Dietrich Maria, Schade Heike, Nadal Jennifer, Keiner Sabine, Schade Götz
Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Private Practice Kleinow, Pfarrer-Kenntemich-Platz 11, 53840 Troisdorf, Germany.
J Clin Med. 2023 Jan 20;12(3):830. doi: 10.3390/jcm12030830.
Intraoperative auditory brainstem response (ioABR) testing following tympanostomy tube (TT) placement may be biased due to temporary threshold shifts (TTS). The purpose of the study was to assess the evidence for TTS in children who have undergone ioABR using prolonged latencies of wave I (males > 1.95 ms, females > 1.88 ms) as a marker of a persisting air-bone gap. Eighty-three children underwent ioABR following surgical procedures at University Hospital Bonn, Germany. The primary outcome measure was the latency of wave I at 80-dB SPL. The total sample consisted of 66 males (79.5%) and 17 females (20.5%) with a mean (SD) age of 46.4 (26.6) months. Of 163 operated ears (83 children), 72 (44.2%) had no middle ear fluid, 19 (11.6%) serous fluid, and 72 (44.2%) mucoid fluid. The risk of having a prolonged latency of wave I at 80-dB SPL was OR 4.61 (95% CI 2.01-10.59; < 0.001) in those with mucoid fluid as compared to those without mucoid fluid. Intraoperative ABR results should account for sex differences and be interpreted with caution and be verified. Ultimately, parents should be engaged in a preoperative discussion to decide if an ioABR should be postponed if mucoid fluid was found.
鼓膜置管（TT）术后进行术中听觉脑干反应（ioABR）测试可能会因暂时阈移（TTS）而产生偏差。本研究的目的是评估在接受ioABR的儿童中TTS的证据，使用I波延长潜伏期（男性>1.95毫秒，女性>1.88毫秒）作为持续气骨导间距的标志。83名儿童在德国波恩大学医院接受手术后进行了ioABR测试。主要观察指标是80分贝声压级下I波的潜伏期。总样本包括66名男性（79.5%）和17名女性（20.5%），平均（标准差）年龄为46.4（26.6）个月。在163只手术耳（83名儿童）中，72只（44.2%）无中耳积液，19只（11.6%）有浆液性积液，72只（44.2%）有黏液性积液。与无黏液性积液的儿童相比，有黏液性积液的儿童在80分贝声压级下I波潜伏期延长的风险为比值比4.61（95%置信区间2.01-10.59；P<0.001）。术中ABR结果应考虑性别差异，谨慎解释并进行验证。最终，应在术前与家长进行讨论，以决定如果发现黏液性积液，ioABR是否应推迟。
