耳声发射异常听性脑干反应正常的婴幼儿听力学分析

目的 探讨听力筛查异常而听性脑干反应(auditory brainstem response,ABR)正常的婴幼儿的听力学特点.方法 以瞬态声诱发性耳声发射听力筛查未通过而ABR正常的新生儿及婴幼儿53例(81耳)作为研究对象,对比各项听力检查结果,分析ABR与其他检查(40 Hz听觉相关电位、听觉稳态诱发反应、畸变产物耳声发射、鼓室声导抗及声反射)之间的相互关系.结果 81耳中所有检查结果均正常18耳(22.2%);其中至少有一项检查异常共63耳(77.8%).40Hz听觉相关电位和听觉稳态诱发反应分别测试36耳和45耳,异常分别为14耳(38.9%)和27耳(60.0%);畸变产物耳声发射测试68耳,异常50耳(73.5%);鼓室声导抗测试50耳,异常9耳(18.0%);声反射测试47耳,异常27耳(57.4%).结论 单纯以ABR作为婴幼儿听力正常的判断标准尚存在不足,综合的听力学评估非常有必要.

The audiological characteristics of infants with abnormal TEOAE and normal ABR

OBJECTIVE To study the audiological characteristics of infants with abnormal transient evoked otoacoustic emission(TEOAE) and normal auditory brainstem response(ABR). METHODS Fifty-three infants with totally 81 ears whose TEOAE screening results were refer but with normal diagnostic ABR results were studied. The relationship between ABR and other hearing testing methods, including 40Hz auditory event related potential (40 Hz AERP), auditory steady state response (ASSR), distortion product otoacoustic emission (DPOAE), tympanometry and acoustic reflex, was analyzed. RESULTS Of the 81 ears, 18 ears (22.2%) were normal, while 63 ears (77.8%) were abnormal in those tests. Among the test with 40 Hz AERP (36 ears) and ASSR(45 ears), 14 ears (38.9%) and 27 ears (60.0%) were abnormal respectively. Among the test with DPOAE for 68 ears, 50 ears (73.5%) were abnormal. Among the test with tympanometry (50 ears) and acoustic reflex(47 ears), 9 ears (18%) and 27 ears (57.4%)were abnormal respectively. CONCLUSION It is insufficient to evaluate the hearing of infants with ABR only. It is necessary to evaluate it with integrative audiological testing methods.