听力筛查未通过婴幼儿的客观听力评估

目的 分析听力筛查未通过婴幼儿的客观听力学特征，为早期干预提供科学依据。方法 对听力筛查未通过患儿286例进行听力诊断性检查。采用听性脑干反应(ABR)、40Hz听觉相关电位(40Hz-AERP)、畸变产物耳声发射(DPOAE)、声导抗进行评估。结果 286例婴幼儿中双耳听力正常95例(33.22%)；听力损失者191例(66.78％)，其中单耳听力损失70例(24.47％)，双耳听力损失121(42.31％)；传导性听力损失59例(20.63%)，感音神经性听力损失132例(46.15%)；轻度听力损失91例(31.82%)，中度43例(15.03%)，重度20例(6.99％)，极重度37例(12.94％)。191例听力异常者只有16例复查，占8.38％，复查结果：听力正常2例，双耳听力损失10例，单耳听力损失4例。结论 部分听力筛查未通过婴幼儿的听力可随着听觉神经系统发育的完善恢复正常；同时中耳病变也是部分婴幼儿听力筛查未通过的影响因素；客观听力学组合测试可有效评估听力筛查未通过患儿的听力特征，为听力损失的早期诊断、早期干预提供科学依据；听力异常患儿的复查率低和失访率高仍是目前亟需解决的问题。

Objective hearing evaluation of infants failed in hearing screening

Objective To analyze the audiological characteristics in infants failed in hearing screening and provide useful information for early intervention in this population． Methods Between January 2011 and December 2012， 286 infants who failed hearing screening in one or two ears received a full audiological test battery consisted of auditory brainstem responses(ABRs)， 40Hz auditory event related potential(40Hz—AERP)， distortion product otoacoustic emissions(DPOAEs)and tympanometry. Results 95(33.22%) infants were normal hearing subjects and 191(66.78％)showed hearing loss, which was either unilateral(n=70， 24.47％) or bilateral(n=121， 42.31％), including 59 cases(20.63%) of conductive hearing loss and 132 cases(46.15%) of sensorineural hearing loss. Hearing loss ranged from mild(n=91， 31.82％)， moderate(n=43， 15.03％)， severe(n=20， 6.99％) to profound(n=37， 12.94％)． Testing was repeated in 16(8.38％) of these 191 infants with hearing loss. The results turned out that 2 of them became normal, while 10 were bilateral loss and 4 were unilateral loss． Conclusion The hearing level in some infants who failed hearing screening can turn into normal owing to the development of auditory system. Middle ear function may be a confusing factor in hearing screening． The audiological characteristics in infants failed in hearing screening can be evaluated by audiological test battery, which provides useful information for early identification and intervention in this population. The results of hearing screening should be interpreted appropriately． However, poor follow-up compliance is still a big problem in such efforts．