Widziszowska Agnieszka, Namysłowski Grzegorz
Katedra i Oddział Kliniczny Laryngologii, w Zabrzu Śląskiego Uniwersytetu Medycznego, w Katowicach.
Otolaryngol Pol. 2012 Mar-Apr;66(2):117-21. doi: 10.1016/S0030-6657(12)70758-8.
Asphyxia in neonates with inadequate blood-inner ear barrier function causes damage to the inner ear included the degeneration of outer hair cells of the organ of Corti and oedematous changes in stria vascularis. The major consequences in the central nervous system (CNS) are found to be hypoxic-ischemic encephalopathy (HIE) in term newborns, peri- (PVH) or intraventricular hemorrhages (IVH) and periventricular leucomalacia (PVL) in preterm neonates.
was to carry out the objective assessment of the cochlea development using CEOAEs in infants with CNS impairment occurring as an effect of perinatal asphyxia, imaged during trans-fontanel ultrasonography.
To the investigation 36 infants with HIE, IVH or PVL were included, the control group encompassed 32 born at term, health children. In all children three times otoscopic examination and CEOAEs recordings were performed: after birth, in 3rd and in 6th month of life using Otodynamics Otoacoustic Analyser ILO-88 in Quick Screen version. Perinatal anamnesis, general pediatric status, results of trans-fontanel ultrasonography and biochemical test results were taken into account in statistical analyses.
The mean amplitudes of CEOAEs in the first days of life were significantly reduced in InvG comparing to control babies. In half-octave frequency bandwidth analysis significant reduction of S/N Ratio at 1,5–4 kHz in InvG was observed. 3 and 6 months later the recorded responses significantly increased, they didn't reach values of CG but no statistical differences between groups were observed.
In conclusion, the outer hair cells activity in first days of life is reduced in newborns with CNS impairment and perinatal asphyxia in anamnesis comparing to health children. The maturation of the cochlea is intensive during first 3 months of life, later only subtle changes in CEOAEs are observed.
新生儿血-内耳屏障功能不全导致的窒息会对内耳造成损害，包括柯蒂氏器外毛细胞的退化以及血管纹的水肿变化。在中枢神经系统（CNS）中，足月儿的主要后果是缺氧缺血性脑病（HIE），早产儿则是脑室周围出血（PVH）或脑室内出血（IVH）以及脑室周围白质软化（PVL）。
本研究旨在通过瞬态诱发耳声发射（CEOAEs）对因围产期窒息导致中枢神经系统损伤的婴儿的耳蜗发育进行客观评估，这些婴儿在经囟门超声检查时成像。
本研究纳入了36例患有HIE、IVH或PVL的婴儿，对照组包括32例足月出生的健康儿童。所有儿童均进行了三次耳镜检查和CEOAEs记录：出生后、出生后第3个月和第6个月，使用Otodynamics耳声分析仪ILO - 88的快速筛查版本。统计分析时考虑了围产期病史、一般儿科状况、经囟门超声检查结果和生化检测结果。
与对照组婴儿相比，研究组（InvG）出生后第一天CEOAEs的平均振幅显著降低。在倍频程频率带宽分析中，观察到研究组在1.5 - 4 kHz处的信噪比显著降低。3个月和6个月后，记录的反应显著增加，虽未达到对照组（CG）的值，但两组之间未观察到统计学差异。
总之，与健康儿童相比，有中枢神经系统损伤且围产期有窒息病史的新生儿出生后第一天外毛细胞活性降低。耳蜗在出生后的前3个月发育迅速，之后仅观察到CEOAEs有细微变化。
