人工耳蜗手术前后使用小儿主观测听法的意义

目的探讨主观听力学测试方法在低龄儿童人工耳蜗植入手术前后的作用。方法和结果103名5岁以下拟接受人工耳蜗植入低龄儿童,术前均完成非助听和助听主观听力测试。31名游戏测听(playaudiometry,PA)法、62名视觉强化测听(visualreinforcementaudiometry,VRA)法、10名行为观察测听(behavioralobservationaudiometry,BOA) VRA法获得左右侧单耳/或双耳裸耳听阈;30名PA法、63名VRA法、10名BOA VRA法分别在声场中获得每侧耳的助听听阈,并结合其他客观测试结果评估了听通路的功能。术后开机调试后103名患儿均有听觉反应并获得T、C值,其中48名由VRA、PA测试方法得到;27名经BOA法得到;28名经神经反应遥测(neuralresponsetelemetry,NRT)结合BOA法获得,患儿的听觉能力有明显改善。结论主观听力测试方法在人工耳蜗植入术前对评估听通路完整性非常重要,对预测低龄患儿术后听觉康复可能的疗效有重要意义。

The role of paediatric subjective audiometry in pre-operative evaluation and post-operative habilitation in cochlear implantation for children

Objective To discuss the role of behavior hearing assessment in pre-operative evaluation and post-operative habilitation in cochlear implantation for children. Method and Results The patients were under the age of 5. All of 103 children who could afford cochlear implants underwent subjective audiometry with and without hearing aids. Of these patients, 31 were examined with PA, 62 with VRA, 10 with BOA and VRA, for hearing sensitivity assessment. 30 were examined with PA, 63 with VRA, 10 with BOA and VRA, for aided threshold evaluation. The integrity of the auditory pathway was evaluated by objective audiometry. T-level and C-level were measured for all of these patients after implantation, 48 of them were measured by VRA and PA, 27 by BOA, 28 by NRT and BOA. Patients demonstrated noticeable hearing improvement. Conclusion Behavior hearing assessment was reliable and valuable for the pre-operative cochlear implant assessment, especially in evaluating cochlear nerve integrity.