I.P. Pavlov First St. Petersburg State Medical University, 6-8 L'va Tolstogo St., St. Petersburg, 197022, Russia.
I.P. Pavlov First St. Petersburg State Medical University, 6-8 L'va Tolstogo St., St. Petersburg, 197022, Russia; St. Petersburg State Pediatric Medical University, 2 Litovskaya St., St. Petersburg, 194100, Russia.
Int J Pediatr Otorhinolaryngol. 2020 Dec;139:110456. doi: 10.1016/j.ijporl.2020.110456. Epub 2020 Oct 17.
OBJECTIVES: To analyze the age-specific pattern of auditory function in preterm children as a function of their gestational age at birth. STUDY DESIGN: longitudinal cohort study. METHODS: a prospective cohort study involved 271 preterm children aged from 6 months to 15 years old. Children were divided into two groups: 70 children with a gestational age at birth of 32-36 weeks (Group 1) and 201 children with a gestational age of 22-31 weeks (Group 2). Hearing was assessed by ABR, ASSR, OAE, behavioral audiometry, and pure tone audiometry. Additionally, for some children, CT, MRI, and GBJ2 evaluations were performed. Assessments of hearing impaired children were performed 3-4 times a year for children under 2 years of age; 2-3 times a year for children from 2 to 5 years of age; and 1-2 times a year for children over 5 years of age. Infants without any hearing problems were examined 2-3 times during their first year of life, followed by annual examinations as they aged. RESULTS: The initial hearing examination identified SNHL and ANSD in 18 children (25.7%) and 64 children (31.8%) in Group 1 and Group 2, respectively. No significant difference in the occurrence of auditory impairment in the two groups was found at the initial assessment (p > 0.05). Further long-term follow-up revealed changes in hearing in 16 children: 15 from Group 2 and only one child from Group 1. Four different kinds of hearing changes were noted: hearing recovery to normal levels in children with ANSD; late onset hearing loss; the transformation of ANSD to SNHL, and vice versa. The age, factors, and possible mechanisms of such changes are discussed in the article. CONCLUSION: The auditory function in prematurely born children tends to be unstable, especially at a very early age. In very preterm infants, it may either deteriorate or improve. Infants born before 31 weeks' gestation require long-term follow-up at least until they are 3-4 years of age. Caution is advised regarding very early cochlear implantation for children born before 32 weeks of gestation age.
目的：分析不同胎龄早产儿听觉功能的年龄特征，作为其出生时胎龄的函数。
研究设计：纵向队列研究。
方法：一项前瞻性队列研究纳入了 271 名胎龄为 6 个月至 15 岁的早产儿。儿童分为两组：32-36 周出生的 70 名儿童（第 1 组）和 22-31 周出生的 201 名儿童（第 2 组）。通过 ABR、ASSR、OAE、行为测听和纯音测听评估听力。此外，对于一些儿童，还进行了 CT、MRI 和 GBJ2 评估。对于 2 岁以下的儿童，每年评估 3-4 次；对于 2-5 岁的儿童，每年评估 2-3 次；对于 5 岁以上的儿童，每年评估 1-2 次。无听力问题的婴儿在生命的第一年接受 2-3 次检查，然后随着年龄的增长每年进行检查。
结果：初次听力检查发现第 1 组和第 2 组分别有 18 名（25.7%）和 64 名（31.8%）儿童存在 SNHL 和 ANSD。两组初次评估时听觉损伤发生率无显著差异（p>0.05）。进一步的长期随访显示，16 名儿童的听力发生变化：15 名来自第 2 组，只有 1 名来自第 1 组。注意到四种不同类型的听力变化：ANSD 儿童听力恢复正常水平；迟发性听力损失；ANSD 向 SNHL 的转变，反之亦然。文章讨论了这些变化的年龄、因素和可能的机制。
结论：早产儿的听觉功能往往不稳定，尤其是在非常早期。在极早产儿中，可能会恶化或改善。胎龄小于 31 周的婴儿需要至少随访到 3-4 岁。对于胎龄小于 32 周的婴儿，建议谨慎考虑非常早期的耳蜗植入。
Int J Pediatr Otorhinolaryngol. 2020-12
Clin Neurophysiol. 2007-3
Int J Pediatr Otorhinolaryngol. 2015-5
Vestn Otorinolaringol. 2018
Ital J Pediatr. 2020-1-6
Int J Pediatr Otorhinolaryngol. 2020-8
Int J Pediatr Otorhinolaryngol. 2019-12
Eur Arch Otorhinolaryngol. 2024-7
World J Clin Pediatr. 2023-6-9
Zotero 插件