腭裂患儿听力检查的临床研究

目的分析腭裂患儿鼓室图、镫骨肌声反射和听性脑干反应（auditory brainstem besponse,ABR）检查的特点,探讨听力学检查对腭裂患儿的临床应用价值。方法采用中耳分析仪和听觉诱发电位仪测试,对40例（80耳）腭裂患儿进行听力学检查。结果鼓室图：B型37耳（46.25%）,C型10耳（12.5%）,A型22耳（27.5%）,As型11耳（13.75%）。镫骨肌声反射：64耳（80%）消失,16耳（20%）存在。ABR结果：听力损失41耳（51.25%）,均伴有V波潜伏期延长,其中鼓室图呈B型25耳（60.98%）,C型9耳（21.95%）。此41耳中轻度听力损失21耳（51.22%）,中度听力损失20耳（48.78%）,无重度和极重度听力损失。80耳中V波潜伏期延长58耳（72.5%）。结论腭裂的解剖生理特点决定了患儿中耳炎的发病率较高。当鼓室图呈B型或C型曲线,同时出现ABR中V波听阈呈轻中度下降且V波潜伏期延长时,应高度警惕发生分泌性中耳炎,否则会严重影响患儿生活和学习。

Clinical research of auditory examinations in cleft palate children

Objective To explore the value of clinical application about hearing examinations for cleft palate children by analyzing the characteristics of tympanograms,acoustic stapedius reflex and auditory brainstem response （ABR） . Methods 40 cleft palate children （80 ears） were examined for tympanograms,acoustic stapedius reflex and ABR. Results The test results of tympanograms for the 80 ears showed that 37 ears （46. 25%） were B type,10 ears （12.5%） were C type,22 ears （27.5%） were A type and 11 ears （13.75%） were As type. The test results of acoustic stapedius reflex showed that 16 ears （ 20%） had reflex and the other 64 ears （80%） had no reflex. The ABR results showed that 58 ears （72.5% ） had latency prolongation of peak V and 41 ears （51.25%） had hearing impairment. In the 41 ears with hearing defect,21 ears （51.22%） had mild hearing loss and 20 ears（48.78%） had moderate hearing loss. And in the 41 ears, 25 ears were B type and 9 ears were C type. There were no ears examined with severe or extreme hearing loss. Conclusion Anatomic and physiological characteristics of cleft palate children can raise the rate of incidence of otitis media. Secretory otitis media need to be diagnosed when the following symptoms occurre simultaneously： tympanogram curves are B or C type; auditory threshold of peak V in the ABR test was reduced mildly or moderately; and the latency prolongation of peak V is observed in ABR test. Diagnosis of secretory otitis media in time will help the cleft palate patients significantly in their daily lives.