正常新生儿226Hz及1000Hz探测音鼓室导抗测试

目的探讨通过瞬态诱发耳声发射（TEOAE）筛查的正常新生儿低频（226 Hz）及高频（1 000 Hz）探测音鼓室导抗图的特点、获得峰声导纳值等指标的正常值范围,为临床新生儿及婴幼儿中耳功能评估和诊断提供依据。方法采用中耳分析仪（GSI-33型）对足月顺产,并通过TEOAE筛查的正常新生儿分别进行低、高频探测音下的鼓室导抗测试,分析鼓室导抗图形态特征并对峰声导纳值等重要数据进行统计。结果在100例首次双耳通过TEOAE筛查的新生儿鼓室导抗测试中,低频鼓室导抗图以双峰型为主（占96%）,高频鼓室导抗图以单峰型为主（占90%）;低频探测音鼓室导抗图为双峰型而其高频探测音鼓室导抗图为单峰型的有174耳（占总耳数87%）;低频及高频探测音鼓室导抗图均为单峰型的仅有6耳（占总耳数3%）。结论正常新生儿低频探测音鼓室导抗图以双峰型为主,高频探测音鼓室导抗图以单峰型为主,应将两者结合来对新生儿及婴幼儿中耳功能进行评估;所获得相应的峰声导纳值、峰声导纳值处外耳道压力、外耳道容积等指标的正常值可以用于初步评估新生儿中耳功能状态。

Clinical guidelines for usage of 226-and 1,000-Hz tympanometry in normal neonates

Objective To evaluate the clinical characteristics of tympanograms using 226-and 1,000-Hz probe frequencies and to provide a clinical guideline.Methods Hearing of all subjects was screened by means of transient-evoked otoacoustic emissions.Tympanograms,recorded with probe-tone frequencies of 226-and 1,000-Hz,were classified based on the Liden/Jerger model of shapes.Furthermore,equivalent ear canal volume,tympanometric peak pressure and other important tympanometric parameters were calculated for each tympanogram.Results Both ears of the 100 neonates passed the TEOAE Screening.Most tympanograms obtained from the 226 Hz tympanometric data were double-peaked(96.0%).The 1 000 Hz tympanometric data obtained showed a single-peaked tympangram in 180 ears(90.0%).174(87.0%) ears were either double-peaked in 226 Hz tympanogram or single-peaked in 1 000 Hz.6 ears had a single peak both in 226 Hz and in 1,000 Hz tympanogram. Conclusion These results have led to the successful implementation of 1,000-Hz tympanometry in neonatal hearing assessment.