Kavanagh K T, Domico W D, Crews P L, McCormick V A
Department of Otolaryngology and Maxillofacial Surgery, University of Tennessee, Memphis 38163.
Ann Otol Rhinol Laryngol. 1988 May-Jun;97(3 Pt 1):264-71. doi: 10.1177/000348948809700310.
The auditory brain stem response (ABR) and middle latency response (MLR) were studied in 48 young children (96 ears). The responses were elicited using low intensity stimuli (30-dB nHL clicks) and simultaneously were recorded on a dual time base. Both the ABR and MLR were elicited in 70 ears. In 12 ears, just one response was recorded (ABR in eight ears and the MLR in four ears). In 14 ears, neither response was recorded. Test-retest analysis on the same subject demonstrated that the ABR was more repeatable and easier to identify than the MLR. The test-retest difference was determined for the amplitude and latency of the ABR and MLR waveforms. The test-retest latency difference for wave Pa was found to be 3.6 times larger than for wave V. The normalized test-retest amplitude difference for P phi-Na, Na-Pa, and Pa-Nb was found to be two to three times larger than for wave V. These data support the conclusion that the ABR, rather than the MLR, should be used to measure hearing in young children. The authors also advocate using minimal high pass (HP) filtering when recording the ABR in a sedated or sleeping child. Muscle artifact was not found to be a problem. The authors suggest the use of minimal HP filtering so that phase-shift distortion is minimized and a larger response amplitude can be recorded.
对48名幼儿（96只耳）进行了听性脑干反应（ABR）和中潜伏期反应（MLR）研究。使用低强度刺激（30 dB nHL短声）引出反应，并同时在双时基上进行记录。70只耳同时引出了ABR和MLR。12只耳仅记录到一种反应（8只耳为ABR，4只耳为MLR）。14只耳未记录到任何反应。对同一受试者的重测分析表明，ABR比MLR更具可重复性且更容易识别。确定了ABR和MLR波形的幅度和潜伏期的重测差异。发现Pa波的重测潜伏期差异比V波大3.6倍。P phi-Na、Na-Pa和Pa-Nb的标准化重测幅度差异比V波大两到三倍。这些数据支持以下结论：应使用ABR而非MLR来测量幼儿的听力。作者还提倡在对镇静或睡眠中的儿童记录ABR时使用最小高通（HP）滤波。未发现肌肉伪迹是一个问题。作者建议使用最小HP滤波，以便将相移失真降至最低，并可记录到更大的反应幅度。
