Huang Li-hui, Deng Xue-qian, Yang Yi-lin, Wang Shi-jie, Tang Xiao-qing, Guo Lian-sheng, Han De-min
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Mar;46(3):195-200.
The present study was to evaluate the audiological characteristics of infants with normal auditory brainstem response thresholds in click and abnormal transiently evoked otoacoustic emissions. Relationships between test results of distortion product otoacoustic emissions (DPOAE) and other hearing testing methods were also evaluated.
The participants consisted of eighty-nine infants, with a total of 123 ears. All participants' TEOAE screening results were abnormal but diagnostic click ABR results were normal. The participants were classified into the following groups based on the test results from distortion product otoacoustic emissions: group A (normal all-frequency), group B (abnormal low-frequency), group C (abnormal high-frequency), and group D (abnormal all-frequency).
Obtained from these groups were compared to results of other hearing tests including the latency of ABR wave I, 40 Hz auditory event related potential (40 Hz AERP), 226 Hz and 1000 Hz tympanometry, and acoustic reflex. Results In six hearing tests in the 123 ears, seven ears (5.7%) were normal, while 116 ears (94.3%) were abnormal. No significantly differences were detected between boys (93.9%) and girls (95.1%), as well as between left (93.1%) and right ears (95.4%). The proportion of abnormal test results ranked as follows: 59 ears in group D (48.0%), 34 ears in group B (27.6%), 20 ears in group A (16.3%), and 10 ears in group C (8.2%). The highest abnormal rates in groups A, B and D were acoustic reflex, which were 40.0% for group A, 55.9% for group B and 66.1% for group D respectively. The highest abnormal rate in group C was the latency of ABR wave I (50.0%). Distribution of low-frequency hearing loss in each group was mainly mild. However, one ear in group B was moderate hearing loss, six ears in group D were moderate hearing loss, and one ear in group D was severe hearing loss.
The present study showed that, of which infants with normal thresholds of ABR failed the hearing screening, comprehensively audiology assessment is needed. And of which infants with normal DPOAE in full frequency or abnormal in high frequency region or low frequency region need to be followed up.
本研究旨在评估听性脑干反应阈值正常但瞬态诱发耳声发射异常的婴儿的听力学特征。同时还评估了畸变产物耳声发射（DPOAE）与其他听力测试方法结果之间的关系。
研究对象为89名婴儿，共123只耳。所有参与者的TEOAE筛查结果均异常，但诊断性听性脑干反应结果正常。根据畸变产物耳声发射测试结果将参与者分为以下几组：A组（全频率正常）、B组（低频异常）、C组（高频异常）和D组（全频率异常）。
将这些组的结果与其他听力测试结果进行比较，包括听性脑干反应I波潜伏期、40赫兹听觉事件相关电位（40Hz AERP）、226赫兹和1000赫兹鼓室图以及声反射。结果在123只耳的六项听力测试中，7只耳（5.7%）正常，116只耳（94.3%）异常。男孩（93.9%）和女孩（95.1%）以及左耳（93.1%）和右耳（95.4%）之间未检测到显著差异。异常测试结果的比例排序如下：D组59只耳（48.0%）、B组34只耳（27.6%）、A组20只耳（16.3%）、C组10只耳（8.2%）。A、B和D组中最高的异常率是声反射，A组为40.0%，B组为55.9%，D组为66.1%。C组中最高的异常率是听性脑干反应I波潜伏期（50.0%）。每组低频听力损失的分布主要为轻度。然而，B组有1只耳为中度听力损失，D组有6只耳为中度听力损失，D组有1只耳为重度听力损失。
本研究表明，对于听性脑干反应阈值正常但听力筛查未通过的婴儿，需要进行全面的听力学评估。对于全频率畸变产物耳声发射正常或高频或低频区域异常的婴儿，需要进行随访。
