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影响婴儿听脑干反应变化的因素。

Factors influencing auditory brainstem response changes in infants.

机构信息

Aichi Children's Health and Medical Center, Aichi, Japan.

Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Int J Pediatr Otorhinolaryngol. 2024 Oct;185:112094. doi: 10.1016/j.ijporl.2024.112094. Epub 2024 Sep 5.

DOI:10.1016/j.ijporl.2024.112094
PMID:39243534
Abstract

BACKGROUND

To elucidate the factors influencing auditory brainstem response (ABR) threshold improvement in infants.

METHODS

This retrospective study included 626 infants who underwent ABR at the our Health and Medical Center between 2016 and 2020. Preliminary assessment indicated that 352 infants had an ABR threshold ≥40 dBnHL in both ears. A second ABR examination was conducted 5 months after delivery. The participants were divided into the improved (improvement ≥20 dBnHL) and unchanged (improvement <20 dBnHL) groups. The associations between risk factors were evaluated. Furthermore, we measured and compared the latencies of waves I, III, and V between participants with normal hearing and those in the improved and unchanged groups.

RESULTS

The improved and unchanged groups consisted of 185 and 167 participants, respectively. ABR deterioration occurred in one infant with unilateral congenital cytomegalovirus-associated hearing loss. Binary logistic regression analysis revealed that the presence of otitis media with effusion and Down syndrome were factors contributing to ABR threshold improvement. In the ABR waveform analysis, patients in the improved group who had otitis media with effusion exhibited prolonged latencies of waves I, III, and V. Conversely, patients in the unchanged group who had Down syndrome showed shortened I-V interval.

CONCLUSIONS

Half of the infants tested the second time showed improvement in ABR threshold. Children with congenital syndromes (such as Down syndrome) or otitis media with effusion should undergo a second ABR examination or other auditory assessments to ensure an accurate diagnosis of hearing loss.

摘要

背景

阐明影响婴儿听觉脑干反应(ABR)阈值改善的因素。

方法

本回顾性研究纳入了 2016 年至 2020 年在我院健康医疗中心接受 ABR 的 626 名婴儿。初步评估表明,双耳 ABR 阈值≥40dBnHL 的婴儿有 352 名。分娩后 5 个月进行第二次 ABR 检查。将参与者分为改善(改善≥20dBnHL)和未改善(改善<20dBnHL)组。评估了风险因素之间的相关性。此外,我们测量并比较了正常听力组和改善组及未改善组参与者中 I、III 和 V 波的潜伏期。

结果

改善组和未改善组分别有 185 名和 167 名参与者。一名患有单侧先天性巨细胞病毒相关性听力损失的婴儿出现 ABR 恶化。二项逻辑回归分析显示,分泌性中耳炎和唐氏综合征的存在是 ABR 阈值改善的因素。在 ABR 波形分析中,患有分泌性中耳炎的改善组患者 I、III 和 V 波潜伏期延长。相反,患有唐氏综合征的未改善组患者 I-V 间隔缩短。

结论

一半的婴儿第二次测试显示 ABR 阈值改善。患有先天性综合征(如唐氏综合征)或分泌性中耳炎的儿童应进行第二次 ABR 检查或其他听力评估,以确保听力损失的准确诊断。

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