Lalayants M R, Brazhkina N B, Geptner E N, Kruglov A V, Barrlyak V V, Tavartkiladze G A
Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, 123, Moscow, Russia, 117513.
Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russia, 123395.
Vestn Otorinolaringol. 2018;83(4):15-20. doi: 10.17116/otorino201883415.
The objective of the present study was to estimate peculiarities of the auditory brainstem evoked potentials (ABR), auditory steady-state responses (ASSR) and cortical auditory evoked potentials (CAEP) in the children presenting with bilateral auditory neuropathy spectrum disorder (ANSD). The study included 100 patients with bilateral ANSD diagnosed based on the positive response of otoacoustic emissions (OAEs) and/or cochlear microphonic (CM) detection, while no synchronous neural activity was detected in the ABR test. Cochlear microphonic was the main clue for the ANSD diagnosing, because OAE was absent in both ears of 49 children. ABR testing revealed no response bilaterally in 72 cases (out of 100). In contrast to ABR, the ASSR thresholds were detectable at all the four main frequencies in both ears in 73 % of the cases (47 out of the 64 tested ones). Both ABR and ASSR in most cases were incomparable with the behavioral audiometric thresholds. 28 children underwent CAEP testing. In 7 cases out of 8 with mild hearing loss detectable CAEP were recorded. CAEP registration in l7 children making use of the hearing aids and in 3 children after cochlear implantation revealed, in the majority of the cases, the concordance between CAEP detectability with behavioral thresholds and rehabilitation outcomes with fairly good speech intelligibility. It is concluded that the ABR registration with CM evaluation is the most informative test for ANSD diagnosis. However, ABR as well as ASSR is useless for the estimation of the behavioral thresholds. The results of this study suggest that the presence or absence of CAEPs can provide some indication of the audibility of a speech sound in the children with ANSD; however this method requires further investigation.
本研究的目的是评估双侧听觉神经病谱系障碍（ANSD）患儿的听觉脑干诱发电位（ABR）、听觉稳态反应（ASSR）和皮层听觉诱发电位（CAEP）的特点。该研究纳入了100例双侧ANSD患者，这些患者基于耳声发射（OAE）阳性反应和/或耳蜗微音电位（CM）检测确诊，而ABR测试中未检测到同步神经活动。耳蜗微音电位是ANSD诊断的主要线索，因为49名儿童双耳均未引出OAE。ABR测试显示100例中有72例双侧无反应。与ABR不同，73%的病例（64例测试者中的47例）双耳在所有四个主要频率均能检测到ASSR阈值。大多数情况下，ABR和ASSR与行为测听阈值均不匹配。28名儿童接受了CAEP测试。8例轻度听力损失患儿中有7例可记录到CAEP。对17名使用助听器的儿童和3名人工耳蜗植入术后儿童进行CAEP记录发现，在大多数情况下，CAEP可检测性与行为阈值及康复效果之间存在一致性，言语清晰度相当好。研究得出结论，结合CM评估的ABR记录是ANSD诊断最具信息量的测试。然而，ABR和ASSR对评估行为阈值均无用处。本研究结果表明，CAEP的有无可为ANSD患儿言语声音的可听度提供一些指示；然而，该方法需要进一步研究。
