正常新生儿226Hz声反射分析

An Analysis of 226 Hz Acoustic Reflex in Normal Neonates

目的应用筛查型声反射检查-鼓室压测试探讨正常新生儿鼓室图及声反射情况,对声导抗在新生儿临床应用中的作用进一步探讨。方法对双耳通过瞬态诱发性耳声发射听力筛查(transiently evoked otoacoustic em ission,TEOAE)的正常新生儿,按纳入标准选入842名(1684耳)进行筛查型声反射检查-鼓室压测试,收集鼓室图及声反射引出结果。结果单成分Y-226 Hz声导纳图分为单峰型、双峰型、平坦型,分别占36.52%、57.78%、5.7%;新生儿外耳道容积的90%医学参考值范围约为0.3～0.8 m l;声顺值的90%医学参考值范围约为0.2～0.9 m l;鼓室图峰压的90%医学参考值范围约为-17.25～100.00 daPa;鼓室图宽度约为50～180 daPa。探测音为226 Hz,刺激声为1000 Hz时的同侧声发射引出率为21.62%,未引出达率78.38%。结论新生儿外耳道容积、声顺值、鼓室图峰压值、鼓室图宽度可作为今后声导抗在新生儿听力筛查中的应用提供依据。采用226 Hz探测音测试时很大一部分新生儿出现声反射消失。

Objective To study the tympanogram and acoustic-reflex of normal neonatesand to discuss the clinical application of acoustic immitance.Methods The acoustic reflection check（screening type） and tympanic pressure test were performed in 842 neonates（1684 ears） passing hearing screening using transiently evoked otoacoustic emission（TEOAE）,and the results of the tympanometry and acoustic-reflex tests were analyzed.Results The 226 Hz single admittance（Y） tympanograms included bimodal,unimodal and flat types,accounted for 36.52%,57.78% and 5.7%,respectively;the 90% reference range of the neonatal external canal volume was 0.3-0.8 ml;the 90% reference range of thestatic compliance value was about 0.2-0.9 ml;the 90% reference range of tympanometric peak pressure（TPP） was-17.25 to 100.00 daPa;tympanometric width was 50-180 daPa.At 226 Hz-probe and 1000 Hz stimulating sound,the positive rate of ipsilateral acoustic reflex was 21.62% of all ears.Conclusion The neonatal ear canal volume,peak compensated static acoustic admittance,tympanometric peak pressure and tympanometric width can be applied in the neonatal hearing screening.226 Hz-acoustic reflex cannot appear in a large part of the newborns.