畸变产物耳声发射在流行性腮腺炎患儿听力检查中的应用价值

Application of Distortion Product Otoacoustic Emission in Hearing Assessment for Children with Mumps

目的对流行性腮腺炎患儿进行畸变产物耳声发射（DPOAE）听力检查，并与听性脑干反应（ABR）阈值检查结果进行比较，了解腮腺炎患儿听力情况，并探讨DPOAE在该类患儿听力检查中的应用价值。方法对2010年3月-2012年10月收治的流行性腮腺炎患儿116例232耳进行DPOAE听力检查和ABR阈值检查，同时选择未患腮腺炎正常同龄儿童50例100耳作为对照。首先将腮腺炎患儿与正常同龄儿童DPOAE和ABR检查结果相比较。其次，将腮腺炎组DPOAE检查通过率与ABR检查正常率进行比较。结果①腮腺炎组DPOAE听力检查通过率为94．83％（220／232），低于对照组通过率100．00％（100／100），差异有统计学意义（P〈0．05），腮腺炎组未通过DPOAE筛查的6例（12耳）行纯音测听，为轻一中度听力下降；②所有受试儿童ABR听阈值检查正常，但75dBnHL时腮腺炎组和对照组Ⅲ波潜伏期、Ⅰ～Ⅲ和Ⅲ～Ⅴ波间期差异无统计学意义（P〉0．05），但Ⅰ波、Ⅴ波潜伏期及Ⅰ～Ⅴ波间期差异有统计学意义（P〈0．05）；③腮腺炎组ABR正常率高于DPOAE听力检查通过率，差异有统计学意义（P〈0．05）。结论流行性腮腺炎患儿听力正常，但腮腺炎病毒感染可影响患儿的听神经和某些脑干听觉核团的功能。DPOAE具有快速、简便、易行等特点，作为腮腺炎快速听力筛查手段，有利于早期发现耳聋患儿，但需进一步结合ABR及其他听力检查结果明确听力损害的程度和类型。

Objective To investigate the effect of distortion product otoacoustic emission （DPOAE） in hearing assessment for children with mumps, by comparing the results of DPOAE and auditory brainstem response （ABR） threshold value examination. Methods A total of 116 children （232 ears） with mumps and 50 healthy children （100 ears） without mumps received DPOAE and ABR threshold value examination between March 2010 and October 2012. The results of these two examinations were compared in the first place. Then, The passing rate of DPOAE and the normal rate of ABR were compared between the two groups. Results The passing rate in the mumps group was significantly lower than that in the control group [94.83% （220/232）, 100.00% （232/232）; P 〈 0.05]. The pure tone test of 6 children （12 ears） in the mumps group who did not pass the DPOAE screening test showed that they had slight or moderate hearing loss. The ABR heating thresholds of all children were normal. No significant difference was detected in II[ wave latency, Ⅰ -Ⅲ and Ⅲ-Ⅴ intervals based on 75 dB nHL （P 〉 0.05）. However, there was a significant difference in the latency of I wave, V wave and interval between Ⅰ and Ⅴ between the two groups （P 〈 0.05）. The normal rate of ABR was significantly higher than the passing rate of DPOAE in the mumps group （P 〈 0.05）. Conclusions The hearing is normal in all mumps children. However, mumps virus infection can affect the function of the eighth nerve and some auditory nuclei in the brainstem. Although DPOAE can be a useful method for heating assessment in the mumps children, other hearing tests including ABR should also be considered.