Muus John S, Weir Forest W, Kreicher Kathryn L, Bowlby Deborah A, Discolo Christopher M, Meyer Ted A
Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, United States.
Department of Endocrinology, Medical University of South Carolina, Charleston, SC, United States.
Int J Pediatr Otorhinolaryngol. 2017 Sep;100:107-113. doi: 10.1016/j.ijporl.2017.06.037. Epub 2017 Jul 1.
Although insulin-like growth factor 1 (IGF-1) has been shown to be important for inner-ear development in animal models, little is known about the otologic and audiologic findings of children with growth hormone deficiency (GHD). The goal of this study is to evaluate the prevalence, type, and severity of hearing impairment in children with GHD.
Audiologic, otologic, and demographic data were recorded for children with a diagnosis of GHD in the AudGen database. Data for each patient were selected based on the first encounter with available complete audiometric data or the first encounter with a type of hearing loss documented. The patients were then stratified by type and severity of hearing loss, and otologic issues were documented. A separate cohort comprised of children with GHD without hearing loss was compared as a control.
209 children with GHD met inclusion criteria. 173 (83%) of these patients had hearing loss. 79% of losses were bilateral and 21% were unilateral (309 total ears with hearing loss). 293 of the 309 ears with hearing loss had audiograms with ear-specific thresholds; 47 had conductive, 24 had sensorineural, 65 had mixed and 157 had undefined hearing loss with incomplete audiograms. Pure-tone averages (PTA) were higher among patients with mixed hearing loss compared to patients with all other loss types.
Hearing loss is prevalent in children with GHD with a predisposition to be bilateral. These findings suggest the need for increased awareness and routine hearing screening for patients with GHD. Further studies may elucidate the etiology of the hearing impairment in children with GHD to better aid pediatricians, endocrinologists, otolaryngologists and audiologists when assessing and managing these children.
尽管胰岛素样生长因子1(IGF-1)在动物模型中已被证明对内耳发育很重要,但对于生长激素缺乏症(GHD)患儿的耳科和听力学表现知之甚少。本研究的目的是评估GHD患儿听力障碍的患病率、类型和严重程度。
在AudGen数据库中记录诊断为GHD的患儿的听力学、耳科和人口统计学数据。根据首次获得完整听力测定数据的就诊情况或首次记录某种听力损失类型的就诊情况,为每位患者选择数据。然后根据听力损失的类型和严重程度对患者进行分层,并记录耳科问题。将一个由无听力损失的GHD患儿组成的单独队列作为对照进行比较。
209名GHD患儿符合纳入标准。其中173名(83%)患者有听力损失。79%的听力损失为双侧性,21%为单侧性(共有309只耳朵有听力损失)。309只听力损失耳朵中的293只进行了有特定耳阈值的听力图检查;47只耳朵为传导性听力损失,24只为感音神经性听力损失,65只为混合性听力损失,157只耳朵因听力图不完整而听力损失类型不明。与所有其他听力损失类型的患者相比,混合性听力损失患者的纯音平均听阈(PTA)更高。
听力损失在GHD患儿中很普遍,且倾向于双侧性。这些发现表明需要提高对GHD患者的认识并进行常规听力筛查。进一步的研究可能会阐明GHD患儿听力障碍的病因,以便在评估和管理这些患儿时更好地帮助儿科医生、内分泌学家、耳鼻喉科医生和听力学家。