先天性外中耳畸形早期听力学干预验证方法的初步研究

Preliminary study on verif ication method of early hearing intervention for patients with microtia and atresia

目的应用软带式骨导助听器对双侧先天性外中耳畸形听力损失儿童进行听力补偿,对不同的调试参数验证方法对听觉发育情况的影响进行评估。方法对20例符合要求的儿童应用软带骨导助听器,根据骨导多频稳态测试结果及患者家属意愿分为佩戴经颅骨模拟器验证调试组(实验组)和经Genie调试软件最佳选配调试组(对照组),用视觉强化测听法测试助听听阈及听觉言语发育情况。结果在500~2000 Hz两组助听听阈均显著改善,其中4000 Hz处实验组(21.00±2.58)dB HL好于对照组(27.50±2.64)dB HL;6个月时儿童格拉斯格受益列表问卷(the Glasgow children’s benefit inventory,GCBI)得分,实验组为36.11±10.35,对照组为35.55±10.87;12个月时实验组得分为43.39±11.31,对照组得分为38.28±12.81。结论对外中耳畸形患儿早期验配骨导助听器时进行颅骨模拟器验证调试参数,助听听阈更接近正常值,有助于听觉言语功能的康复。

OBJECTIVE To evaluate the effects of different parameters on hearing development in children with microtia and atresia(MA) by using bone anchored hearing aid(BAHA).METHODS Twenty children with bilateral MA were compensated with BAHA.The frequency response threshold of BC-ASSR test was less than 30 dB nHL.The children were divided into two groups:the debugging group(experimental group) verified by wearing the skull simulator and the best matching debugging group(control group) by Genie debugging software,after debugging good adopts visual reinforcement audiometry(VRA) to assess hearing threshold and auditory speech development.RESULTS In 500-2000 Hz,the hearing threshold of both groups was significantly improved,experimental group[(21.00±2.58)dB HL]at 4000 Hz was better than that of control group[(27.50±2.64)dB HL]with significant difference(P<0.05).The GCBI scores were 36.11±10.35 in experimental group and 35.55±10.87 in control group respectively after 6 months of wearing BAHA.The scores of experimental group and control group were 43.39±11.31 and 38.28±12.81 at 12 months with significant difference(P<0.05).CONCLUSION After debugging of skull simulator,the hearing development in MA children wearing BAHA is better.In the early test of MA children wearing BAHA,the skull simulator is used to verify and debug parameters,which is helpful for the early recovery of children’s hearing and speech function.