McPherson B, Kei J, Smyth V, Latham S, Loscher J
Department of Speech Pathology and Audiology, University of Queensland, Brisbane, Australia.
Public Health. 1998 May;112(3):147-52. doi: 10.1038/sj.ph.1900452.
This study investigated the feasibility of obtaining transient evoked otoacoustic emissions for hearing screening purposes from infants and children at seven child health clinics. Factors affecting the outcomes of the community hearing screening program were examined. The subject group comprised 2305 children aged two weeks to 11 y 11 mon. Many children were attending the clinics for initial immunisation at two months of age. While there were no exclusion criteria for the 1305 young infants tested who were in this category, all other children were screened only upon receipt of a referral from clinic nurses. Results indicated that 182 children (7.9%) did not complete the screening for both ears within the time constraint (usually 15 min) of a child health clinic visit. Three hundred and sixty-two children (15.7%) failed the first screening. Of the 226 children who returned for a second screening test, separated from the first by at least two weeks, 121 children failed. With parents' consent, 107 children (4.6% of all participants) were referred for diagnostic or medical assessment. Subsequently, 77 out of 94 children who received audiological or medical assessment were found to have some degree of hearing impairment. The majority of positive screening results were associated with middle ear disorder. The results suggest that TEOAE screening has potential as a technique in the community health setting but improvements in instrumentation are required to reduce 'could not test' cases and to separate probable conductive hearing loss from cases likely to have other disorders.
本研究调查了在七家儿童健康诊所对婴儿和儿童进行瞬态诱发耳声发射听力筛查的可行性。研究考察了影响社区听力筛查项目结果的因素。研究对象包括2305名年龄在两周至11岁11个月的儿童。许多儿童在两个月大时到诊所进行初次免疫接种。在接受测试的1305名此类幼儿中没有排除标准，而所有其他儿童只有在收到诊所护士的转诊后才接受筛查。结果表明，182名儿童（7.9%）未在儿童健康诊所就诊的时间限制（通常为15分钟）内完成双耳筛查。362名儿童（15.7%）初次筛查未通过。在226名至少相隔两周返回进行第二次筛查测试的儿童中，121名儿童未通过。在获得家长同意后，107名儿童（占所有参与者的4.6%）被转诊进行诊断或医学评估。随后，在接受听力学或医学评估的94名儿童中，77名被发现有某种程度的听力障碍。大多数阳性筛查结果与中耳疾病有关。结果表明，瞬态诱发耳声发射筛查作为社区卫生环境中的一项技术具有潜力，但需要改进仪器设备，以减少“无法测试”的情况，并将可能的传导性听力损失与可能患有其他疾病的情况区分开来。
