Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Laryngoscope. 2020 Jun;130(6):1540-1546. doi: 10.1002/lary.28264. Epub 2019 Sep 5.
OBJECTIVES/HYPOTHESIS: Evaluate patterns of hearing impairment in children with Turner's syndrome (TS) and determine factors influencing severity and progression.
Retrospective database review.
Demographic, audiological, and medical data for children with TS were extracted from the Audiological and Genetic Database to analyze patterns of hearing loss with comorbidities, demographics, and interventions.
Two hundred seventy-two children with TS were identified; 213 had audiological data. Of these children, 72.3% (N = 154) had hearing loss in which 84.4% (N = 130) was bilateral. In individual ears, conductive hearing loss was most common (28.7%, n = 73), followed by mixed (22.0%, n = 93) and sensorineural (7.9%, n = 20). Otitis media (odds ratio [OR] = 2.7, 95% confidence interval [CI]: 1.2-6.5), eustachian tube dysfunction (OR = 9.5, 95% CI: 3.2-35.2), and aortic valve anomalies were also associated with higher rates of hearing loss (OR = 3.6, 95% CI: 1.3-11.5). Of ears with quantifiable severity, 16.3% (n = 40) had moderate or worse hearing loss. Aortic coarctation (36.3 vs. 21.3 dB, P < .001), seizures (40.6 vs. 21.3 dB, P = .006), facial anomalies (32.5 vs. 21.3 dB, P = .029), and hypertension (36.3 vs. 21.3 dB, P = .015) portended more severe loss.
Children with TS have high rates of hearing loss. High rates of sensorineural loss were unexpected. Nonotologic comorbidities, including seizures, hypertension, and anomalies of the kidney and aorta were associated with greater prevalence, severity, and progression of loss. Children with TS, particularly with the above comorbidities, are at risk for poor hearing outcomes, and should be offered audiological intervention to efficiently direct patient care.
NA Laryngoscope, 130:1540-1546, 2020.
目的/假设:评估特纳综合征(TS)儿童的听力障碍模式,并确定影响严重程度和进展的因素。
回顾性数据库研究。
从听力和遗传数据库中提取 TS 儿童的人口统计学、听力和医学数据,以分析伴有合并症、人口统计学和干预措施的听力损失模式。
确定了 272 名患有 TS 的儿童;213 名儿童有听力数据。在这些儿童中,72.3%(N=154)有听力损失,其中 84.4%(N=130)为双侧。在单个耳朵中,传导性听力损失最常见(28.7%,n=73),其次是混合性(22.0%,n=93)和感音神经性(7.9%,n=20)。中耳炎(比值比[OR] = 2.7,95%置信区间[CI]:1.2-6.5)、咽鼓管功能障碍(OR = 9.5,95% CI:3.2-35.2)和主动脉瓣异常也与听力损失发生率较高相关(OR = 3.6,95% CI:1.3-11.5)。在可量化严重程度的耳朵中,16.3%(n=40)有中度或更严重的听力损失。主动脉缩窄(36.3 与 21.3 dB,P<.001)、癫痫发作(40.6 与 21.3 dB,P=.006)、面部异常(32.5 与 21.3 dB,P=.029)和高血压(36.3 与 21.3 dB,P=.015)预示着更严重的听力损失。
患有 TS 的儿童听力损失率较高。感觉神经性听力损失的高发生率出乎意料。非耳科合并症,包括癫痫发作、高血压以及肾脏和主动脉异常,与听力损失的患病率、严重程度和进展相关。患有 TS 的儿童,特别是伴有上述合并症的儿童,听力预后较差,应提供听力干预措施,以有效地指导患者护理。
无 喉镜,130:1540-1546,2020。