Yang Y, Gao J Y, Qian X Y, Guan Y, Cao Y H, Zhao N, Huang J, Gao X
Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Research Institute of Otolaryngology, Nanjing, 210008, China.
Jiangsu Rehabilitation Center for Hearing and Speech Impairment.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Jun 5;32(11):841-844. doi: 10.13201/j.issn.1001-1781.2018.11.010.
To study the accuracy of preoperative-ASSR in predicting behavioral thresholds of children at low age with profound hearing loss and to evaluate the feasibility of using hearing aids in non-operating ear after the cochlear implantation. Children aged less than 2 years old at the time of surgery were selected as study subjects.The preoperative ASSR response threshold in 0.5, 1.0, 2.0 and 4.0 kHz were recorded.The play audiometry test was used to get the non operative ear behavioral thresholds of the children after three years old. Altogether 179 children with good cooperation and reliable results were enrolled in this study. The results of behavioral thresholds were made a comparison with the results of ASSR response threshold with corresponding frequency before operation for statistical analysis. The behavioral threshold is better than corresponding ASSR response threshold with significant differences(<0.01). Prediction rates of ASSR response threshold corresponding to behavioral thresholds from 0.5 kHz to 4.0 kHz are 49.7%, 70.9%, 59.2% and 60.9%.There are cases at all frequencies where ASSR showed no reaction but a behavioral thresholds were detected. The proportions of undrawn ASSR reaction at each frequency were 83.3%,75.5%,64.9%,45.1%. In profound hearing loss, the deviation between preoperative ASSR response thresholds and postoperative behavioral thresholds exists, especially in low frequency. No ASSR reaction in clinic cannot represent that there is no measurable hearing threshold. We suggest children at low age continue to wear hearing aids in the non operative ear after cochlear implantation. Whether to give up hearing aids should be judged after gaining the behavioral audiometry to avoid missing the bimodal opportunity.
研究术前听性稳态反应(ASSR)预测低龄重度听力损失儿童行为阈值的准确性,并评估人工耳蜗植入术后非手术耳使用助听器的可行性。选择手术时年龄小于2岁的儿童作为研究对象。记录术前0.5、1.0、2.0和4.0kHz的ASSR反应阈值。采用游戏测听法获取3岁后儿童非手术耳的行为阈值。本研究共纳入179例合作良好、结果可靠的儿童。将行为阈值结果与术前相应频率的ASSR反应阈值结果进行比较,进行统计学分析。行为阈值优于相应的ASSR反应阈值,差异有统计学意义(<0.01)。0.5kHz至4.0kHz对应行为阈值的ASSR反应阈值预测率分别为49.7%、70.9%、59.2%和60.9%。各频率均有ASSR无反应但检测到行为阈值的情况。各频率ASSR未引出反应的比例分别为83.3%、75.5%、64.9%、45.1%。在重度听力损失中,术前ASSR反应阈值与术后行为阈值之间存在偏差,尤其是在低频。临床上ASSR无反应并不代表没有可测量的听力阈值。我们建议低龄儿童人工耳蜗植入术后非手术耳继续佩戴助听器。是否放弃助听器应在获得行为测听结果后判断,以免错过双耳聆听机会。