Delaroche Monique, Gavilan-Cellié Isabelle, Maurice-Tison Sylvie, Kpozehouen Alphonse, Dauman René
Pediatric Audiology Unit, Department of ORL-HNS, University Hospital of Bordeaux, France.
Int J Pediatr Otorhinolaryngol. 2011 Dec;75(12):1502-9. doi: 10.1016/j.ijporl.2011.08.016. Epub 2011 Sep 19.
When carried out in addition to objective tests, behavioral audiometry performed in children with the so-called "Delaroche protocol" [IJORL 68 (2004) 1233-1243] enables to determine hearing thresholds by air and bone conduction over the whole auditory frequency range. In the present report, seventy-three hearing-impaired infants with different levels of motor and cognitive development were tested behaviorally before 6 months of age. Reliability of these early determined behavioral thresholds was then after analyzed using: (a) cross-sectional study, and (b) longitudinal study.
Cross-sectional study compared click-evoked ABR thresholds in the better ear with binaural high-frequency hearing thresholds. In longitudinal study, early measured binaural hearing thresholds from 500 through 4000 Hz were reassessed at 18 months.
In 13% of babies behavioral testing was not fully completed by 6 months of age. Nevertheless, both cross-sectional and longitudinal studies yielded intraclass correlation coefficients above 0.80, suggesting that behavioral testing is applicable to this very young population.
Assessment of hearing after newborn screening should not be restricted to objective tests before 5 ½ months. It should also include bone- and air-conduction behavioral tests adjusted to developmental stage and performed in presence of parents.
在对儿童进行客观测试的同时，采用所谓的“德拉罗什方案”[《国际耳鼻咽喉科杂志》68(2004)1233 - 1243]进行行为测听，能够在整个听觉频率范围内通过气导和骨导测定听力阈值。在本报告中，对73名运动和认知发育水平不同的听力受损婴儿在6个月龄前进行了行为测试。然后使用：(a)横断面研究和(b)纵向研究分析这些早期确定的行为阈值的可靠性。
横断面研究将较好耳的短声诱发听性脑干反应阈值与双耳高频听力阈值进行比较。在纵向研究中，对500至4000Hz早期测量的双耳听力阈值在18个月时进行重新评估。
13%的婴儿在6个月龄前行为测试未完全完成。然而，横断面研究和纵向研究的组内相关系数均高于0.80，表明行为测试适用于这个非常年幼的群体。
新生儿筛查后的听力评估不应局限于5个半月前的客观测试。还应包括根据发育阶段调整并在父母在场的情况下进行的骨导和气导行为测试。
