游戏测听与听觉诱发脑干反应评估小儿听力

Play audiometry and auditory brainstem responses for hearing evaluation in young children

目的通过对60例3～6岁感音神经性耳聋小儿听性脑干反应(auditory brainstem response,ABR)与小儿游戏测听(play audiometry,PA)测试结果比较,综合评估小儿听力。方法选择60例3～6岁门诊患儿,均经声导抗测试及耳声发射测试排除传导性耳聋及听神经病,将60例3～6岁小儿120耳分别进行ABR测试。根据ABR测试结果,选择ABR波Ⅴ反应阈为50～90dB nHL的小儿30例为A组,ABR最大输出97dB nHL未引出波Ⅴ反应阈的小儿30例为B组;之后两组小儿分别进行游戏测听,将两组的ABR反应阈与游戏测听测试结果进行比较。结果 A组ABR的波Ⅴ反应阈与小儿游戏测听中2kHz～4kHz最小听阈相差均无显著差异;B组ABR最大输出97dB nHL未引出波Ⅴ的小儿,游戏测听绝大部分均能获得行为听阈。结论 ABR的波Ⅴ反应阈与小儿行为测听的高频听阈一致性较好;ABR最大输出97dB nHL未引出波Ⅴ的不等于无听力。

Objective To report hearing evaluation in young children using auditory brainstem responses （ABRs） and play audiometry （PA）. Methods Sixtychildren（120 ears） aged 3-6 years were subjected to ABR evaluation after tympanometry and otoacoustic emission testing had ruled out conductive hearing loss and auditory neuropathy. The children were divided into two groups based upon ABR wave V threshold： Group A （n=30） — threshold between 50 and 90 dB nHL, and Group B （n-30） — no response at the system maximum output at 97 dB nHL. PA results in the two groups were compared. Results In Group A, ABR wave V thresholds were similar to PA thresholds at 2 and 4 kHz. In Group B, despite failure in obtaining ABR wave V thresholds, behavioral thresholds were determined in most children on PA. Conclusion ABR wave V thresholds appear to correlate to behavioral thresholds at high frequencies. Failure to determine ABR threshold at 97 dB nHL does not equal to no hearing.