Afifi Pretty O, Elsanadiky Hanaa Hussein
Lecturer of Audiology, Otorhinolaryngology Department, Ain Shams University, Cairo, Egypt.
Assistant Professor of Audiology, Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Egypt.
Int J Pediatr Otorhinolaryngol. 2017 Jan;92:94-98. doi: 10.1016/j.ijporl.2016.11.012. Epub 2016 Nov 15.
To assess peripheral and central hearing in children with A-T.
3 children diagnosed with A-T according to the diagnostic criteria for A-T of the European Society for Immunodeficiencies. Involuntary movements were seen in the form of chorea-athetosis together with tremors. They were examined to assess both peripheral and central hearing was assessed (hearing thresholds). Sound-field testing, tympanometry, acoustic reflexes, Otoacoustic Emissions (OAEs) and Auditory Brainstem Responses (ABR) were done for all of them.
Basic Audiological evaluation is of a limited value as the children are not co-operative. Sound field testing could not be done. Bilateral normal middle ear functions as reflected by Tympanometry and Acoustic Reflexes. Advanced Audiological evaluation including OAEs and ABR are more valuable in assessing hearing in children with A-T. Bilateral pass response at all test frequencies in DPOAEs. Abnormal ABR findings were obtained in the form of a delay in wave V latency more than 2 SD with subsequent increased in I-V interpeak latency with no significant interaural latency difference.
Consistent with bilateral normal peripheral hearing sensitivity with central hearing affection.
The rarity of the disease, make it difficult to be applied on many cases.
评估共济失调毛细血管扩张症(A-T)患儿的外周和中枢听力。
3名根据欧洲免疫缺陷学会A-T诊断标准确诊为A-T的患儿。可见不自主运动,表现为舞蹈样手足徐动症并伴有震颤。对他们进行检查以评估外周和中枢听力(听力阈值)。对所有患儿进行了声场测试、鼓室图、声反射、耳声发射(OAE)和听性脑干反应(ABR)检查。
由于患儿不配合,基本听力评估价值有限。无法进行声场测试。鼓室图和声反射显示双侧中耳功能正常。包括OAE和ABR在内的高级听力评估在评估A-T患儿听力方面更有价值。畸变产物耳声发射(DPOAE)在所有测试频率下双侧通过反应。ABR检查结果异常,表现为V波潜伏期延迟超过2个标准差,随后I-V间期潜伏期增加,双耳潜伏期差异无统计学意义。
符合双侧外周听力敏感度正常但伴有中枢听力损害。
该疾病罕见,难以应用于许多病例。