正常新生儿高频探测音的鼓室导抗测试

Application of High-Frequency Tympanometry to Normal Neonates

目的 探讨经瞬态诱发耳声发射（transient evoked otoacoustic emission,TEOAE）听力筛查通过的正常新生儿（2～7天龄）高频（1000 Hz）探测音鼓室导抗图的特点.方法采用AccuScreen Pro型TEOAE听力筛查仪对135例新生儿进行听力筛查;对双耳通过TEOAE听力筛查的新生儿采用GSI-33型中耳分析仪检测在高频（1000 Hz）探测音下的鼓室导抗图,对其进行分型,并分析外耳道容积、峰声导纳值等指标的正常值.结果 135例新生儿中有100例（200耳）新生儿双耳通过TEOAE听力筛查,其鼓室导抗图单峰型有180耳（占90.0%）、双峰型5耳（占2.5%）、平坦无峰型7耳（占3.5%）、其它型8耳（占4.0%）.其中,单峰型鼓室导抗图的峰声导纳值为2.21±0.53mmHo,峰压点处外耳道压力为11.19±41.35 daPa,外耳道容积约0.50±0.08 ml.男性与女性相比：外耳道容积、峰声导纳值、＋200 daPa时的声顺值、峰补偿静态声导纳值的差异均有统计学意义（P＜0.05）;峰声导纳值对应的外耳道压力在性别中的差异无统计学意义（P＞0.05）.结论通过听力筛查的新生儿高频（1000 Hz）探测音的鼓室导抗图以单峰型为主,相应的峰声导纳值、峰压点处外耳道压力、外耳道容积等指标的正常值可以作为新生儿中耳状态评估时的参考依据.

Objective To study the clinical characteristic of high frequency （1 000 Hz） probe tone tympanograms obtained from normal neonates. Methods TEOAE screening were performed using AccuScreen Pro instrument to screen the heating for 135 healthy neonates aged from 2 to 7 days. The 1 000 Hz probe tone tympanograms and their normative values were obtained from the neonates who passed the TEOAE screen in both ears using GSI - 33 middle ear analyzer. Re,suits 100 neonates passed the TEOAE Screening in both ears. The 1000Hz tympanometric data thus obtained showed a single- peaked tympangram in 180 ears （90.0%）, a double - peaked tympanogram in 5 ears （2.5%）, a flat - shaping tympanogram in 7 ears （3.5%） and other irregular shapes in 8 ears （4.0%）. For single - peaked tympanogram in 180 ears, the tympanometric normative values were as follows： peak admittance（Yp） was 2.21 ± 0. 53mmho, the pressure of the peak admittance（Tpp） was about 11.19 ± 41.35 daPa, the volume of ear canal（Vec） was about 0.50 ± 0.08 ml. Significant gender effect was noted with male ears showing significantly higher means in Vec, Peak compensated satic admittance（Ypc）, peak admittance, and acoustic admittance at ＋ 200daPa （Y ＋ 200） （P〈0.05） than female. Conclusion The majority of 1 000 Hz tympanograms obtained from this cohort show a single- peaked . These data may serve as a guide for detecting middle ear dysfunction in neonates.