听性稳态反应在新生儿听力评估中的应用

目的 探讨听性稳态反应(auditory steady-state responses,ASSR)在新生儿听力评估中的准确性及应用价值.方法 对30例(60耳)畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)正常的新生儿和45例(78耳)DPOAE异常的新生儿进行ASSR与听性脑干反应(auditory brainstem response audiome-try,ABR)测试,比较ASSR与ABR阈值差异有无统计学意义,并进行两者反应阈的相关性分析.结果 ①DPOAE正常组:ASSR 250 Hz反应阈与ABR阈值差异有统计学意义(P＜0.05),ASSR平均阈值及4 000 Hz反应阈与ABR阈值差异无统计学意义(P＞0.05),ASSR的250、500、1 000 Hz反应阈与ABR阈值相关性不明显,但2 000、4 000 Hz反应阈与ABR阈值有明显的相关性;②DPOAE异常组:ASSR的250～4 000 Hz阈值及平均阈值与ABR阈值差异均无统计学意义(P＞0.05).ASSR各频率反应阈与ABR阈值均有显著的相关性.结论 ASSR可以比较准确地评估听力筛查正常新生儿的平均听阈和中、高频听阈以及听力筛查未通过新生儿的各频率听阈.

The Application of Auditory Steady - State Responses to the Neonates Hearing Evaluation

Objective To explore the use of auditory steady-state response (ASSR) for threshold evaluation in neonates. Methods 30 neonates 60 ears) were included in the study who passed distortion product otoacoustic emission (DPOAE) screening and 45 neonates (78 ears) who failed DPOAE. The ASSR thresholds were evaluated screening, the significant difference was found between the ASSR thresholds at 250 Hz and the ABR thresholds (P ＜0.05), however the ASSR thresholds at 4 000 Hz and average thresholds were not different from the ABR thresholds (P＞0.05). For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds from 250 to 4 000 Hz and average thresholds were not significant different from the ABR thresholds respectively (P＞0.05). olds were not correlated, but there were significant correlations at 2 000 and 4 000 Hz. For the neonates whose DPOAE screening results were abnormal, the ASSR thresholds and the ABR thresholds were significantly correlated at all the carrier frequencies. Conclusion Reliable and frequency specific results could be obtained by ASSR,so it could be a promising audiometry to evaluate the hearing of neonates.