婴儿多种客观听力检测方法的综合评估

目的探讨多种客观听力检测方法在婴儿听力评估中的应用。方法采用听性脑干反应、40Hz听觉相关电位或听觉稳态反应、畸变产物耳声发射及鼓室声导抗等方法，对初筛和复筛未通过的200例（400例）婴儿进行了听力测试，并对测试结果进行对比分析。结果400耳中各项结果均正常77耳（19．25％），一项或一项以上检查异常323耳（80．75％）。检查异常的323耳中传导性听力损失59耳（18．27％），感音神经性听力损失172耳（53．25％），混合性听力损失92耳（28．48％）。接受听性脑干反应测试的400耳中。正常199耳（49．75％），异常201耳（50．25％）。以听性脑干反应阈值评估听力损失程度。轻度96耳（47．76％），中度29耳（14．43％），重度22耳（10．95％），极重度54耳（26．86％）。接受40Hz听觉相关电位测试的184耳中，正常52耳（28．26％），异常132耳（71．74％）。以40Hz听觉相关电位反应阈值评估听力损失程度，轻度68耳（51．51％），中度34耳（25．76％），重度14耳（10．61％），极重度16耳（12．12％）。接受听觉稳态反应测试的216耳中，正常62耳（28．70％），异常154．1~-（71．30％）。接受畸变产物耳声发射测试的400耳中，正常114耳（28．50％），异常286耳（71．50％）。接受鼓室声导抗测试的400耳中，正常310耳（77．50％），异常90耳（22．50％）。结论多种客观听力检测方法的联合运用，对判断婴儿听力损失的程度和性质有一定帮助，可为早期干预提供依据。

The Assessment and Application of Multiple Objective Hearing Tests in Infants

Objective To explore the application of multiple objective hearing tests in the hearing assessment in infants. Methods Two hundred infants who failed in the initial and secondary hearing screening received the follow-up examinations, including auditory brainstem response（ABR）, 40 Hz auditory evoked related potential （40 Hz AERP）or auditory steady-state response （ASSR）, distortion product otoacoustic emission（DPOAE） and acoustic impedance test. The test results were compared and analyzed. Results Of 400 ears, 77 ears （19.25%） had normal hearing and 323 ears （80.75%） were abnormal in one or more tests. Among the 323 ears,59 ears（18.27%） had conductive hearing Ioss,172 ears （53.25%） sensorineural hearing loss and 92 ears（28.48%）mixed hearing loss. 400 ears received ABR test and 201 ears （50.25%） failed. According to the ABR results, 96（47.76%）,29（14.43%）,22（10.95%）and 54（26.86%） ears were found to have mild, moderate, severe and profound hearing loss. 184 ears received 40 Hz AERP test and 132 ears （71.74%） failed. According to the 40 Hz AERP results, 68（51.51%）, 34（25.76%）, 14（10.61%） and 16（12.12%） were found to have mild, moderate, severe and profound hearing loss. 216 ears received ASSR test and154 ears （71.30%） failed. 400 ears received DPOAE test and 286 ears （71.50%） failed. 400 ears received acoustic impedance test and 90 ears （22.50%） failed. Conclusion The combined use of multiple objective hearing tests can help assess the type and degree of infant hearing loss more accurately and provide references for early intervention.