Xu Zheng-min, Cheng Wen-xia, Yao Zhi-hong
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102, PR China.
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102, PR China.
Int J Pediatr Otorhinolaryngol. 2014 May;78(5):812-6. doi: 10.1016/j.ijporl.2014.02.020. Epub 2014 Feb 26.
To investigate the clinical usefulness of the LS-chirp auditory brainstem response for estimation of behavioral thresholds in young children with mild to severe hearing losses.
68 infants (136 ears) aged 6-12 months (mean age=9.2 months) with bilateral mild to severe hearing losses were studied at Children's Hospital of Fudan University. In all cases, the children were referred for LS-chirp ABR and visual reinforcement audiometric (VRA) measurements. The low-frequency band chirp (LF-chirp) thresholds (frequency band=0.1-0.85kHz) were compared to the average VRA thresholds (frequency band=0.25-0.5kHz), whereas the high-frequency band chirp (HF-chirp) thresholds (frequency band=1-10kHz) were compared to the average VRA thresholds (frequency band=1-4kHz) using statistical correlation coefficient values.
The LS-chirp ABR thresholds are very close to behavioral hearing levels. The mean differences between chirp-ABR and VRA thresholds were within 5dBHL for all measurements. The smallest mean threshold difference (<3dBHL) was obtained for the severe hearing loss group. The correlation coefficient values (r) were 0.97 at low-frequency and high-frequency bands. For each carrier frequency, the best correlations between chirp-ABR thresholds and VRA thresholds were obtained at VRA frequency of 0.25kHz/LF-chirp (r=0.98) and VRA frequency of 1kHz/HF-chirp (r=0.98).
This study demonstrates the effectiveness using chirp-ABR predicted frequency-specific thresholds, especially of low and middle frequencies. LS-chirp ABR thresholds determined behavioral thresholds in patients with severe hearing losses were better than for mild hearing losses. The use of a chirp-ABR testing ensures higher sensitivity and accuracy than that of auditory stead-state evoked response (ASSR) for measuring frequency-specific thresholds in young children.
探讨低斜率线性调频脉冲刺激听性脑干反应（LS-chirp ABR）在评估轻至重度听力损失幼儿行为阈值方面的临床实用性。
在复旦大学附属儿科医院对68例年龄在6至12个月（平均年龄9.2个月）的双侧轻至重度听力损失婴儿（136耳）进行研究。所有病例中，患儿均接受LS-chirp ABR和视觉强化测听（VRA）测量。将低频带线性调频脉冲刺激（LF-chirp）阈值（频段 = 0.1 - 0.85kHz）与平均VRA阈值（频段 = 0.25 - 0.5kHz）进行比较，而高频带线性调频脉冲刺激（HF-chirp）阈值（频段 = 1 - 10kHz）与平均VRA阈值（频段 = 1 - 4kHz）使用统计相关系数值进行比较。
LS-chirp ABR阈值与行为听力水平非常接近。所有测量中，线性调频脉冲刺激听性脑干反应（chirp-ABR）和VRA阈值之间的平均差异在5dBHL以内。重度听力损失组获得的最小平均阈值差异（<3dBHL）。低频和高频带的相关系数值（r）均为0.97。对于每个载波频率，在VRA频率为0.25kHz/LF-chirp（r = 0.98）和VRA频率为1kHz/HF-chirp（r = 0.98）时，线性调频脉冲刺激听性脑干反应（chirp-ABR）阈值与VRA阈值之间获得最佳相关性。
本研究证明了使用线性调频脉冲刺激听性脑干反应（chirp-ABR）预测特定频率阈值的有效性，尤其是低频和中频。在重度听力损失患者中，LS-chirp ABR阈值确定行为阈值的效果优于轻度听力损失患者。使用线性调频脉冲刺激听性脑干反应（chirp-ABR）测试在测量幼儿特定频率阈值时比听性稳态诱发反应（ASSR）具有更高的灵敏度和准确性。
