hearing loss, normal ABR in each groups also had a large proportion. The proportion of moderate hearing loss in the group of no more than three months old infants was significantly increased compared with the other two groups (P < 0.01), and no significant difference of severe hearing loss among the three groups (P > 0.05). (4) More than 70% of type A tympanogram was found in each groups (P > 0.05), the ratio of type B in moderately abnormal group was higher than other groups. Type C was only detected in one ear with severe hearing loss. (5) 29.5% infants had suffered the hyperbilirubinemia, which was much higher than the other risk factors (P < 0.05).
The hearing loss of infants with high-risk factors are mostly mild, and show some indication of fluctuating. Some moderate hearing loss have the tendency to changes better. The combined use of electrophysiological measures can improve the accuracy of hearing evaluation.
评估具有听力损失高危因素的听力筛查未通过婴儿的特征及听力变化。
本研究对244例（488耳）听力筛查未通过或首次与第二次筛查结果不同的婴儿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。
（1）三种DPOAE筛查结果中有小部分结果存在差异，右耳通过率高于左耳。（2）184耳通过第三次DPOAE评估中有45耳ABR结果异常，两种方法的差异率为24.5%（45/184）；听力筛查未通过的304耳中有20耳ABR结果正常，差异率为6.6%（20/304）。（3）各分组中ABR异常结果比例最高的为轻度听力损失，各分组中ABR正常的比例也较大。三个月龄及以下婴儿组中度听力损失比例较其他两组显著升高（P<0.01），三组中重度听力损失差异无统计学意义（P>0.05）。（4）各分组中A型鼓室导抗图均占70%以上（P>0.05），中度异常组B型比例高于其他组。C型仅在1耳重度听力损失中检测到。（5）29.5%的婴儿曾患高胆红素血症，远高于其他危险因素（P<0.05）。
具有高危因素婴儿的听力损失多为轻度，且有一定波动性。部分中度听力损失有好转倾向。联合应用电生理检测方法可提高听力评估的准确性。
