单侧大前庭导水管患儿的听力测定结果
Audiometric findings in children with unilateral enlarged vestibular aqueduct.
作者信息
Macielak Robert J, Mattingly Jameson K, Findlen Ursula M, Moberly Aaron C, Malhotra Prashant S, Adunka Oliver F
机构信息
The Hearing Program in the Pediatric Otolaryngology Department, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA; College of Medicine, The Ohio State University, 370 W 9th Ave, Columbus, OH, 43210, USA; Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA.
The Hearing Program in the Pediatric Otolaryngology Department, Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH, 43205, USA; Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA.
出版信息
Int J Pediatr Otorhinolaryngol. 2019 May;120:25-29. doi: 10.1016/j.ijporl.2019.01.034. Epub 2019 Jan 25.
OBJECTIVE
To evaluate the prevalence of bilateral hearing loss in children with unilateral enlarged vestibular aqueduct (EVA) at a single institution.
METHODS
A retrospective case review was performed at a tertiary care pediatric referral center involving children with radiologic findings of unilateral EVA and normal labyrinthine anatomy of the contralateral ear diagnosed via CT and/or MRI. The main outcome measure of interest is the number of patients with unilateral EVA who were diagnosed with bilateral hearing loss.
RESULTS
Sixty-one pediatric patients were identified. The mean audiometric follow-up was 48.2 months (0-150). Three (4.9%) patients with unilateral EVA were noted to have bilateral hearing loss, and this rate was not significantly different (p = 1.0) from the rate reported in a comparison group of patients with contralateral hearing loss (6.0%) without an EVA. The pure-tone average (defined as the average dB HL at 500, 1000, 2000, and 4000 Hz) in the group with bilateral hearing loss was 31.3 dB HL in the better hearing ear and 79.6 dB HL in the worse hearing ear, with the difference being statistically significant (p = 0.02). In the unilateral EVA patients without contralateral hearing loss (n = 56, 91.8%), the PTA was 9.4 dB HL in the better hearing ear and 51.9 dB HL in the worse hearing ear, with the difference being statistically significant (p < 0.001). Two patients (3.3%) with unilateral EVA were found to have hearing within normal limits bilaterally. The EVA was ipsilateral to the worse hearing ear in all cases.
CONCLUSION
The prevalence of bilateral hearing loss in children with unilateral EVA appears to be low. Specifically, it may be no different than the rate of contralateral hearing loss in children with unilateral hearing loss without an EVA. The present report is somewhat different than the previously described prevalence in the literature. This difference could be related to the imaging type and diagnostic criteria used, the patients included, the source of the identified patents, and the overall population of patients studied.
目的
评估某单一机构中单侧大前庭导水管（EVA）患儿双侧听力损失的患病率。
方法
在一家三级儿科转诊中心进行回顾性病例分析，纳入经CT和/或MRI诊断为单侧EVA且对侧耳迷路解剖结构正常的患儿。主要观察指标是被诊断为双侧听力损失的单侧EVA患者数量。
结果
共确定61例儿科患者。平均听力随访时间为48.2个月（0 - 150个月）。3例（4.9%）单侧EVA患者被发现有双侧听力损失，该比率与无EVA的对侧听力损失患者比较组报告的比率（6.0%）无显著差异（p = 1.0）。双侧听力损失组中较好听力耳的纯音平均听阈（定义为500、1000、2000和4000Hz处的平均dB HL）为31.3dB HL，较差听力耳为79.6dB HL，差异有统计学意义（p = 0.02）。在无对侧听力损失的单侧EVA患者中（n = 56，91.8%），较好听力耳的PTA为9.4dB HL，较差听力耳为51.9dB HL，差异有统计学意义（p < 0.001）。2例（3.3%）单侧EVA患者双侧听力均在正常范围内。所有病例中EVA均与较差听力耳同侧。
结论
单侧EVA患儿双侧听力损失的患病率似乎较低。具体而言，它可能与无EVA的单侧听力损失患儿的对侧听力损失发生率无差异。本报告与文献中先前描述的患病率有所不同。这种差异可能与所使用的成像类型和诊断标准、纳入的患者、已识别患者的来源以及所研究患者的总体人群有关。
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