215例正常新生儿瞬态诱发耳声发射测试分析及随访研究

目的：进一步了解正常新生儿瞬态诱发耳声发射（TEOAE）的特征，为新生儿听力筛查提供帮助。方法：采用ILO96型耳声发射仪，对出生后0（出生当天）-8d的215例（425耳）正常新生儿进行TEOAE测试，并跟踪随访结果：TEOAE总检出率为89%，检出率与检测时的天龄有一定的关系。新生儿出生后0-3d检出率平均为72%，4-8d为97%，分娩方式，左右耳，孕龄36至41周间的差异对检出率无明显影响；女性的检出率显著高于男性，快速扫描较TEOAE测试敏感，经随访确诊有1耳听力损害。结论：新生儿听力筛查应在出生后≥4d出院前进行；分娩方式对耳蜗功能无明显影响；人耳蜗毛细胞的成熟是在怀孕36周以前；快速扫描不能代替TEOAE测试；对于1耳或双耳未检出TEOAE的受测者必须跟踪随访和复检，并结合ABR测试尽早确诊。

Measurement of transient evoked otoacoustic emissions and follow-up of 215 healthy newborns

OBJECTIVE: To evaluate the characteristics of transient evoked otoacoustic emissions (TEOAE) of healthy newborns and improve hearing screening of newborns. METHOD: To investigate the history of pregnancy and parturition, TEOAE was measured in 425 ears of 215 healthy newborns from 0 to 8 days postpartum and follow-up study was undertaken. RESULT: The general prevalence was 89%. There was some relationship between prevalence and testing time. The average prevalence was 74% in newborns of 0-3 days. The prevalence was 97% in newborns of 4-8 days. The way of parturition, laterality and time of pregnancy over 36 weeks hadn't any significant effect on the prevalence rate. The prevalence of females was higher than males. Quick screen was more sensitive than TEOAE. One ear of hearing loss was diagnosed after follow-up. CONCLUSION: The hearing screening test of newborns should be taken in hospitals after 4 days of birth, the way of parturition had no effect on the cochlear function. The mature time of cochlear hair cells was by the 36th week of pregnancy. Quick screen couldn't take place of TEOAE. Someone who had no TEOAE in one ear or two ears must be followed up and reexamined and exact diagnosis could be made as soon as possible combining with ABR.