儿童听力筛查的质量与控制——北京市儿童听力诊断中心2016年度第二季度学术研讨会纪要

<正>在北京市卫生计生委大力支持下,于2016年07月02日由中国聋儿康复研究中心承办了北京市儿童听力诊断中心2016年度第二季度学术活动,共有100余人参加。本次学术研讨会得到了听力学专业人士的广泛关注和支持,包括北京市儿童听力诊断中心的六家医院代表,如北京大学第三医院、北京同仁医院、解放军总医院、北京协和医院、北京儿童医院和中国聋儿康复中心,还有来自北京大学第一医院、北京妇幼保健院及北京各区县妇幼保健院的医     

北京市0-6岁儿童听力诊断干预指南修订——暨北京市儿童听力诊断中心2014年第二季度研讨会纪要

<正>由首都医科大学附属北京同仁医院、北京市耳鼻咽喉科研究所、首都医科大学耳鼻咽喉科学院承办的北京市儿童听力诊断中心2014年第二季度研讨会暨北京市0-6岁儿童听力诊断干预指南修订研讨会,于2014年3月15日在北京崇文门饭店成功举办。来自北京市六家儿童听力诊断定点医疗机构以及各区县从事新生儿听力筛查工作的听力学同道共70余人参加了讨论。"北京市0-6岁儿童听力诊断干预指南"出台已历经10     

第四届全国0～6岁儿童听力筛查诊断培训班

根据卫生部向全国普及和推广“新生儿听力筛查技术”的文件精神和北京市卫生局0～6岁儿童听力筛查及诊断管理办法,北京市耳鼻咽喉科研究自2003年8月起已成功举办了三届全国新生儿听力筛查和诊断培训班。为进一步在全国范围内普及儿童听力筛查技术,规范筛查和诊断程序,首都医科大学北京耳鼻咽喉科学院、北京同仁医院、     

NICU患儿中听力障碍的疾病谱研究——北京0-6岁听力筛查诊断中心2012年第三季度学术研讨会纪要

2012年第三季度会议北京市6家0-6岁听力诊断机构的学术活动于9月5日下午在北京大学第三医院眼科中心耳鼻喉科门诊会议室举行。此次会议在诊断中心专家组的关心和指导下由北京大学第三医院耳鼻喉科承办。此次中心会议的议题为《NICU患儿中听力障碍的疾病谱研究》。这是一个目前在新生儿听力筛查中值得关注的热点话题。首先发言的为解放军总医院的王秋菊主任,她     

0～6岁儿童听力筛查及诊治信息管理系统的研发和临床应用

目的 研发0~6岁儿童听力筛查及诊治信息管理系统,探讨该系统在听力筛查及诊治工作中的应用价值.方法 通过需求收集与调研,针对目前听力筛查数据信息化管理面临的问题,研发0~6岁儿童听力筛查及诊治信息管理系统,将新生儿听力筛查、儿童听力学诊断和干预康复资料通过互联网环境下的医生工作平台录入0~6岁儿童听力筛查及诊治管理系统.听力筛查、诊断结果输入数据库提交后,系统按照预先设置的诊断结果分类,自动识别需要复诊患儿,并预先提前一周报警于系统主界面,由工作人员通过短信、电话方式通知复诊.医生工作平台可查询历次听力筛查、诊断结果和耳聋干预方法、语言康复结果等,并可完成各种统计报表和数据提取、汇总等.结果 本研究成功研发出0~6岁儿童听力筛查、诊治信息管理和随访系统,该系统具有随时随地查询、统计报表、实现多方面数据检索及电子病历的生成和管理功能,方便管理及统计分析.结论 0~6岁儿童听力筛查及诊治信息管理系统能满足婴幼儿听力筛查-诊断-干预-康复、随访-质量控制一体化功能,实现听力筛查、诊治数据库智能管理和电子病历的完整保存.     

2011年第三季度北京市儿童听力诊断中心学术活动纪要

由北京儿童医院承办,北京市儿童听力诊断中心联合北京预防医学会、儿童保健专业委员会举办的本年度第三季度学术研讨会于2011年9月13日下午在首都医科大学附属北京儿童医院电教楼举行。本次研讨会的主题是关于儿童孤独症的有关问题。参加人员有耳鼻喉科专家、听力学专家;六家儿童听力诊断中心的工作人员;城市、农村地区的儿童     

第十五届全国0～6岁儿童听力筛查诊断培训班通知

为了进一步在全国范围内普及儿童听力筛查和诊断技术,规范筛查和诊疗程序,介绍该领域研究最新进展,首都医科大学北京耳鼻喉科学院、北京市耳鼻咽喉科研究所、首都医科大学附属北京同仁医院和世界卫生组织防聋合作中心拟于2010年4月23~28日举办第十五届0～6岁儿童听力筛查诊断培训班（项目号：2010-07-01—011（国）,     

第十五届全国0～6岁儿童听力筛查诊断培训班通知

北京市耳鼻咽喉科研究所／首都医科大学附属北京同仁医院成功举办了14届0-6岁全国儿童听力筛查诊断培训班。为了进一步在全国范围内普及儿童听力筛查和诊断技术,规范筛查和诊疗程序,介绍该领域研究最新进展,拟于2010年4月23日举办第十五届0-6岁儿童听力筛查诊断培训班（项目号：2010-07-01-011（国）,授予学分10分）,     

2012年第四季度北京市儿童听力诊断中心学术研讨会纪要

在北京市0-6岁儿童听力保健专家组的指导下,由首都医科大学附属北京同仁医院承办了北京市儿童听力诊断中心2012年度第四季度的学术活动。本次研讨会由北京市耳鼻咽喉科研究所张华主任主持,主题是关于《失匹配负波及听觉皮层诱发电位的研究进展》。参加本次学术研讨会的各位代表,除了北京市六家儿童听力诊断中心:即北京大学第三医院、北京同仁医院、解放军总医院、北京协和医院、北京     

全国0～6岁儿童听力筛查诊断培训班调查结果

本文重点介绍了对参加全国0～6岁儿童听力筛查诊断培训班学员的调查结果。95.65%的学员对培训班表示满意;78.46%和75.36%的学员认为培训内容实用和合理;94.20%的学员回答单位领导对新生儿听力筛查工作持肯定、支持态度;88.41%学员还希望参加该项目的提高班学习,另外,学员们还提出了许多宝贵的建议。在做好后勤工作保证学员安心学习的同时,完善教学内容和教学模式,不断提高教学质量,是今后的重点课题。     

Contribution of various frequency bands to ABR in dolphins

Auditory brainstem responses (ABR) to clicks and noise bursts of various frequency bands and intensities were recorded in two bottlenosed dolphins, Tursiops truncatus. The purpose was to assess contributions of various parts of the cochlear partition to ABR and travelling wave velocity in the cochlea. At band-pass filtered stimuli (1-0.25 oct wide), ABR amplitude increased with increasing stimulus frequency, thus indicating higher contribution of basal cochlear parts. At high-pass and low-pass filtered stimuli, ABR amplitude increased with passband widening. However, the sum of all narrow-band contributions was a waveform of higher amplitude than the real ABR evoked by the wide-band stimulus. Applying a correction based on an assumption that the 'internal spectrum' is about 0.4 oct wider than the nominal stimulus spectrum resulted in the sum of narrow-band contributions equal to the wide-band ABR. The travelling wave velocity was computed based on ABR latencies and assigned a frequency of 128 kHz to the basal end of the cochlea. The computation gave values from 38.2 oct/ms at the proximal end of the basilar membrane to 4.0 oct/ms at a distance of 3.25 oct (13.5 kHz).     

Detectability of newborn chirp-evoked ABR in the frequency domain at different stimulus rates

Abstract

Objective: The present paper reports the results of a study on a group of newborns whose chirp-evoked auditory brainstem responses (ABR) were recorded at different repetition rates. The study was aimed at finding an optimum repetition rate for the chirp stimulus that facilitates a short response detection time in the frequency domain. Design: Chirp-evoked ABR were recorded at six different stimulation rates between 20/s and 100/s. The stimulation level was 35 dB nHL. The mean harmonic related SNR was calculated, and the response detection time and rate were assessed using a detection algorithm. Study sample: A group of 80 sleeping and 27 awake newborns with normal hearing were included. Results: The highest mean harmonic-related SNR in both groups was found at 60/s. The signal-to-noise ratio (SNR) was significantly smaller for the awake newborns. A significantly shorter detection time can be achieved for both newborn groups at 60/s compared to the other rates tested. Response detection in the group of awake newborns profited more from the change to 60/s compared to the sleeping newborns. Conclusions: It can be expected that with this optimized stimulus paradigm a shorter test time and a higher specificity of the hearing screening can be reached.     

Application of frequency modulated chirp stimuli for rapid and sensitive ABR measurements in the rat

Rodents have proven to be a useful model system to screen genes, ototoxic compounds and sound exposure protocols that may play a role in hearing loss. High-throughput screening depends upon a rapid and reliable functional assay for hearing loss. This study describes the use of a frequency modulated (FM) chirp stimulus as an alternative to the click to derive a rapid assessment of auditory brainstem response (ABR) threshold in the rodent. We designed a rising frequency A-chirp based upon the spatial mapping of preferred frequency along the rat basilar membrane to provide a more synchronous and equipotent input across the length of the cochlea. We observed that the ABR wave I and wave IV amplitudes evoked by the A-chirp were significantly greater than the click and that A-chirp minimum response thresholds were lower than the click. Subsequent analyses compared the efficacy of the A-chirp to linear, time-reversed and amplitude-reversed chirps and confirmed that the A-chirp was most effective chirp configuration. These data suggest that the A-chirp may be optimally suited as a single screening broad-frequency stimulus for rapid ABR threshold estimations in the rodent and could serve to complement more detailed frequency-specific physiologic and behavioral estimates of hearing threshold.     

Comparison of ABR stimuli for the early detection of ototoxicity: conventional clicks compared with high frequency clicks and single frequency tonebursts

Effective objective testing methodology is needed for early detection of the effects of ototoxicity on hearing in patients. The requirements for such testing include responses that are: 1) reliable across test sessions; 2) sensitive to ototoxic change ( > 8 kHz), and 3) recordable in a time-efficient manner. Auditory brainstem responses (ABR) appear well suited to this task however, conventional clicks stimulate primarily mid-frequencies (1-4 kHz) and high frequency tonebursts require too much time. We hypothesized that delivery of a band of high frequencies (a high frequency "click"), would elicit reliable and useful ABRs. In the current study, flat and sloped HF (high frequency) clicks with a bandwidth of 8-14 kHz were used. The purpose was to compare brainstem responses elicited by tonebursts, two HF clicks and conventional clicks. The results show that the reliability of responses to the HF clicks were comparable to the tonebursts and further, both HF clicks produced responses slightly larger than tonebursts.     

人工耳蜗植入手术相关问题探讨

目的 探讨人工耳蜗植入手术的相关问题。方法2000.12～2000.12人工耳蜗植入手术30例(男15例,女15例)。年龄1.4～20岁,其中语前聋24例,语后聋6例;先天性聋16例,有耳毒性药物史12例,腮腺炎病史2例。先天性聋中,经CT和MRI证实Mondini综合症2例,前庭导水管扩大2例。术前听力学检查60耳中59耳短声ABR阈值>100dBnHL,1耳>90db,1例病人畸变产物耳声发射正常。所有患者均经后鼓室进路行右侧人工耳蜗植入手术,术中面神经监测。其中植入澳大利亚24型K、M人工耳蜗23例,24Contour4例,奥地利Med-EL 40~+2例,美国Clarion人工耳蜗1例。术后1～1.5月开机调试及跟踪随访。结果 耳蜗植入成功29例,1例因耳蜗纤维化电极未能全部植入。10例病人术后3d有轻度眩晕,1例病人术后出现皮下血肿,1例病人出院后因感冒发生急性化脓性中耳炎,无其他手术并发症发生。出院前行X线电极定位,开机调试后所有患者均能听到声音。行为测听,平均听阈40dBHL,术后随访,已有8例入正常学校上学。结论 保证人工耳蜗植入的安全、有效,除术前对病人的检查进行综合评价外,术中要对不同的情况采取不同的措施。     

Homo- and anti-phasic stimulation in ABR

Effects of homo-phasic and anti-phasic stimulation on the binaurally evoked auditory brain-stem responses (ABRs) were investigated in 10 normal subjects. Clicks were presented at 47 dB SL with two in-phase (binaural condensation and binaural rarefaction) and two out-of-phase (left ear condensation, right ear rarefaction and right ear condensation, left ear rarefaction) stimulus configurations. The earlier of the latencies obtained with homo-phasic stimulation were compared with the earlier of the latencies obtained with anti-phasic stimulation. Repeated measures ANOVAs on the peaks (P) and troughs (N) of each component, revealed significantly earlier latencies for the anti-phasic condition, for components II N (p less than 0.049), III P (p less than 0.012) and VIN (p less than 0.025). Similar trends were apparent for components IVP (p less than 0.075), VP (p less than 0.099) and VIP (p less than 0.12). The results are discussed in terms of the binaural-level difference phenomenon and possible clinical applications.     

Effects of tone burst frequency and intensity on the auditory brainstem response (ABR) from albino and pigmented rats.

Young adult male Sprague-Dawley (SD) and Long-Evans (LE) rats were evaluated using the auditory brainstem response (ABR). ABRs were evoked by stimuli with intensities ranging from 15 to 100 dB peSPL. Stimuli were tone bursts of 2000, 4000 and 8000 Hz. As stimulus intensity decreased from 100 to 15 dB, the ABR peak latencies prolonged, interpeak latencies (IPLs) shortened and amplitudes decreased. As stimulus frequency decreased from 8000 to 2000 Hz, ABR latencies prolonged, amplitudes decreased and ABR thresholds increased. The longest IPLs were in response to the 4000 Hz tone bursts. SD rats had ABRs with shorter peak latencies, larger amplitudes and lower thresholds than LE rats. The IPLs usually did not show significant strain-dependent differences. Our observations on stimulus intensity and frequency are consistent with previous reports. Our observations also suggest that the SD (albino) rat has better auditory acuity than the LE (pigmented) rat over the frequency range of 2000 to 8000 Hz. This implies that previous concerns about the use of albino animals in audiological research are somewhat overstated.     

ABR differences before and after dialyses.

The aim of the study was the objective evaluation of the hearing organ in children. Seven children aged 6-17 with end stage renal failure treated by haemodialysis were examined. Four- to five-hour dialyses were performed 2-3 times a week. Pure-tone audiometry was normal in five children. The reactions of brain stem responses (latency and interpeak latency) were analysed before and after haemodialyses. We conclude that the ABR differences were connected with biochemical parameters of uraemia. The present study is a preliminary one and will be continued in the future.