Streppel M, Richling F, Roth B, Walger M, von Wedel H, Eckel H E
Klinik und Poliklinik für Hals, Nase, und Ohrenheilkunde, Kopf und Halschirurgie, der Universität Köln, Germany.
Int J Pediatr Otorhinolaryngol. 1998 Aug 1;44(3):235-43. doi: 10.1016/s0165-5876(98)00070-6.
Because of their serious consequences for all aspects of development, severe hearing disorders in children are an important clinical entity. A better understanding of the epidemiology and etiology of acquired hearing disorders may potentially lead to more effective prevention. Marked differences in the epidemiology of acquired hearing disorders are reported in the literature. In order to illuminate the problem of acquired disorders and to define current etiological causes with special regard to ethnological factors in the Cologne area, we started a retrospective study. A total of 314 children in residence at the school for hearing impaired children in Cologne were investigated. We also obtained concise data on the structure of the population in order to determine prevalence of acquired hearing disorders in the German and immigrant portions of the population. We found an overall prevalence of 0.43 per thousand for severe hearing disorders and deafness. German children were most frequently affected by acquired, and non-German children by hereditary hearing disorders. The most common causes of acquired severe hearing disorder were the perinatal complex of premature delivery, anoxia and hyperbilirubinuria or kernicterus. Other causes were congenital rubella infections and meningitis in early childhood. The accumulation of perinatal etiologies seems to be the reason for the remarkable majority of acquired hearing disorders among German children. One reason might be progress in neonatology which exerts two effects. It decreases perinatal mortality but increases perinatal complications like acquired hearing impairment. The incidence of congenital rubella in Germany has decreased during recent years, reaching a low level.
由于儿童严重听力障碍对发育的各个方面都会产生严重后果，因此它是一个重要的临床病症。更好地了解获得性听力障碍的流行病学和病因学可能会带来更有效的预防措施。文献报道了获得性听力障碍在流行病学方面存在显著差异。为了阐明获得性听力障碍问题，并特别针对科隆地区的人种学因素确定当前的病因，我们开展了一项回顾性研究。对科隆市听力障碍儿童学校的314名住校儿童进行了调查。我们还获取了有关人口结构的简要数据，以确定德国人和移民群体中获得性听力障碍的患病率。我们发现严重听力障碍和失聪的总体患病率为千分之0.43。德国儿童最常受到获得性听力障碍的影响，而非德国儿童则多受遗传性听力障碍影响。获得性严重听力障碍最常见的病因是早产、缺氧和高胆红素血症或核黄疸的围产期综合征。其他病因包括先天性风疹感染和幼儿期脑膜炎。围产期病因的累积似乎是德国儿童中获得性听力障碍占绝大多数的原因。一个原因可能是新生儿学的进步产生了两种影响。它降低了围产期死亡率，但增加了诸如获得性听力损伤等围产期并发症。近年来，德国先天性风疹的发病率有所下降，达到了较低水平。
