腭裂患儿中枢听觉神经系统功能障碍的电生理研究

Electrophysiological study on the central auditory nervous system dysfunction in children with cleft palates

目的采用测试听觉诱发电位和事件相关电位(ERP)的方法,了解腭裂患儿的中枢听觉神经系统功能。方法以34名非综合征型腭裂患者为研究对象,记录儿童的听觉脑干诱发电位(ABR)、中潜伏期诱发电位(MLR)和ERP中的负失配电位成分(MMN),并与正常同龄儿童相比较。结果与正常儿童相比,腭裂儿童的MMN反应明显较弱(F=227.69,P<0.01);而腭裂儿童的ABR、MLR与正常儿童相比无统计学差异(P>0.05)。结论腭裂儿童的中枢听觉神经系统存在功能障碍,主要表现为大脑听觉皮层水平的听觉处理功能障碍,而脑干和皮层下水平的听觉感知功能基本正常。

Objective We aim to explore the central auditory nervous system（CANS） functioning in children with nonsyndromic cleft palates by analyzing the auditory evoked potentials and event-related potentials（ERP）.Methods A total of 34 children with nonsyndromic cleft palates were recruited as subjects,and 27 normally developed children were selected as the normal controls.Auditory brainstem response（ABR）,middle latency response（MLR）,and mismatch negativity（MMN） of ERP were selected as indices to observe the function of CANS in children in both groups.Results Astatistically significant difference between the groups was obtainedin the MMN recording（F=227.69,P〈0.01）,whereas no significant group differences were obtained in the ABR and MLR results（P〉0.05）.Children with nonsyndromic cleft palates showed diminished MMN responses compared with the normal controls,whereas ABR and MLR were within the normal range.Conclusion Children with nonsyndromic cleft palates are at risk of central auditory discrimination dysfunction.The significant abnormal eventrelated potentials recorded in children with cleft palates suggest that the dysfunction of CANS maybe located at the cortical level and normal function of CANS was located at the brain stem and sub-cortical level.