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1.
同步多频听觉稳态诱发反应在小儿听力诊断中的应用 总被引:11,自引:1,他引:10
目的 探讨同步多频听觉稳态诱发反应在小儿听力诊断中的应用。方法 39例受试者,年龄6个月~5岁,平均2.75岁,男21例,女18例。分别进行同步多频听觉稳态诱发反应和小儿行为听力测试。同步多频听觉稳态诱发反应刺激声信号的载波频率为0.5 kHz 、1 kHz 、2 kHz及4kHz。双耳上述各个频率分别以70~100 Hz不同的调制频率进行调幅调制。测试时,双耳八个(每耳四个)声信号经ER-3A插入式耳机同步给出。测试状态为水合氯醛镇静睡眠。小儿行为听力测试中,6~24月龄小儿行视觉强化定向条件反应测听、25月龄~5岁行游戏测听。所有数据以SPSS统计软件分析。结果 ①小儿行为听阈通常比同步多频听觉稳态诱发反应阈低,在0.5kHz、1kHz 、2kHz及4kHz二者差异的平均值及标准差分别为:15.2±9.1dB、8.8 ±7.5dB、8.2±7.7dB、10.7±8.8dB。各个频率之间这一差异存在统计学意义(F =10.395;μ 3 ;P=0.000),进一步的两两比较显示0.5 kHz行为听阈与反应阈的差异高于其它频率;②小儿行为听阈与同步多频听觉稳态诱发反应阈在各个频率均呈显著相关(P =0.000)。Pearson相关系数分别为0.799,0.859,0.894,0.850。结论 同步多频听觉稳态诱发反应测试具有频率特异性、客观及与行为听阈相关性好的特点,可以作为无法配合行为听力测试的小 相似文献
2.
目的通过对感音神经性聋患儿的多频听觉稳态反应(multiple frequency auditory steady--state response,MFASSR)测试结果进行分析,并比较其在0.5 kHz处与40 Hz听相关电位(40Hz auditory event related potential,40 Hz AERP)对客观听阈评估的准确性,为MFASSR临床应用提供指导。方法对感音神经性聋儿进行纯音测听、ABR、40 Hz AERP和MFASSR测试。MFASSR与ABR、40 Hz AERP测试均在睡眠状态下进行。按照测试结果分为ABR未引出组与ABR引出组。结果①MFASSR在0.5 kHz处引出率比40 Hz AERP低。②0.5 kHz MFASSR反应阈对纯音听阈的评估较1、2、4 kHz MFASSR反应阈对纯音听阈的评估差。③以纯音听阈为标准,在0.5 kHz处MFASSR与40 Hz AERP对纯音听阈的评估差别具有统计学意义(P=0.001),说明,在0.5 kHz处MFASSR对纯音听阈评估的准确性不如40 Hz AERP。结论MFASSR反应阈对0.5 kHz处纯音听阈的预测需要结合40 Hz AERP来判断。 相似文献
3.
听力正常成年人同时多频听觉稳态诱发反应研究 总被引:10,自引:3,他引:10
目的 了解正常听力成人同时多频听觉稳态诱发反应的特性。方法 32名受试者 (6 4耳 ) ,年龄 2 2~ 32岁 ,平均 2 8.3岁 ,男 12名 ,女 2 0名 ,双耳纯音听阈测试各频率听阈在 2 0dB以内。以载波频率为 0 .5、1、2和 4kHz的纯音 ,调制频率分别为 77、85、93和 10 1Hz(左耳 )以及 79、87、95、10 3Hz(右耳 )的调幅声作为测试信号 ,双耳 8个频率同时给声刺激 ,同时自动判定并记录反应。各载波频率的阈值、反应幅度等数据采用SPSS统计软件分析。结果 ①同时多频听觉稳态诱发反应阈高于纯音听阈 7~ 19dB。②反应阈经双因素方差分析 (侧别×频率 ) ,左右耳之间无显著性差异 (F =1.94 2 ;μ 1,179;P =0 .16 5 ) ,但各频率之间有显著性差异 (F =31.2 5 4 ;μ 3,179;P =0 .0 0 0 ) ,各频率反应阈均值之间进一步的两两比较显示 0 .5kHz反应阈与其它频率之间存在显著性差异。③以 6 0dBSPL作为分析强度 ,男女受试者在各个频率的反应幅度的差异经双因素方差分析 (性别×频率 )有显著性差异 (F =2 .94 8;μ 3,175 ;P =0 .0 34) ,0 .5kHz反应幅度最低 ,4kHz最高。性别之间有显著性差异 (F =16 .4 90 ;μ 1,175 ;P=0 .0 0 0 ) ,男性反应幅度高于女性。④各频率不同状态下背景噪声的差异经双因素方差分析 ,提示清醒状 相似文献
4.
目的分析婴幼儿短纯音诱发的听性脑千反应(tone burst click auditory brain stem response, TB-ABR)与短声诱发的听性脑千反应(click auditory brain stem response, C-ABR)阈值的相关性,以探讨TB—ABR在婴幼儿客观听力评估中的临床应用价值。方法对2007年1月-2009年1月,新生儿听力筛查通过且C—ABR阈值正常者27例(54耳),以短纯音为刺激声,进行ABR波V反应阈值及潜伏期测试,并与C-ABR作差异与相关性分析。结果本组27例(54耳)婴幼儿中完成4个频率TB-ABR测试的共27例(54耳),0.5、1、2、4kHz TB—ABR波V反应阈值分别为(40.0±11.6)dBnHL、(36.7±9.0)dBnHL、(27.2±6.7)dBnHL和(25.9±6.3)dB nHL,明显高于C-ABR阈值(17.8±6.4)dBnHL(P〈0.05),TB-ABR波V反应阑值随着刺激声频率的升高而下降,潜伏期随着刺激声频率的升高而缩短。0.5、1、2及4kHz1BABR反应阈与GABR反应阈的线性相关系数分别为0.53、0.60、0.67、0.72,存在直线正相关关系(P〈0.01)。结论婴幼儿TB-ABR和C-ABR反应阈之间存在相关性,且高频相关性优于低频,TB-ABR可作为一种具有频率特异性的婴幼儿客观听力评估方法。 相似文献
5.
0~6岁听力损失儿童短纯音诱发的听性脑干反应研究 总被引:2,自引:0,他引:2
目的比较听力损失儿童短纯音听性脑干反应(auditory brainstem response,ABR)反应阈与40Hz听觉事件相关电位(auditory event-related potentials,AERP)及短声ABR反应阈的相关性,评价短纯音ABR在儿童听力评估中的应用。方法应用SmartEP听觉诱发电位仪在0~6岁听力损失儿童中记录短声、短纯音ABR及40 Hz AERP的反应阈,共43例85耳(男/女=27/16)。结果0.5、1、2kHz短纯音ABR反应阈与40 Hz AERP反应阈的线性相关系数分别为0.84、0.80、0.80,反应闯之差分别为3.6±12.2、5.9±14.8、1.7±13.7dB。0.5、1、2、4kHz短纯音ABR反应阈与短声ABR反应阈的线性相关系数分别为0.81、0.89、0.94、0.91,反应阈之差分别为6.6±13.4、0.2±10.7、1.5±8.1、4.2±10.2dB。2kHz、4kHz短纯音反应阈的平均值与短声ABR反应阈的线性相关系数为0.93,反应阈之差为2.8±8.3dB。结论短纯音ABR的反应阈可作为一种儿童听力评估的方法。 相似文献
6.
目的比较以压耳式及插入式耳机给声诱发的听性脑干反应(ABR)的差异。方法以TDH-39P压耳式和ER-3A插入式耳机给声,通过真耳测试短声在外耳道的频谱图,对一组听力正常青年人(男30耳,女24耳)进行短声诱发ABR测试,并观察对侧给予白噪声掩蔽后ABR反应阈的改变。结果两种给声方式诱发出极为相似的ABR波形,两者反应阈及潜伏期均无显著性差异(P>0.05)。采用插入式耳机对侧加40~70dBSPL强度的白噪声对ABR的阈值及阈上10dB强度下波V潜伏期均无显著性影响(P>0.05)。真耳分析测试结果显示两种耳机给声方式下外耳道短声的频谱图极为相似,仅强度相差3dB(0.5~4kHz)。结论插入式和压耳式耳机给声方式的ABR测试结果之间无显著性差异。为此,建议临床中应准备两种给声方式并获取相应的正常值,以便使用时灵活选择。插入式耳机对侧给声的ABR掩蔽不存在中枢掩蔽现象。 相似文献
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目的采用chirp信号作为声刺激进行听性稳态反应(auditory steady-state response,ASSR)测试,观察chirp-ASSR反应阈值与纯音听阈的相关性,探讨chirp-ASSR客观听力检测在成人临床听力评估中的价值。方法研究对象包括正常成人组(年龄20~60岁,共计151耳)和感音神经性听力损失组(年龄22~82岁,共计83耳)。在500Hz、1000Hz、2000Hz和4000Hz处进行Chirp-ASSR和纯音听阈测试,并对结果进行统计学分析。结果 0.5~4kHz频率听力正常组Chirp-ASSR反应阈与纯音听阈的相关系数r分别为0.19、0.43、0.58、068;0.5-4.0kHz频率感音神经性听力障碍者的相关系数r分别为0.68、0.84、0.87、0.84;校正后0.5~4kHz各听力组预估听力阈值与纯音听阈的差值较校正前明显缩小。结论在0.5~4.0kHz频率,Chirp-ASSR反应阈与纯音听阈之间存在明显的相关性,在听力损失组中两者的相关性更加显著,而在500Hz处两者的相关性较其它频率低。Chirp-ASSR在客观听力评价中有较好的准确率。 相似文献
8.
正常新生儿和婴儿的短音听性脑干反应和听觉稳态反应 总被引:1,自引:0,他引:1
目的 建立听力正常婴儿短音听性脑干反应(tone-pip ABR)和听觉稳态反应(auditorysteady state response,ASSR)反应阈的正常参考值,研究其听觉发育的生物学规律,并比较两种听力检测技术的频率特性.方法 选取0~6月龄听力正常婴儿80例(160耳),按月龄分为四组:新生儿组、42 d组、3月龄组和6月龄组,每组20例(40耳),男女例数均等,分别记录其短声ABR的潜伏期及在0.25、0.5、1、2、4、8 kHz频率范围内tone-pip ABR和ASSR的反应阈.结果 在70 dB正常听力级短声刺激下,短声ABRⅠ、Ⅲ、Ⅴ波潜伏期、Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波间期随月龄增加逐渐缩短,波Ⅰ于42 d前、波Ⅲ于3个月前发育变化显著.tone-pip ABR波形与短声ABR相似,Ⅰ、Ⅲ、Ⅴ波潜伏期随频率增加逐渐缩短,波形分化逐渐清晰.不同频率、不同月龄tone-pip ABR和ASSR反应阈差异具有统计学意义(P值均<0.05).除0.25 kHz外,其余频率tone-pip ABR反应阈均低于ASSR.不同月龄tone-pip ABR和ASSR听力曲线形状相似.结论 0~6月正常婴儿tone-pip ABR的潜伏期和波间期随月龄增加逐渐缩短,而反应阈无明显变化.tone-pip ABR和ASSR均有稳定的频率特异性,tone-pip ABR反应阈低于ASSR,可能更接近主观纯音听阈. 相似文献
9.
多频稳态反应阈与听性脑干反应阈的相关性 总被引:3,自引:2,他引:3
目的用多频稳态反应(auditory steady-state response,ASSR)与听性脑干反应(auditory brainstemre-sponse audiometry,ABR)测试聋儿残余听力,观察两者反应阈之间的相关性,对测试结果的准确性做出初步评价。方法对300例(600耳)感音神经性聋儿和30例(60耳)听力正常儿童(对照组)在睡眠状态下进行ASSR与ABR测试,得到不同阈值分布范围,并进行两者反应阈的相关性分析。结果30例(60耳)正常儿童ASSR各频率结果与ABR测试结果进行配对t检验,两者差异无统计学意义(P>0.05)。600例聋儿ASSR高频与ABR测试结果:Pearson统计高频相关系数为0.992,两者有显著相关性。结论ASSR和ABR两者高频反应阈之间有相关性,ASSR频率特性好,对聋儿听力检测及助听器验配具有临床价值。 相似文献
10.
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. 相似文献
11.
68例感音神经性耳聋患者ASSR测试听阈与ABR测试V波反应阈的相关性研究 总被引:2,自引:0,他引:2
目的旨在探讨ASSR与ABR在诊断感音神经性耳聋中的相关性。方法68例临床诊断为感音神经性耳聋患者分别行0.5kHz,1kHz,2kHz,4kHzASSR测试及ABR测试,进行不同耳别、不同测试频率ASSR阈值与不同耳别ABRV波反应阈之间的相关分析。结果除了0.5kHz ASSR阈值与ABRV波反应阈的相关系数低而无显著意义外,1kHz,2kHz,4kHz ASSR阈值均与ABRV波反应阈有极显著性相关(P〈0.01),且随着测试频率的递增两者的相关系数随之增加,尤其是4kHz ASSR与ABRV波相关系数达到0.95以上(P〈0.01)。结论ASSR诊断感音神经性耳聋是可靠客观的,具有频率特性,可弥补ABR测试在诊断耳聋疾病中的频率局限性。 相似文献
12.
Luts H Desloovere C Kumar A Vandermeersch E Wouters J 《International journal of pediatric otorhinolaryngology》2004,68(7):915-926
OBJECTIVE: To report on clinical experience using dichotic multiple-stimulus auditory steady-state responses (ASSRs) as an objective technique to estimate frequency-specific hearing thresholds in hearing-impaired infants. METHODS: A comparison was made between the click-evoked auditory brainstem response (ABR), auditory steady-state responses and behavioral hearing thresholds (BHTs). Both ears of 10 infants between 3 and 14 months of age were tested. ABR and ASSRs were recorded during the same test session. ABR was evoked by 100 micros clicks. ASSRs were evoked by amplitude- and frequency-modulated tones with carrier frequencies of 0.5, 1, 2 and 4 kHz and modulation frequencies ranging from 82 to 110 Hz. Eight signals (four to each ear) were presented simultaneously. ASSR thresholds were derived after separate recordings of approximately 5, 7.5 and 10 min to compare the influence of test duration. BHTs were defined in later test sessions as soon as possible after the ASSR test, dependent on medical and developmental factors. RESULTS: For the subjects tested in this study 60% of ABR thresholds and 95% of ASSR thresholds for 1, 2 and 4 kHz were found at an average age of 7 months. Only 51% of frequency-specific BHTs could be obtained but on average 5 months later. The correlation of ABR thresholds and ASSR thresholds at 2 kHz was 0.77. The correlation of ASSRs and BHTs was 0.92. The mean differences and associated standard deviations were 4 +/- 14, 4 +/- 11, -2 +/- 14 and -1 +/- 13 dB for 0.5, 1, 2 and 4 kHz, respectively. The average test duration was 45 min for ABR (one threshold in both ears) and 58 min for ASSR (four thresholds in both ears). By reducing the duration of the separate recordings of ASSR, the precision of the hearing threshold estimate decreased and the number of outlying and missing values increased. Correlation coefficients were 0.92, 0.89 and 0.83 for recordings of maximum 10, 7.5 and 5 min, respectively. A compromise between test duration and precision has to be sought. CONCLUSIONS: Multiple-frequency ASSRs offer the possibility to estimate frequency-specific hearing thresholds in babies in a time-efficient way. 相似文献
13.
目的 探讨不同程度感音神经性听力损失儿童听性稳态反应(ASSR)、短声听性脑干反应(click-ABR)与行为阈值的相关性及在听障儿童听力评估中的价值.方法 回顾性分析2019年1月至2019年12月确诊的46例(92耳)感音神经性听力损失儿童的ASSR、click-ABR及行为听阈结果,其中,轻度听力损失4耳,中度听... 相似文献
14.
Firszt JB Gaggl W Runge-Samuelson CL Burg LS Wackym PA 《Archives of otolaryngology--head & neck surgery》2004,130(5):536-540
OBJECTIVE: To determine the effectiveness of auditory steady-state response (ASSR) as a measure of hearing sensitivity in young children suspect for significant hearing loss. DESIGN: Within-subject comparisons of click auditory brainstem response (ABR) thresholds and ASSR thresholds. SUBJECTS: The study population comprised 42 children suspect for hearing loss and subsequently referred for hearing assessment using electrophysiologic techniques. MAIN OUTCOME MEASURES: Electrophysiologic threshold responses for click ABR and ASSR stimuli (0.5, 1, 2, and 4 kHz) for right and left ears. RESULTS: Based on ABR and ASSR thresholds, 50% of the subjects demonstrated significant hearing loss in the severe to profound range. In some subjects, ASSRs were present at higher stimulus levels when click ABRs were absent. Significant correlations (P<.05) were found between high-frequency ASSR and click ABR thresholds for this study sample. For some subjects, ASSR findings suggested differences between ears that were not observable from the no-response click ABR results. CONCLUSIONS: Auditory steady-state response testing may provide additional information for children who demonstrate hearing levels in the severe to profound range. This information may be helpful when selecting the ear for cochlear implantation for a young hearing-impaired child. Multiple objective methods, such as ABR and ASSR testing, may be needed to determine accurate hearing sensitivity for young children being considered for sensory devices, and in particular, cochlear implants. 相似文献
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目的 应用多频听觉稳态反应(ASSR)Chirp刺激信号在声场中测试助听反应阈,观察其阈值与行为测试助听听阈的相关性,探讨多频听觉稳态反应Chirp刺激信号声场测试评估助听器补偿效果的临床意义.方法 选取22例(39耳)重度感音神经性听力损失、已配戴助听器的患儿(听障组)和16例(32耳)听力正常儿童(对照组)为研究对象.应用国际听力Eclipse EP25型多频稳态诱发电位仪及美国GSI-61型听力计,分别对听障组在声场中使用两种仪器测试助听听阈;对对照组进行裸耳行为听阈与声场中听觉稳态反应阈测试.结果 在0.5、1、2、4 kHz处,听障组ASSR助听反应阈与行为助听听阈的相关系数分别为0.65、0.68、0.77和0.82,P值均<0.01,显示两种测试结果有相关性;对照组裸耳行为听阈与声场中记录的听觉稳态反应阈在0.5、1、2、4 kHz配对t检验均呈显著差异(P<0.01),ASSR声场反应阈高于行为听阈20~30 dB HL.结论 应用多频听觉稳态反应Chirp刺激信号声场测试进行助听器补偿效果评估在临床上具有可行性. 相似文献
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The inclusion of the auditory steady-state response (ASSR) into test-batteries for objective audiometry has allowed for clinical
comparisons with the most widely used procedure, the auditory brainstem response (ABR). The current study describes ASSR and
ABR thresholds for a group of infants and young children with various types and degrees of hearing loss. A sample of 48 subjects
(23 female) with a mean age of 2.8 ± 1.9 years SD were assessed with a comprehensive test-battery and classified according
to type and degree of hearing loss. Thresholds were determined with a broadband click-evoked ABR and single frequency ASSR
evoked with continuous tones (0.25–4 kHz) amplitude modulated (67–95 Hz). Mean difference scores (±SD) between the ABR and
high frequency ASSR thresholds were 9.8 (±11), 3.6 (±12) and 10.5 (±12) dB at 1, 2 and 4 kHz, respectively. An ASSR mean threshold
for 2–4 and 1–4 kHz compared to the ABR threshold revealed an average difference of 7 (±9) and 7.9 (±8) dB, respectively.
The overall correlation between the ABR and ASSR thresholds was highest for the mean ASSR thresholds of 2–4 and 1–4 kHz (r = 0.92 for both conditions). Correlations between the ABR and individual ASSR frequencies were slightly less (0.82–0.86).
The average of the 2–4 kHz ASSR thresholds correlated best with the click-evoked ABR for all categories of hearing loss except
for the sensorineural hearing loss category for which the 1–4 kHz ASSR average was better correlated to ABR thresholds. Findings
demonstrate the reliability of verifying high frequency ASSR thresholds with a click-evoked ABR as an important cross-check
in infants for whom behavioural audiometry may not be possible. 相似文献
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目的:分析感音神经性聋儿童听性稳态反应(auditory steady-state response,ASSR)与行为听阈的相关性。方法63例(126耳)重度或极重度感音神经性听力损失儿童,年龄0.5~6岁,按年龄分为 A 组(0.5~1.0岁,21例),B 组(1.1~3.0岁,21例),C 组(3.1~6.0岁,21例);分别进行 ASSR 及小儿行为听阈测试,A 组采用行为观察测听(BOA),B 组采用视觉强化测听(VRA),C 组采用游戏测听(PA),采用 SPSS17.0统计软件分析二种检查结果的相关性。结果①ASSR 反应阈与行为听阈在0.5、1、2和4 kHz 处的相关系数分别为0.75、0.76、0.76、0.83,呈极显著相关(P <0.01)。②小儿行为听阈值通常比 ASSR 反应阈值低,随着频率的增高,两者间差距缩小。③A 组(相关系数0.70)各频率 ABR 反应阈与行为听阈相关性均较 B(相关系数0.78)、C(相关系数0.83)组低。结论0.5~6.0岁感音神经性聋儿童 ASSR 与行为听阈值均有良好的相关性,ASSR 可预测感音神经性聋儿言语频率的客观听阈,为低龄儿童及难以检测行为听力的患儿验配助听器提供参考。 相似文献
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Threshold estimation in children using auditory steady-state responses to multiple simultaneous stimuli 总被引:3,自引:0,他引:3
Han D Mo L Liu H Chen J Huang L 《ORL; journal for oto-rhino-laryngology and its related specialties》2006,68(2):64-68
OBJECTIVE: It was the aim of this study to explore the use of auditory steady-state response (ASSR) to multiple simultaneous stimuli for threshold estimation in young children. METHOD: The subjects consisted of 40 children, aged from 6 months to 5 years, with variant degrees of sensorineural hearing loss. Simultaneous tonepips (0.5, 1, 2 and 4 kHz) with an amplitude modulated at different rates from 77 to 103 Hz were presented to both ears by insert phones. All children were tested with ASSR and age-appropriate behavioral tests. RESULTS: We found that (1) ASSR thresholds were usually higher than behavioral thresholds with a difference of 8-15 dB, (2) the behavioral thresholds were significantly correlated with ASSR thresholds (p = 0.000), and (3) there was a great difference between ASSR thresholds and behavioral thresholds found in a child with auditory neuropathy. CONCLUSION: Being objective, frequency specific and well correlated with behavioral thresholds, ASSR to multiple simultaneous stimuli was proven to be a good tool to predict behavioral hearing thresholds. 相似文献
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