Luo Renzhong, Wang Xiaoya, Wen Ruijin, Xiong Qi, Peng Jiaochen
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):885-8.
To compare the auditory steady-state response (ASSR) test data of severe sensorineural hearing loss children with cochlear lesion and those with retrocochlear lesion and find some specific phenomena of retrocochlear lesion in ASSR, then to improve diagnostic accuracy in clinical practice.
Between 2008 to 2012. 96 children (179 ears) were diagnosed with "retrocochlear auditory nerve lesion" and recieved ASSR test (" retrocochlear lesion" group). Eighty-one (143 ears) the same age children (143 ears) were diagnosed as "cochlear auditory nerve lesion" and selected them as the "cochlear lesion" group. Twenty-six (50 ears) normal hearing children at the same age who had ASSR test records selected from the pediatric hearing center database of our hospital were selected as "normal control" group. Compare the difference of ASSR threshold, ASSR elicit rate and ASSR audiogram among the three groups.
(1) ASSR threshold: Compared each frequency threshold in ASSR test with cochlear.lesion group, the retrocochlear lesion group with wave V and wave I had no significant difference in 500 Hz and 1000 Hz but had significant difference in 2000 Hz and 4000 Hz. As for the retrocochlear lesion group without wave V and wave I, there was a decline in 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz compared with cochlear lesion group. (1) ASSR elicit rate: When compared to retrocochlear lesion group, the cochlear lesion group had a significance lower elicit rate in the four frequency. (3) Number of elicit reactions in ASSR test . In the retrocochlear lesion group, the elicit reactions in all the four frequency in ASSR test was significantly higher than ochlear lesion group. (4) ASSR audiogram type. The proportion of rising curve audiogram in retrocochlear lesion group was 26.83% (with wave I and wave V), 40% (with wave I and without wave V ) and 33.80% (without wave I and wave V).
(1) Children with a severe hearing loss in ABR test and a rise type audiogram in ASSR test should be most possibly considered as retrocochlear lesion. (2) ASSR threshold cannot be used in determinate the severity of hearing loss in children with retrocochlear lesion.
比较重度感音神经性听力损失的耳蜗病变患儿与蜗后病变患儿的听觉稳态反应（ASSR）测试数据，寻找ASSR中蜗后病变的一些特殊现象，以提高临床诊断准确性。
2008年至2012年期间，96例儿童（179耳）被诊断为“蜗后听神经病变”并接受ASSR测试（“蜗后病变”组）。81例（143耳）同年龄儿童被诊断为“耳蜗听神经病变”并选为“耳蜗病变”组。从我院儿科听力中心数据库中选取有ASSR测试记录的26例（50耳）同龄听力正常儿童作为“正常对照组”。比较三组ASSR阈值、ASSR引出率及ASSR听力图的差异。
（1）ASSR阈值：将ASSR测试中各频率阈值与耳蜗病变组比较，有波V和波I的蜗后病变组在500Hz和1000Hz时无显著差异，但在2000Hz和4000Hz时有显著差异。对于无波V和波I的蜗后病变组，与耳蜗病变组相比，在500Hz、1000Hz、2000Hz和4000Hz时均有下降。（2）ASSR引出率：与蜗后病变组相比，耳蜗病变组在四个频率的引出率显著较低。（3）ASSR测试中的引出反应数量。在蜗后病变组中，ASSR测试中所有四个频率的引出反应均显著高于耳蜗病变组。（4）ASSR听力图类型。蜗后病变组上升型听力图的比例分别为26.83%（有波I和波V）、40%（有波I无波V）和33.80%（无波I和波V）。
（1）ABR测试重度听力损失且ASSR测试为上升型听力图的儿童最有可能被认为是蜗后病变。（2）ASSR阈值不能用于确定蜗后病变儿童听力损失的严重程度。
