Śliwa L, Hatzopoulos S, Kochanek K, Piłka A, Senderski A, Skarżyński P H
Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
Int J Pediatr Otorhinolaryngol. 2011 Apr;75(4):483-8. doi: 10.1016/j.ijporl.2010.12.024. Epub 2011 Feb 3.
In newborn hearing screening, one exclusively applies objective hearing testing methods--based on evoked potentials and/or on otoacoustic emissions. However, when testing school children, one can consider both audiometric and electrophysiological methods. The choice of methods is determined by the aims of the program. If one wants to detect conductive hearing losses, impedance audiometry seems to be the method of choice.
The aim of this study was to compare test performance measures from audiometric and objective methods (OAEs and impedance audiometry), in the hearing screening of school children. Screening protocols were applied on a group of 190 children of about 12 years of age (6th grade of primary school).
For a single application of a screening procedure, the best performance was observed in the automated four-tone audiometry, followed by the tympanometry and the TEOAE-based procedures. Screening performance was enhanced using a combination of automated and impedance audiometry. A four-tone audiometry test combined with tympanometry gives a sensitivity of 65%, and the PPV of 46%, which are reasonable values, acceptable for practical use. The use of a TEOAE protocol degrades the overall performance of screening.
Screening of school children is feasible with a combination of automated audiometry and tympanometry with time requirements equal to 3 min per subject.
在新生儿听力筛查中，仅采用基于诱发电位和/或耳声发射的客观听力测试方法。然而，在对学龄儿童进行测试时，可以考虑听力测定法和电生理学方法。方法的选择取决于项目的目标。如果想要检测传导性听力损失，声阻抗测听法似乎是首选方法。
本研究的目的是比较学龄儿童听力筛查中听力测定法和客观方法（耳声发射和声阻抗测听法）的测试性能指标。对一组190名约12岁（小学六年级）的儿童应用了筛查方案。
对于单次应用筛查程序，自动四音听力测定法的表现最佳，其次是鼓室图检查和基于瞬态诱发性耳声发射的程序。结合使用自动听力测定法和声阻抗测听法可提高筛查性能。四音听力测定法测试与鼓室图检查相结合，灵敏度为65%，阳性预测值为46%，这些数值是合理的，在实际应用中可以接受。使用瞬态诱发性耳声发射方案会降低筛查的整体性能。
结合自动听力测定法和鼓室图检查对学龄儿童进行筛查是可行的，每个受试者的时间要求为3分钟。
