Arora Shilpi, Kochhar L K
Department of Otolaryngorhinology, Army Hospital, Research & Referral, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2003 Oct;55(4):246-50. doi: 10.1007/BF02992430.
to evaluate hearing in high-risk neonates to find the incidence of congenital and early acquired sensory-neural hearing loss.
The study was designed as a consecutive cases, hospital based study in a tertiary care hospital.
The subjects were 70 normal born neonates and 70 high-risk neonates. The 70 neonates with various high risks included in the study had family history of deafness, prematurity, IUGR, asphyxia, perinatal infections, hyperbilirubinemia, neonatal sepsis, meningitis, ototoxicity and fetal malformations.
The study was conducted over a period of two years from Sep 2000 to Aug 2002. BERA using Octavus neuro-otological computer and a main unit BERA module with integrated pre-amplifier was performed within first 28 days of life and at 6 months follow up.
44 out of 140 neonates showed abnormalities on initial BERA testing. 28 ears out of 67 ears (44 neonates) had losses confirmed at repeat BERA. Wave V was considered to determine the threshold of hearing and was found to be consistently present in neonates and also the wave . Hyperbilirubinemia (18 cases) and prematurity (29 cases) were the most commonly observed. The cases of Hyperbilirubinemia showed raised thresholds, absolute latencies and Wave 1 abnormalities (suggesting affection of eighth nerve). In the cases of Prematurity, 8 ears showed raised threshold at follow up. Asphyxia was found in 5 cases and is known to affect the auditory nerve. Family history of deafness found in 3 cases showed X-linked inheritance in one case and autosomal recessive inheritance in the others. Perinatal Rubella was observed in two cases, which showed hearing loss. Congenital malformations were seen in 7 cases (Waardenberg, Downs, Hydrocephalus and T-O Fistula). Neonatal Sepsis was observed in 3 cases and is known to affect the eighth nerve. IUGR was observed in 3 cases, two had normal hearing while one had no waveforms.
BERA should be used as a screening tool to test the auditory function in all high-risk neonates.
评估高危新生儿的听力，以确定先天性和早期获得性感音神经性听力损失的发生率。
本研究设计为一项在三级护理医院进行的基于医院的连续病例研究。
研究对象为70例正常出生的新生儿和70例高危新生儿。本研究纳入的70例具有各种高危因素的新生儿包括耳聋家族史、早产、宫内生长受限、窒息、围产期感染、高胆红素血症、新生儿败血症、脑膜炎、耳毒性和胎儿畸形。
本研究于2000年9月至2002年8月期间进行了两年。在出生后的前28天内以及6个月随访时，使用Octavus神经耳科计算机和带有集成前置放大器的主单元BERA模块进行脑干听觉诱发电位（BERA）检测。
140例新生儿中，44例在初次BERA检测时显示异常。在67只耳朵（44例新生儿）中，28只耳朵在重复BERA检测时确诊听力损失。V波被认为可确定听力阈值，且在新生儿中始终存在，波也是如此。高胆红素血症（18例）和早产（29例）是最常见的情况。高胆红素血症病例显示阈值升高、绝对潜伏期延长和I波异常（提示第八对脑神经受影响）。在早产病例中，8只耳朵在随访时显示阈值升高。发现5例窒息，已知其会影响听神经。3例有耳聋家族史的病例中，1例显示X连锁遗传，其他2例显示常染色体隐性遗传。观察到2例围产期风疹，均表现为听力损失。7例出现先天性畸形（瓦登伯格综合征、唐氏综合征、脑积水和颞骨-外耳道瘘）。观察到3例新生儿败血症，已知其会影响第八对脑神经。观察到3例宫内生长受限，2例听力正常，1例无波形。
BERA应作为一种筛查工具，用于检测所有高危新生儿的听觉功能。
