Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China.
Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China.
Int J Pediatr Otorhinolaryngol. 2024 Sep;184:112074. doi: 10.1016/j.ijporl.2024.112074. Epub 2024 Aug 22.
This study explored the value of Chirp-auditory brainstem response (ABR) thresholds in assessing the hearing threshold of children diagnosed with auditory neuropathy spectrum disorder (ANSD).
A total of 20 children with ANSD (40 ears, aged 1.5-7.0 years, median age 4.5 years) and 31 children with sensorineural hearing loss (SNHL) (52 ears, aged 0.9-8.0 years, median age 3.7 years) were included. Besides, 25 normal children (50 ears, aged 0.8-7.5 years, median age 4.6 years) were used as controls. Chirp-ABR and behavioral audiometry were performed simultaneously among three groups of children, allowing for a comparison of the thresholds obtained through both methods.
In ANSD children, the correlation (r-values) between the thresholds obtained from Chirp-ABR and behavioral audiometry at 500-4000 Hz were 0.84, 0.67, 0.59, and 0.60, respectively. The average threshold differences between two methods ranged from 9.7 to 13.3 dB at 500-4000 Hz. Notably, 20 % ears (8/40) exhibited considerable discrepancies (>30 dB) in thresholds at certain frequencies. For SNHL children, the r-values between two methods were 0.84, 0.89, 0.92, and 0.93, respectively. The average threshold differences between two methods were 5.7-8.2 dB at 500-4000 Hz. Similarly, in normal children, the average threshold differences between two methods ranged from 6.1 dB to 7.7 dB, the r-values were 0.81, 0.78, 0.80, and 0.80 at 500-4000 Hz, respectively.
Chirp-ABR threshold is not suitable to predict the behavioral audiometry threshold in ANSD children. When there is a significant discrepancy (>30 dB) between Chirp-ABR thresholds and behavioral audiometry thresholds in hearing loss, ANSD should be highly suspected.
本研究旨在探讨啁啾听觉脑干反应(ABR)阈值在评估诊断为听神经病谱系障碍(ANSD)儿童听力阈值中的价值。
共纳入 20 例 ANSD 患儿(40 耳,年龄 1.5-7.0 岁,中位数年龄 4.5 岁)和 31 例感音神经性听力损失(SNHL)患儿(52 耳,年龄 0.9-8.0 岁,中位数年龄 3.7 岁),同时纳入 25 例正常儿童(50 耳,年龄 0.8-7.5 岁,中位数年龄 4.6 岁)作为对照组。三组儿童同时进行啁啾 ABR 和行为测听,比较两种方法获得的阈值。
在 ANSD 患儿中,500-4000 Hz 时,Chirp-ABR 阈值与行为测听阈值的相关系数(r 值)分别为 0.84、0.67、0.59 和 0.60。两种方法的平均阈值差异在 500-4000 Hz 时为 9.7-13.3 dB。值得注意的是,20%的耳朵(8/40)在某些频率的阈值差异较大(>30 dB)。在 SNHL 患儿中,两种方法的 r 值分别为 0.84、0.89、0.92 和 0.93,两种方法的平均阈值差异在 500-4000 Hz 时为 5.7-8.2 dB。同样,在正常儿童中,两种方法的平均阈值差异在 500-4000 Hz 时为 6.1-7.7 dB,r 值分别为 0.81、0.78、0.80 和 0.80。
Chirp-ABR 阈值不能预测 ANSD 患儿的行为测听阈值。当听力损失时 Chirp-ABR 阈值与行为测听阈值差异较大(>30 dB)时,应高度怀疑 ANSD。