Wu Wenjin, Lü Jingrong, Li Yun, Kam Anna Chi Shan, Fai Tong Michael Chi, Huang Zhiwu, Wu Hao
Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
Department of Otorhinolaryngology, Head and Neck Surgery and Institute of Human Communicative Research, The Chinese University of Hong Kong, Hong Kong, China.
Int J Pediatr Otorhinolaryngol. 2014 Feb;78(2):290-5. doi: 10.1016/j.ijporl.2013.11.026. Epub 2013 Dec 1.
This study aimed to investigate the practical application of Smart Hearing, a new hearing screening system for preschool children.
The screening system was applied to 6288 preschool children. The system auto-tested hearing thresholds at three frequencies: 1kHz, 2kHz, and 4kHz; a 30dB hearing level (HL) was the critical intensity for passing. Children with positive results were referred for audiological evaluation (pure tone audiometry, tympanometry and distortion product otoacoustic emissions assessment, etc.). To evaluate the test accuracy, 312 children (5%) were randomly selected to receive audiology assessment.
In this study, 582 children (9.3%) tested positive in the screening, and the referral rate of the four age groups from 3 to 6 years old was 18.8%, 11.9%, 6.5% and 4.0%, respectively. A total of 463 children underwent audiological assessment, of which 12 cases (1.91‰; 95% CI: 0.83‰, 2.99‰) were diagnosed with permanent hearing loss, and 75 cases (1.19%; 95% CI: 0.92%, 1.46%) were diagnosed with temporary conductive hearing loss. No mixed hearing loss was found in this study. The specificity of the system was 92.6% and the sensitivity was only 37.5%.
This screening system is suitable for the universal hearing screening of preschool children above 4 years old, and further improvements of the system are needed to increase its sensitivity.
本研究旨在调查一种针对学龄前儿童的新型听力筛查系统——智能听力的实际应用情况。
该筛查系统应用于6288名学龄前儿童。该系统自动测试1kHz、2kHz和4kHz三个频率的听力阈值；30dB听力级（HL）是通过测试的临界强度。筛查结果呈阳性的儿童被转介进行听力学评估（纯音听力测定、鼓室图和畸变产物耳声发射评估等）。为评估测试准确性，随机选择312名儿童（5%）接受听力学评估。
在本研究中，582名儿童（9.3%）筛查呈阳性，3至6岁四个年龄组的转诊率分别为18.8%、11.9%、6.5%和4.0%。共有463名儿童接受了听力学评估，其中12例（1.91‰；95%CI：0.83‰，2.99‰）被诊断为永久性听力损失，75例（1.19%；95%CI：0.92%，1.46%）被诊断为暂时性传导性听力损失。本研究未发现混合性听力损失。该系统的特异性为92.6%，敏感性仅为37.5%。
该筛查系统适用于4岁以上学龄前儿童的普遍听力筛查，需要对该系统进行进一步改进以提高其敏感性。
