听力筛查未通过109例婴幼儿随访分析

Follow-up study and analysis for newborns and infants who failed hearing screening.

【目的】对未通过听力筛查的婴幼儿进行定期听力检查及随访,了解先天性听力损失程度的构成以及康复现状。【方法】对109例未通过听力筛查的婴幼儿采取畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)、听性脑干诱发电位(auditory brainstem response,ABR)和声导抗检查方法,进行综合评估和听力学诊断,并随访观察听力障碍婴幼儿的听力变化情况、康复状况。【结果】双耳听力正常76例。双耳或单耳听力异常33例,其中轻中度听力损失24例,重度及极重度听力损失9例。不同程度听力损失的婴幼儿和单耳重度听力损失的婴幼儿言语能力接近同龄儿。随访发现7例轻中度听力损失和2例重度、极重度聋婴幼儿听力有不同程度改善,佩戴助听器是目前聋儿的主要康复手段,效果不佳者未能及时进行人工耳蜗植入。【结论】听力损失婴幼儿经过至少6个月以上跟踪随访,有改善和正常化的趋势;对重度及极重度听力损失的婴幼儿应及早干预,对助听效果不佳者应早期植入人工耳蜗,重视语训康复,降低致残率。

[Objective] To investigate the composition of the degree of congenital hearing loss and rehabilitation sta tus of children failing the newborn hearing screening by routine audiologic tests and follow-up. [Methods] One hundred and nine infants who could not pass hearing screening received auditory brainstem response（ABR）, distortion product otoa- coustic emission（DPOAE） and acoustic immittance measurement. Hearing-impaired infants were confirmed due to the re- sults of routine audiologic evaluations and their hearing changes and rehabilitation status were followed-up. [Results] The test results showed that 76 cases had normal hearing in both ears; 33 cases were bilaterally or unilateral impaired including 24 cases with mild and moderate hearing loss, 9 cases with severe and profound hearing loss. After following-up, the hearing levels were improved in 7 cases with mild and moderate hearing loss, 2 cases with severe and profound hearing loss. Wearing a hearing aid is the main means of rehabilitation for deaf children. Cochlear Implant could not be adopt timely in those failed to rehabilitation effecxively. [Conclusions] Newborns and infants who could not pass hearing screening should be followed up for at least 6 months and their hearing levels may improve in some eases. Children with severe and profound hearing loss should be early intervened. Hearing-aid ineffective cases should be turn to cochlear implant without delay for reducing disability.