唇腭裂新生儿听力检测

Analysis of hearing screening results in cleft lip and palate newborns

目的分析唇腭裂新生儿瞬态声诱发耳声发射、鼓室图以及听性脑干反应(ABR)的特点,以探讨相关听力学检查对这类新生儿的临床应用价值。方法采用瞬态声诱发耳声发射(transiently evoked otoacoustic emission,TEOAE)及鼓室图测试,对23例(46耳)唇腭裂新生儿进行新生儿听力筛查,初筛未通过的患儿于生后1个月及2个月进行复筛,并于3个月采用ABR和40 Hz听觉事件相关诱发电位(40 Hz-auditory evoked relevant potential,40 Hz-AERP)进行诊断性检查。结果 23例(46耳)唇腭裂新生儿中TEOAE检查通过18耳(39.13%),未通过28耳(60.87%)。其中12例双耳未通过(24耳,52.17%),4例单耳未通过(4耳,占8.70%)。鼓室图检查:A型16耳(34.78%),As型1耳(2.17%),B型24耳(52.17%),C型5耳(10.87%)。确诊传导性听力损失12例(24耳,52.17%),其中轻度听力损失5耳(10.87%),中度听力损失18耳(39.13%),重度听力损失1耳(2.17%)。结论大部分唇腭裂患儿存在听力损失,而传导性听力损失是唇腭裂新生儿的听力学特点。通过相关听力学检测手段尽早明确唇腭裂新生儿的听力损失情况,有利于制定有效干预方案,促进患儿言语及智力发育,并可为家长提供符合唇腭裂患儿听力学特点的听觉保健建议。

OBJECTIVE To investigate the clinical applied value of auditory examinations of cleft lip and palate newborns by analyzing the characteristics of transient evoked otoacoustic emission,tympanograms and auditory brainstem response.METHODS 23（46 ears）cleft lip and palate newborns in Haidianmaternity and children hospital were taken as subjects.Transient evoked otoacoustic emissions（TEOAE）and tympanogram were used to do the first interval screening when the newborns were 24 to 48 hours old.Referred newborns received a second interval screening when they were 1month or 2 months old.Referred re-screening newborns would receive diagnosis tests by auditory brainstem response（ABR）,40Hz hearing-related potential（40Hz-AERP）and acoustic impedance when they were 3 months old.RESULTS The TEOAE test results of these 46 ears（23 cases）were that 18 ears（39.13%）passed and 28 ears（60.87%） referred.The tympanogram test results of these 46 ears（23 cases）were that 16 ears（34.78%）were A type,1ear（2.17%）was As type,24 ears（52.17%）were B type and 5 ears（10.87%）were C type.The diagnosis test results were that 24 ears（52.17%）were conductive hearing loss;5 ears were mild（10.87%）,18 ears were moderate（39.13%）,1 case of them was severe（2.17%）.CONCLUSION Conductive hearing loss is the major audiological characteristic of cleft lip and palate newborns.It is feasible to implement newborn hearing screening and relative audiology tests in these aimed newborns in order to ？nd the degree of hearing loss as soon as possible and design the effective intervention program,provide the appropriate health care suggestion to parents.