婴幼儿中耳炎的听力学特征分析

目的 分析婴幼儿中耳炎的听力学特征,探讨多种听力学测试方法在婴幼儿中耳炎的诊断和干预中的作用.方法 收集2004年12月至2007年6月由外院转入本院进行听力学诊断性检查后确诊或高度怀疑中耳炎的56例婴幼儿患者(男加例,女16例).初诊年龄为42 d至3岁,平均为5个月.患儿在完成耳鼻咽喉科常规检查后,进行了多种听力学测试方法联合诊断,包括听性脑干反应(ABR)、耳声发射(OAE)、鼓室声导抗测试(226和1000 Hz探测音),4例患儿完成了小儿行为测听.结果 56例(112耳)中有87耳诊断为中耳炎,31例为双侧,25例为单侧.56例中有49例在出生后3 d内进行了新生儿听力筛查,其中36例初筛未通过;42 d时行进一步筛查的有52例(其中有3例未行初筛直接进行了复筛),显示均为未通过.4例患儿未经过听力筛查,为家长发现听力不佳来诊.52例(104耳)进行了226 Hz鼓室声导抗测试,其中20例(28耳)鼓室图B型或c型;39例(78耳)进行了1000 Hz鼓室声导抗测试,其中38例(55耳)出现异常;56例(112耳)进行了ABR检查,其中49例(74耳)出现ABR的波I潜伏期延长;56例(112耳)进行了OAE测试,其中55例(81耳)未通过;4例(8耳)完成了小儿行为测听,均出现骨、气导差.结论 联合应用226 Hz及1000 Hz鼓室声导抗测试、ABR潜伏期及阈值测试、小儿行为测听、OAE测试多种方法能够发现婴幼儿中耳炎的特征性表现,在早期诊断中具有帮助.

Audiological characteristics of young children with otitis media with effusion

Objective To characterize the audiological features in the infants with otitis media with effusion(OME)and to investigate the utility of variety of objective andiometry methods in diagnosis and intervention on OME.Methods Fifry six infants(40 males and 16 females)were investigated,who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME.The ages at the initial diagnosis ranged from 42 days to three years,with an average of five months.The infants,after receiving the conventional otolaryngological exams,were subjected to the tests of auditory brainstem response (ABR),otoacoustic emission(OAE),tympanometry(226 Hz and 1000 Hz)and behaviors audiometry.Results Among 56 affected infants.87 ears were diagnosed with OME,of which 31 infants were affected bilateral and 25 with monaural.For the 49 infants who received hearing screening at birth.36 infants were referred at the initial screening.For the 52 infants who received repeated screening.all subjects were referred.Six infants without receiving hearing screening came to clinic when their parents observed their kids'hearing impairment.Among the 52 cases(104 ears)who received tympanometry test,20 subjects (28 ears)showed B or C type tympanometry curve.Thirty-nine cases(78 ears)were given tympanometry test at 1000 Hz,of which 38 cases(55 ears)showed abnormal hearing.Among 56 infants(112 ears)with ABR test,49 subjects(74 ears)exhibited prolonged ABR type Ⅰ curve.All 56 infants(112 ears)received OAE test,of which 55 subjects(81 ears)were referred Four infants(8 ears)accepted the behavior test and all of them showed A-B Gap.Conclusions The combined tympanometry test at both 226 Hz and 1000 Hz,ABR latency or threshold test,infant's behavior test and OAE,used jointly,enable characterizing better OME in infants.thus helping early diagnosis of this hearing disorder.