Savenko I V, Garbaruk E S, Boboshko M Yu
Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
Saint Petersburg State Pediatric Medical University of the Ministry of Health of Russia, Saint Petersburg, Russia.
Vestn Otorinolaringol. 2020;85(3):11-17. doi: 10.17116/otorino20208503111.
The presence of numerous perinatal risk factors and comorbid pathology in prematurely born children, even in the absence of peripheral auditory deficit, can lead to disruptions in the processes of higher nervous sound information processing with the formation of central auditory disorders.
Audiological assessment of the functional state of auditory system central parts in prematurely born children.
The study involved 54 deeply premature born infants, which were divided into 3 groups depending on age (6-7, 8-9, and 10-11 years), 18 subjects in each group, and 70 healthy, term-born children of the corresponding age. In addition to the traditional audiological examination, all children underwent an assessment of functional state of the central parts of auditory system through a pause detection test (Random Gap Detection Test, RGDT); the perception of fast rhythmic sequences of stimuli, monaural low excess speech testing, binaural interaction test in alternating binaural speech format (ABS ), dichotic presentation of pairs of single digits, single digits and monosyllables, two-digit numerals, Russian matrix phrasal test in noise (RUMatrix) were studied.
Prematurely born infants of all age groups were significantly worse compared to control group (<0.01) while having RGDT, a test for assessing the perception of fast rhythmic sequences of stimuli and dichotic binaural integration tests. Monaural intelligibility of monosyllabic words in silence in children of all three groups did not differ from normal values, but it suffered from contralateral use of noise interference in children aged 6-7. According to the RUMatrix test, legibility of phrases in noise was impaired in 65% of subjects. Test results in the ABS format revealed a significant violation of speech intelligibility (<0.01) only in children of the younger age group.
In prematurely born children, there is a dysfunction of the central parts of the auditory system, which is multilevel in nature, partially leveling as children grow older. Moreover, the processes of temporary processing of acoustic information suffer to the greatest extent, not being compensated up to adolescence.
即使没有外周听觉缺陷，早产儿童中存在众多围产期危险因素和合并病理状况，也可能导致高级神经声音信息处理过程中断，进而形成中枢听觉障碍。
对早产儿童听觉系统中枢部分的功能状态进行听力学评估。
该研究纳入了54名极早产婴儿，根据年龄分为3组（6 - 7岁、8 - 9岁和10 - 11岁），每组18名受试者，以及70名相应年龄的健康足月儿。除了传统的听力学检查外，所有儿童都通过间隙检测试验（随机间隙检测试验，RGDT）对听觉系统中枢部分的功能状态进行评估；研究了对快速节奏刺激序列的感知、单耳低声过量言语测试、双耳交替言语格式（ABS）的双耳交互测试、成对单数字的双耳分听呈现、单数字和单音节、两位数数字、俄语噪声矩阵短语测试（RUMatrix）。
在进行RGDT、评估对快速节奏刺激序列感知的测试以及双耳分听双耳整合测试时，所有年龄组的早产婴儿与对照组相比均明显更差（<0.01）。三组儿童在安静环境下单音节词的单耳可懂度与正常值无差异，但6 - 7岁儿童在对侧使用噪声干扰时可懂度受到影响。根据RUMatrix测试，65%的受试者在噪声环境下短语的清晰度受损。ABS格式的测试结果显示，仅在较年轻年龄组的儿童中语音可懂度有显著受损（<0.01）。
早产儿童存在听觉系统中枢部分功能障碍，这种障碍本质上是多层面的，随着儿童年龄增长会部分缓解。此外，声学信息的暂时处理过程受影响最大，直至青春期都未得到补偿。
