Mijares Eleina, Báez Lidia, Cabrera Licer, Pérez-Abalo María C, Torres-Fortuny Alejandro
Departamento de Audición y Lenguaje, Centro de Neurociencias de Cuba, La Habana, Cuba.
Departamento de Neurofisiología, Hospital Pediátrico William Soler, La Habana, Cuba.
Acta Otorrinolaringol Esp. 2015 Jan-Feb;66(1):8-15. doi: 10.1016/j.otorri.2014.02.006. Epub 2014 Apr 22.
Minimising false positives rates is an important goal of universal newborn hearing screening programmes. An adequate way for reaching that goal could be differentiating between transient conductive hearing losses (false positives) and permanent sensorineural hearing impairments (true positives) by means of a methodology that studies electrophysiological responses obtained using both air- and bone-conduction stimuli. Our objective was to evaluate the efficiency of an automated hearing screening test based on auditory steady state responses obtained using simultaneous air- and bone-conduction stimuli.
A sample of 80 high risk babies lees than 2 months of born were screened using the automatic screening test. A confirmatory clinical and electrophysiological evaluation was used as the gold standard.
The estimated diagnostic efficiency of this screening test was equivalent (100% sensitivity and 97.7% specificity) to the efficiency reported for otoacoustic emissions and automated auditory brainstem responses. The introduction of bone conduction in the screening reduced the false positive rate from 13.3% to 2.2%. The test duration was 5.3 (± 1.9)min. In 34% of babies only one repetition of the test was needed to raising the result.
The screening test performed quite well in this initial clinical trial, differentiating transient conductive hearing losses from permanent neurosensory impairments and improving the diagnostic efficiency of auditory steady state responses.
将假阳性率降至最低是新生儿听力普遍筛查项目的一个重要目标。实现该目标的一种适当方法可能是通过一种研究使用气导和骨导刺激获得的电生理反应的方法,来区分短暂性传导性听力损失(假阳性)和永久性感音神经性听力障碍(真阳性)。我们的目的是评估一种基于同时使用气导和骨导刺激获得的听觉稳态反应的自动听力筛查测试的效率。
使用自动筛查测试对80名出生不到2个月的高危婴儿样本进行筛查。采用验证性临床和电生理评估作为金标准。
该筛查测试的估计诊断效率与耳声发射和自动听性脑干反应报告的效率相当(灵敏度为100%,特异度为97.7%)。在筛查中引入骨导将假阳性率从13.3%降至2.2%。测试持续时间为5.3(±1.9)分钟。34%的婴儿仅需重复测试一次即可得出结果。
在这项初步临床试验中,该筛查测试表现良好,能够区分短暂性传导性听力损失和永久性神经感觉性损伤,并提高了听觉稳态反应的诊断效率。