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南非人群中的儿童听力损失及风险概况。

Childhood hearing loss and risk profile in a South African population.

作者信息

Swanepoel De Wet, Johl Lorné, Pienaar Danelle

机构信息

Department of Communication Pathology, University of Pretoria, South Africa.

出版信息

Int J Pediatr Otorhinolaryngol. 2013 Mar;77(3):394-8. doi: 10.1016/j.ijporl.2012.11.034. Epub 2012 Dec 23.

Abstract

OBJECTIVE

To describe the nature of hearing loss and associated risk profile in a South African population of infants and children diagnosed at a pediatric referral clinic.

METHODS

A retrospective review of patient files for a pediatric auditory evoked potential clinic in Pretoria was conducted (January 2007-December 2011). Collected data included demographical information, risk factors from case history questionnaire, diagnosis (type and degree of hearing loss), documented age of caregiver suspicion and age of first diagnosis.

RESULTS

Hearing loss was present in 73% (73/100) of cases evaluated. Permanent hearing losses (SNHL, ANSD and mixed) constituted 76% of losses. Unilateral hearing losses constituted 8% of SNHL and 20% of conductive hearing loss. ANSD was diagnosed in 21.4% and SNHL in 78.6% of permanent non-conductive hearing loss cases. The most prevalent SNHL risk was family history of hearing loss and for ANSD it was admittance to the NICU for more than 5 days. The majority of the sample was diagnosed with a permanent bilateral SNHL and ANSD after 36 months of age (47%) despite 40% already suspected of having a hearing loss before 12 months of age.

CONCLUSIONS

A high prevalence of ANSD was found with preventable risk factors often indicated. Age of diagnosis was significantly delayed, evidencing the lack of early hearing detection services in South Africa. The majority of children were diagnosed at ages precluding optimal benefits from early detection and subsequent intervention.

摘要

目的

描述在一家儿科转诊诊所确诊的南非婴幼儿人群中听力损失的性质及相关风险情况。

方法

对比勒陀利亚一家儿科听觉诱发电位诊所的患者档案进行回顾性研究(2007年1月至2011年12月)。收集的数据包括人口统计学信息、病史问卷中的风险因素、诊断结果(听力损失的类型和程度)、记录的照护者怀疑年龄及首次诊断年龄。

结果

在评估的病例中,73%(73/100)存在听力损失。永久性听力损失(感音神经性听力损失、听神经病谱系障碍及混合性听力损失)占听力损失病例的76%。单侧听力损失占感音神经性听力损失的8%,占传导性听力损失的20%。在永久性非传导性听力损失病例中,听神经病谱系障碍的诊断率为21.4%;感音神经性听力损失的诊断率为78.6%。感音神经性听力损失最常见的风险因素是听力损失家族史,听神经病谱系障碍则是入住新生儿重症监护病房超过5天。尽管40%的样本在12个月龄前就已被怀疑有听力损失,但大多数样本在超过36个月龄时被诊断为永久性双侧感音神经性听力损失和听神经病谱系障碍(47%)。

结论

发现听神经病谱系障碍的患病率较高,且常存在可预防的风险因素。诊断年龄显著延迟,这表明南非缺乏早期听力检测服务。大多数儿童在无法从早期检测及后续干预中获得最佳益处的年龄才被诊断出来。

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