Robertson C M, Cheung P Y, Haluschak M M, Elliott C A, Leonard N J
Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation Hospital Site, Capital Health Authority, Edmonton, Alberta.
Am J Otol. 1998 Nov;19(6):730-6.
This study aimed to determine the prevalence of sensorineural hearing loss (SNHL) in 2-5-year-old survivors with neonatal respiratory failure due to congenital diaphragmatic hernia (CDH) with or without the need for extracorporeal membrane oxygenation (ECMO).
The study design was a prospective, multicenter, longitudinal outcome study of consecutively surviving neonates admitted to a single tertiary intensive care unit.
The study was conducted at four audiologic departments affiliated with tertiary-level intensive care follow-up programs.
Thirty-seven surviving children receiving neonatal intensive care from February 1989 through January 1995 for neonatal respiratory failure due to CDH were studied. Excluded were 15 children with early death and I child lost to follow-up.
The initial treatment depended on the severity of neonatal respiratory failure: ECMO-treated (n=31, 20 survivors) (death before ECMO initiation, 2) and non-ECMO treated (n=20, 17 survivors, another survivor lost to follow-up).
Early childhood audiologic test results were measured.
Sensorineural hearing loss was found in almost 60% of subjects: ECMO-treated, 12 (60%) of 20; non-ECMO-treated, 10 (59%) of 17. Of the 22 children with SNHL, 16 had mild- to-moderate low-frequency sloping to moderate-to-severe high-frequency loss. Of the remaining, six had severe-to-profound loss at 500 Hz and above. Seventeen children had normal responses to sound as newborns or in infancy. Five children were not tested. Documented progression was found in nine children. Twenty children currently are using amplification, and 2 have had cochlear implantation.
Of children with CDH in this area presenting early with severe neonatal respiratory failure, SNHL developed in 60% by 2-5 years of life. Ongoing monitoring of the hearing status of children with CDH is imperative.
本研究旨在确定2至5岁因先天性膈疝（CDH）导致新生儿呼吸衰竭且有或没有接受体外膜肺氧合（ECMO）治疗的幸存者中感音神经性听力损失（SNHL）的患病率。
本研究设计为一项对入住单一三级重症监护病房的连续存活新生儿进行的前瞻性、多中心纵向结局研究。
该研究在四个隶属于三级重症监护随访项目的听力学科室进行。
对1989年2月至1995年1月期间因CDH导致新生儿呼吸衰竭而接受新生儿重症监护的37名存活儿童进行了研究。排除了15名早期死亡儿童和1名失访儿童。
初始治疗取决于新生儿呼吸衰竭的严重程度：接受ECMO治疗的（n = 31，20名幸存者）（在开始ECMO之前死亡2例）和未接受ECMO治疗的（n = 20，17名幸存者，另1名幸存者失访）。
测量儿童早期的听力学测试结果。
几乎60%的受试者发现有感音神经性听力损失：接受ECMO治疗的20名中12名（60%）；未接受ECMO治疗的17名中10名（59%）。在22名患有SNHL的儿童中，16名有轻度至中度低频下降至中度至重度高频损失。其余6名在500Hz及以上有重度至极重度损失。17名儿童在新生儿期或婴儿期对声音反应正常。5名儿童未接受测试。9名儿童有听力损失进展记录。20名儿童目前正在使用助听器，2名已接受人工耳蜗植入。
该地区早期出现严重新生儿呼吸衰竭的CDH患儿中，到2至5岁时60%出现了感音神经性听力损失。对CDH患儿的听力状况进行持续监测势在必行。
