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36个月以下先天性小耳畸形患儿使用短声听觉脑干反应和啁啾声听觉稳态反应进行的听力学评估:单中心经验

Audiological assessment using click auditory brainstem response and chirp auditory steady-state response in pediatric patients with congenital microtia under 36 months: A single-center experience.

作者信息

Wang Yuan, Zhu Jikai, Wang Danni, Zhao Shouqin

机构信息

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China.

Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, 100730, China.

出版信息

Int J Pediatr Otorhinolaryngol. 2025 May;192:112320. doi: 10.1016/j.ijporl.2025.112320. Epub 2025 Mar 24.

DOI:10.1016/j.ijporl.2025.112320
PMID:40147197
Abstract

OBJECTIVE

To investigate the audiological characteristics of congenital microtia (CM), and explores the effectiveness of click auditory brainstem responses (c-ABR) and chirp auditory steady-state responses (chirp-ASSR) in assessing hearing loss in affected children.

METHODS

Audiological assessments were performed using c-ABR and chirp-ASSR in infants and toddlers under 36 months with CM who were unable to cooperate for behavioral testing. We used c-ABR to assess the nature of hearing loss. Spearman coefficients were used to evaluate correlations, and differences were assessed by subtracting c-ABR air conduction (AC) thresholds from chirp-ASSR AC thresholds. Additionally, differences were analyzed based on the external auditory canal status, auricle status, unilateral or bilateral CM.

RESULTS

The findings indicate that most CM patients experience conductive hearing loss (CHL, 90.36 %) and mixed hearing loss (MHL, 8.21 %), with a smaller number exhibiting normal (0.71 %) or sensorineural hearing loss (SNHL, 0.71 %). Across the entire sample, ABR thresholds showed the strongest correlation with ASSR thresholds at an average of 2-4 kHz (r = 0.723). Chirp-ASSR was found to be a complementary test to c-ABR for screening hearing loss in CM patients, particularly when behavioral testing is not feasible. Significant differences were found in patients with external auditory canal atresia and stenosis, as well as in those with different auricle statuses (Grade I + II, and Grade III).

CONCLUSION

The study supports the use of c-ABR and chirp-ASSR as valuable tools in the audiological assessment of congenital microtia, aiding in early diagnosis and appropriate intervention for hearing loss in pediatric patients.

摘要

目的

研究先天性小耳畸形(CM)的听力学特征,并探讨短声听觉脑干反应(c-ABR)和啁啾听觉稳态反应(chirp-ASSR)在评估患耳儿童听力损失中的有效性。

方法

对36个月以下无法配合行为测试的CM婴幼儿采用c-ABR和chirp-ASSR进行听力学评估。我们使用c-ABR评估听力损失的性质。采用Spearman系数评估相关性,并通过从chirp-ASSR气导(AC)阈值中减去c-ABR AC阈值来评估差异。此外,还根据外耳道状况、耳廓状况、单侧或双侧CM进行差异分析。

结果

研究结果表明,大多数CM患者为传导性听力损失(CHL,90.36%)和混合性听力损失(MHL,8.21%),少数表现为正常(0.71%)或感音神经性听力损失(SNHL,0.71%)。在整个样本中,ABR阈值与ASSR阈值在平均2 - 4 kHz时相关性最强(r = 0.723)。发现chirp-ASSR是c-ABR的补充测试,用于筛查CM患者的听力损失,特别是在行为测试不可行时。在外耳道闭锁和狭窄患者以及不同耳廓状况(I + II级和III级)的患者中发现了显著差异。

结论

该研究支持将c-ABR和chirp-ASSR作为先天性小耳畸形听力学评估中的重要工具,有助于小儿患者听力损失的早期诊断和适当干预。

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