Wentland Carissa J, Ronner Evette A, Basonbul Razan A, Pinnapureddy Sandeep, Mankarious Leila, Keamy Donald, Lee Daniel J, Cohen Michael S
Department of Otolaryngology Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Harvard University, Cambridge, MA, USA.
Int J Pediatr Otorhinolaryngol. 2018 Aug;111:26-31. doi: 10.1016/j.ijporl.2018.05.024. Epub 2018 May 22.
BACKGROUND/OBJECTIVE: Sensorineural hearing loss is a common diagnosis among children. The diagnostic workup varies widely among practitioners. This study's aim was to assess the utilization of diagnostic testing for SNHL and determine the yield of each test.
Retrospective chart review.
Tertiary care center.
827 patients with a diagnosis of SNHL from January 1, 2011 to January 1, 2015.
746 patients met inclusion criteria. Temporal bone imaging was performed on 561 (75%) of patients with 224 (40%) having positive results that explained the etiology of the SNHL. Congenital SNHL was more likely to be associated with abnormal imaging than acquired SNHL (109/299 versus 106/316 respectively) (p = 0.001). Unilateral SNHL was more likely to be associated imaging abnormalities than bilateral SNHL (101/221 and 123/340 respectively) (p = 0.028). Genetic testing was performed on 244 (33%) patients, of which 94 (39%) had abnormalities. Positive genetics results were more common with bilateral than unilateral SNHL (82/191 and 12/53 respectively) (p = 0.007). There was no statistically significant difference in the utility of genetic testing for congenital and acquired SNHL (p = 0.0836). Cytomegalovirus (CMV) testing was available for 104 (14%) of patients with 13 (12.5%) being positive and consistent with congenital CMV. Electrocardiogram, urinalysis, and Lyme titers were less useful.
Imaging and genetic testing had the highest yield in the evaluation of children with SNHL and were the most commonly performed. CMV testing was valuable in neonates who failed newborn hearing screening.
背景/目的：感音神经性听力损失是儿童常见的诊断。不同从业者的诊断检查差异很大。本研究的目的是评估感音神经性听力损失诊断测试的应用情况，并确定每项测试的阳性率。
回顾性病历审查。
三级医疗中心。
2011年1月1日至2015年1月1日期间诊断为感音神经性听力损失的827例患者。
746例患者符合纳入标准。561例（75%）患者进行了颞骨成像，其中224例（40%）结果阳性，解释了感音神经性听力损失的病因。先天性感音神经性听力损失比后天性感音神经性听力损失更可能与影像学异常相关（分别为109/299和106/316）（p = 0.001）。单侧感音神经性听力损失比双侧感音神经性听力损失更可能与影像学异常相关（分别为101/221和123/340）（p = 0.028）。244例（33%）患者进行了基因检测，其中94例（39%）有异常。双侧感音神经性听力损失的基因检测阳性结果比单侧更常见（分别为82/191和12/53）（p = 0.007）。先天性和后天性感音神经性听力损失的基因检测效用无统计学显著差异（p = 0.0836）。104例（14%）患者进行了巨细胞病毒（CMV）检测，其中13例（12.5%）阳性，与先天性CMV一致。心电图、尿液分析和莱姆病滴度检测用处较小。
影像学和基因检测在感音神经性听力损失儿童评估中的阳性率最高，且是最常进行的检测。CMV检测对新生儿听力筛查未通过者有价值。
