Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few ...Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.展开更多
The analysis of the Auditory Brainstem Response (ABR) is of fundamental importance to the investigation of the auditory system behavior, though its interpretation has a subjective nature because of the manual process ...The analysis of the Auditory Brainstem Response (ABR) is of fundamental importance to the investigation of the auditory system behavior, though its interpretation has a subjective nature because of the manual process employed in its study and the clinical experience required for its analysis. When analyzing the ABR, clinicians are often interested in the identification of ABR signal components referred to as Jewett waves. In particular, the detection and study of the time when these waves occur (i.e., the wave latency) is a practical tool for the diagnosis of disorders affecting the auditory system. In this context, the aim of this research is to compare ABR manual/visual analysis provided by different examiners. Methods: The ABR data were collected from 10 normal-hearing subjects (5 men and 5 women, from 20 to 52 years). A total of 160 data samples were analyzed and a pair- wise comparison between four distinct examiners was executed. We carried out a statistical study aiming to identify significant differences between assessments provided by the examiners. For this, we used Linear Regression in conjunction with Bootstrap, as a method for evaluating the relation between the responses given by the examiners. Results: The analysis suggests agreement among examiners however reveals differences between assessments of the variability of the waves. We quantified the magnitude of the obtained wave latency differences and 18% of the investigated waves presented substantial differences (large and moderate) and of these 3.79% were considered not acceptable for the clinical practice. Conclusions: Our results characterize the variability of the manual analysis of ABR data and the necessity of establishing unified standards and protocols for the analysis of these data. These results may also contribute to the validation and development of automatic systems that are employed in the early diagnosis of hearing loss.展开更多
Objective To explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea-hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion produ...Objective To explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea-hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion product otoacoustic emissions (DPOAEs) in 60 ears in children with OSAHS and type "A" tym-panograms, and in 30 ears in normal children. Results ABR latencies of waves I, III and V, and I-III, III-V and I-V intervals were not statistically different between OSAHS and normal children. Wave I latency was delayed in children with OSAHS compared to normal children3 (P < 0.05). DPOAE amplitudes in children with mild OSAHS were lower than normal children at 8 kHz (P < 0.05). DPOAEs were lower at 6 kHz and 8 kHz in children with moderate/severe OSAHS than normal children (P < 0.05). Conclusion Cochlear function was affected when AHI was at or greater than 10/hour. ABR and DPOAE can be used to detect early changes in auditory function in children with OSAHS.展开更多
Objective:To analyze neurophysiological characteristics in infants and young children with auditory neuropathy(AN) and explore their clinical significance.Methods: Audiological measurements(acoustic immittance, EOAEs,...Objective:To analyze neurophysiological characteristics in infants and young children with auditory neuropathy(AN) and explore their clinical significance.Methods: Audiological measurements(acoustic immittance, EOAEs, ABR, CM, MLR and ERPs) and peripheral neurological tests were conducted and evaluated in 13 infants and young children with AN. Six of them received high-resolution temporal bone CT scans and/or cerebral MRI examinations.Results: All of the children showed type “A” tympanograms with abseatation of stapedial reflexes. EOAEs were normal in 12 of 13 subjects. In one child who had a history of anoxia during the birth,the EOAEs were not elicited. Click-evoked ABRs were absent in 12 of 13 subjects when maximum output of the instrument was reached. The CM potentials were presented bilaterally in all individuals,which were independent of the EOAEs and ABR. Of eight cases tested,all had clear MLR and six showed normal ERPs(P300 and MMN). Peripheral neurological tests and radiological findings were within the normal ranges. Conclusion: The diagnosis of AN in infants and young children should focus on analyzing their neurophysiological characteristics,especially on CM,MLR and ERPs. Combined use of EOAEs, ABR and CM was recommended for hearing screening on newborns with high risk factors.展开更多
目的探讨多种听力学检测方法在听性脑干反应(ABR)最大输出未引出患儿的听力学诊断中的应用价值。方法回顾性分析69例(138耳)ABR最大强度未引出患儿的临床资料,年龄42天到5岁,平均1岁6个月,鼓室导抗图均为A型或正向单峰,声反射均未引出,...目的探讨多种听力学检测方法在听性脑干反应(ABR)最大输出未引出患儿的听力学诊断中的应用价值。方法回顾性分析69例(138耳)ABR最大强度未引出患儿的临床资料,年龄42天到5岁,平均1岁6个月,鼓室导抗图均为A型或正向单峰,声反射均未引出,影像学检查内耳无畸形。69例患儿均进行ABR、耳蜗微音电位(CM)、畸变产物耳声发射(DPOAE)和听性稳态反应(ASSR)测试。结果69例138耳中,8例16耳(11.59%)记录到CM,其中10耳(7.25%)记录到DPOAE,0.5、1、2、4 kHz ASSR反应阈值分别为83.2±13.1、82.9±13.0、75.3±12.4、63.1±9.1 dB nHL,结合其他检查结果诊断为听神经病。余61例(122耳)CM和DPOAE均未引出,0.5、1、2、4 kHz的ASSR引出率分别为82.3%、81.9%、76.9%、60.2%,其中20耳ASSR各频率均未引出,102耳至少一个频率引出,0.5、1、2、4 kHz ASSR反应阈分别为93.2±6.1、99.8±7.0、105.4±5.4、108.2±9.8 dB nHL,诊断为极重度感音神经性聋。结论对于ABR最大输出强度未引出的患儿,CM和/或DPOAE引出且ASSR各频率反应阈低于感音神经性聋患儿,有助于听神经病的诊断;CM和DPOAE均未引出有助于极重度感音神经性聋的诊断,ASSR测试有助于评估其残余听力。展开更多
目的建立军事航空噪声性隐匿性听力损失(HHL)C57小鼠动物模型,并对其有效性进行评价,为军事航空噪声性HHL的研究提供稳定的小鼠动物模型构建方法。方法将听力正常的雄性C57BL/6J小鼠随机分成4组,分别给予不同强度的噪声暴露:105 dB 2 h,...目的建立军事航空噪声性隐匿性听力损失(HHL)C57小鼠动物模型,并对其有效性进行评价,为军事航空噪声性HHL的研究提供稳定的小鼠动物模型构建方法。方法将听力正常的雄性C57BL/6J小鼠随机分成4组,分别给予不同强度的噪声暴露:105 dB 2 h,110 dB 2 h,110 dB 4 h,115 dB 4 h。将噪声暴露前的小鼠作为对照组,根据噪声暴露后不同时间分为噪声暴露后1 d组(NE-1 d)、噪声暴露后7 d组(NE-7 d)、噪声暴露后14 d组(NE-14 d)和噪声暴露后28 d组(NE-28 d)。各实验组进行相应强度的军用直升机噪声暴露,并在各时间节点进行听性脑干反应(ABR)测试。筛选出符合条件的噪声暴露强度,并进行该条件噪声暴露后基底膜的免疫荧光染色和带状突触计数验证。结果105 dB 2 h军用直升机噪声暴露后C57小鼠听阈阈移不明显;110 dB 4 h和115 dB 4 h军用直升机噪声暴露后小鼠听阈发生永久性阈移;110 dB 2 h军用直升机噪声暴露后,C57小鼠听阈暂时性阈移,ABR波Ⅰ幅值降低,耳蜗带状突触数量降低,满足HHL的功能学和形态学要求。结论110 dB 2 h军用直升机噪声暴露可作为军事航空噪声性HHL C57小鼠模型的理想刺激参数。展开更多
目的构建小鼠隐匿性听力损失(HHL)和噪声性听力损失模型,分析军事航空噪声暴露对小鼠耳蜗核神经元激活状态的影响。方法将听力正常的雄性C57小鼠随机分成3组,分别给予110 dB 2 h噪声、115 dB 4 h噪声和不给噪声刺激。在噪声暴露后1、7...目的构建小鼠隐匿性听力损失(HHL)和噪声性听力损失模型,分析军事航空噪声暴露对小鼠耳蜗核神经元激活状态的影响。方法将听力正常的雄性C57小鼠随机分成3组,分别给予110 dB 2 h噪声、115 dB 4 h噪声和不给噪声刺激。在噪声暴露后1、7、14、28 d进行听性脑干反应(ABR)测试和小鼠耳蜗核c-Fos蛋白免疫荧光染色。结果HHL组小鼠噪声暴露后听阈发生暂时性阈移,阈上刺激ABRⅠ波幅值降低,耳蜗核c-Fos蛋白表达阳性神经元数量增多。结论军事航空噪声引起小鼠HHL表现为听觉暂时性阈移、阈上刺激ABRⅠ波幅值降低,并且耳蜗核神经元出现过度激活。展开更多
目的分析3岁听障儿童与同龄健听儿童语言细节句子测试结果,为提高康复教学效果提供参考依据。方法在康复机构和普通幼儿园选取听障儿童与健听儿童各30例,采用言语听觉反应评估(evaluation of auditory resporse to speech,EARS)中的语...目的分析3岁听障儿童与同龄健听儿童语言细节句子测试结果,为提高康复教学效果提供参考依据。方法在康复机构和普通幼儿园选取听障儿童与健听儿童各30例,采用言语听觉反应评估(evaluation of auditory resporse to speech,EARS)中的语言细节句子测试表进行测试,比较两组儿童的句子和词汇水平得分。结果儿童的听力状况对语言细节句子测试得分影响显著(T句子(1,58)=3.36,P<0.01;T词语(1,58)=2.89,P<0.01),健听儿童句子和词汇水平得分(M句子=8.47,M词语=58.23)均显著高于听障儿童(M句子=7.03,M词语=56.63)(P<0.05)。结论与健听儿童相比,语言年龄达到3岁水平的听障儿童句法语法能力滞后,这可能与听障儿童输入性语言信息不足及输入环境有关。康复训练中应加强相应训练,拓展应用到生活场景中。展开更多
Introduction and Objectives: The idiopathic sensorineural cochlear hearing loss is one of the most frequent human sensory deficits and there is no specific drug therapy for it. The possible hearing recovery is related...Introduction and Objectives: The idiopathic sensorineural cochlear hearing loss is one of the most frequent human sensory deficits and there is no specific drug therapy for it. The possible hearing recovery is related with the reestablishment of normal ionic homeostasis of the endolymph controlled by the mineralocorticoid as could be demonstrate experimentally. The purpose of this clinical trial was to confirm the efficacy of mineralocorticoids to the recovery of hearing level in patients suffering idiopathic sensorineural hearing loss (SNHL) against the glucocorticoids and vasodilator drugs. Material and Methods: The research lasted three months and involved 90 patients allocated into four different groups: Placebo group, consisted of 20 patients (10 men and 10 women);the group consisting of 22 patients treated with glucocorticoid therapy (12 men and 10 female);the group treated with mineralocorticoid therapy encompassed 26 patients (13 males and 13 females) and the group of vasodilators formed by 22 patients (12 men and 10 women). The level of hearing loss was estimated by the tests Liminal Tone Audiometry (LTA) and Auditory Brainstem Response (ABR). Results: The main features in this research were overall better response in improving the hearing level with the mineralocorticoid therapy. This improvement in hearing levels was greater in women than in men, and a higher response was found in the left ear regardless of patient’s gender. Conclusions: The hearing gain was significantly superior in the mineralocorticoids group followed by the glucocorticoids group whereas the response to vasodilators was lesser and with no statistical significance.展开更多
Background:Hearing loss(HL)is becoming increasingly common and is more commonly caused by noise,ototoxic substances,or a combination of ototoxic factors.However,so far,few studies have examined the mechanism by which ...Background:Hearing loss(HL)is becoming increasingly common and is more commonly caused by noise,ototoxic substances,or a combination of ototoxic factors.However,so far,few studies have examined the mechanism by which compound factors cause HL.The only relevant study is about occupational ototoxic substances combined with environmental noise at 85-110 dB SPL.In this study,to address the shortcomings of existing research,we innovatively focused on HL induced by loud noise(impulse noise,>160 dB SPL)combined with common ototoxic drugs.The aim of this study was to establish and validate a mature animal model,and then to compare the characteristics of audiology,pathomorphology and molecular features,and to preliminarily predict pathogenesis in compound HL.Materials and Methods:We selected guinea pigs to construct in vivo HL model groups for different extents of exposure,including a blank control group,a single-drug group,a single-impulse noise group,and a compound group.The animal model of the mature compound HL group was established using gentamicin combined with impulse noise.We then performed audio-logical and pathological verification.We analyzed the auditory brainstem response(ABR),pathological morphology of the cochlea,and molecules(including important self-radicals,cytokines,and apoptosis signal trans-duction pathway proteins in the pathogenesis of drug-and noise-induced HL),compared the effect of different extents of exposure on HL,and preliminarily predict the pathogenic mechanism of compound HL.Results:Four groups of animal models were established successfully and verified by audiology and pathology.Regarding audiology,there were no sig-nificant differences in the ABR thresholds before exposure(p>0.05),but differences emerged among the groups after exposure.Notably,after 3,7,and 14 days of exposure,there were significant differences in the ABR thresholds between the compound group and both the drug and noise groups(p<0.01),and after 14 days,the HL of the compound group was much more severe(greater than the linear sum of single-factor HL group).Regarding the patho-morphology,compared with the control group,the cochleae were damaged to different degrees in the factor exposure groups.The drug group had the least severe HL,the noise group had serious HL(p<0.05),and the compound group had the most severe HL(p<0.01).The compound group's damage was greater than the linear sum of the single-factor group in many ways,such as the loss and damage of hair cells and cilia,disturbed morphology and arrangement of hair cells,protein metabolism,cell function,and structural defects on the epidermal plate(p<0.01).From a molecular perspective,the trend was similar to pathology and audiology,and the synergistic effect of ototoxic drugs and impulse noise significantly increased cytokine levels(IL-6,ICAM-1,8-OHDG,IL-1,and TNF-α),free radicals Malondialdehyde([MDA],▪OH,LPO,O•2ˉ),and the apoptosis signal transduction pathway protein.There were significant differences between the compound group and single-factor groups(p<0.05).Conclusion:Gentamicin,impulse noise,and compound factors were used to induce HL in animal models,which were verified by audiology and pathology,laying a foundation for future studies.After constructing the animal models,we found that 50 mg/kg of gentamicin for 10 days was a subinjury dose,and 50�impulse noise caused partial HL,but the two factors combined had a significant synergistic ototoxicity effect,which increased the level of oxidative stress and the waterfall response of inflammatory cytokines in the cochleae and enhanced the expression of apoptosis-related proteins,resulting in syn-ergistic pathomorphological and audiological injury.We preliminarily analyzed the pathogenic mechanism of compound HL,establishing the basis for further study of the mechanism,prevention,and treatment of this increasing global problem.展开更多
文摘Newborn hearing screening(NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016;however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.
文摘The analysis of the Auditory Brainstem Response (ABR) is of fundamental importance to the investigation of the auditory system behavior, though its interpretation has a subjective nature because of the manual process employed in its study and the clinical experience required for its analysis. When analyzing the ABR, clinicians are often interested in the identification of ABR signal components referred to as Jewett waves. In particular, the detection and study of the time when these waves occur (i.e., the wave latency) is a practical tool for the diagnosis of disorders affecting the auditory system. In this context, the aim of this research is to compare ABR manual/visual analysis provided by different examiners. Methods: The ABR data were collected from 10 normal-hearing subjects (5 men and 5 women, from 20 to 52 years). A total of 160 data samples were analyzed and a pair- wise comparison between four distinct examiners was executed. We carried out a statistical study aiming to identify significant differences between assessments provided by the examiners. For this, we used Linear Regression in conjunction with Bootstrap, as a method for evaluating the relation between the responses given by the examiners. Results: The analysis suggests agreement among examiners however reveals differences between assessments of the variability of the waves. We quantified the magnitude of the obtained wave latency differences and 18% of the investigated waves presented substantial differences (large and moderate) and of these 3.79% were considered not acceptable for the clinical practice. Conclusions: Our results characterize the variability of the manual analysis of ABR data and the necessity of establishing unified standards and protocols for the analysis of these data. These results may also contribute to the validation and development of automatic systems that are employed in the early diagnosis of hearing loss.
文摘Objective To explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea-hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion product otoacoustic emissions (DPOAEs) in 60 ears in children with OSAHS and type "A" tym-panograms, and in 30 ears in normal children. Results ABR latencies of waves I, III and V, and I-III, III-V and I-V intervals were not statistically different between OSAHS and normal children. Wave I latency was delayed in children with OSAHS compared to normal children3 (P < 0.05). DPOAE amplitudes in children with mild OSAHS were lower than normal children at 8 kHz (P < 0.05). DPOAEs were lower at 6 kHz and 8 kHz in children with moderate/severe OSAHS than normal children (P < 0.05). Conclusion Cochlear function was affected when AHI was at or greater than 10/hour. ABR and DPOAE can be used to detect early changes in auditory function in children with OSAHS.
文摘Objective:To analyze neurophysiological characteristics in infants and young children with auditory neuropathy(AN) and explore their clinical significance.Methods: Audiological measurements(acoustic immittance, EOAEs, ABR, CM, MLR and ERPs) and peripheral neurological tests were conducted and evaluated in 13 infants and young children with AN. Six of them received high-resolution temporal bone CT scans and/or cerebral MRI examinations.Results: All of the children showed type “A” tympanograms with abseatation of stapedial reflexes. EOAEs were normal in 12 of 13 subjects. In one child who had a history of anoxia during the birth,the EOAEs were not elicited. Click-evoked ABRs were absent in 12 of 13 subjects when maximum output of the instrument was reached. The CM potentials were presented bilaterally in all individuals,which were independent of the EOAEs and ABR. Of eight cases tested,all had clear MLR and six showed normal ERPs(P300 and MMN). Peripheral neurological tests and radiological findings were within the normal ranges. Conclusion: The diagnosis of AN in infants and young children should focus on analyzing their neurophysiological characteristics,especially on CM,MLR and ERPs. Combined use of EOAEs, ABR and CM was recommended for hearing screening on newborns with high risk factors.
文摘目的探讨多种听力学检测方法在听性脑干反应(ABR)最大输出未引出患儿的听力学诊断中的应用价值。方法回顾性分析69例(138耳)ABR最大强度未引出患儿的临床资料,年龄42天到5岁,平均1岁6个月,鼓室导抗图均为A型或正向单峰,声反射均未引出,影像学检查内耳无畸形。69例患儿均进行ABR、耳蜗微音电位(CM)、畸变产物耳声发射(DPOAE)和听性稳态反应(ASSR)测试。结果69例138耳中,8例16耳(11.59%)记录到CM,其中10耳(7.25%)记录到DPOAE,0.5、1、2、4 kHz ASSR反应阈值分别为83.2±13.1、82.9±13.0、75.3±12.4、63.1±9.1 dB nHL,结合其他检查结果诊断为听神经病。余61例(122耳)CM和DPOAE均未引出,0.5、1、2、4 kHz的ASSR引出率分别为82.3%、81.9%、76.9%、60.2%,其中20耳ASSR各频率均未引出,102耳至少一个频率引出,0.5、1、2、4 kHz ASSR反应阈分别为93.2±6.1、99.8±7.0、105.4±5.4、108.2±9.8 dB nHL,诊断为极重度感音神经性聋。结论对于ABR最大输出强度未引出的患儿,CM和/或DPOAE引出且ASSR各频率反应阈低于感音神经性聋患儿,有助于听神经病的诊断;CM和DPOAE均未引出有助于极重度感音神经性聋的诊断,ASSR测试有助于评估其残余听力。
文摘目的 研究长期接噪人群非镇静听性脑干反应特征及其有效性。方法 选取2023年1月—4月浙江中医药大学医学技术与信息工程学院无长期接噪史的15例青年学生为正常组,另选取杭州祖明豆腐工厂有长期接噪史(接噪时间8 h/d左右)的15例工人为接噪组,两组进行非镇静听性脑干反应,比较两组Ⅰ、Ⅴ波潜伏期及Ⅴ波振幅的差异,采用双变量Pearson相关性分析,探究两组纯音与非镇静ABR的相关性。结果 在80 dB nHL强度下,I波潜伏期正常组潜伏期早于接噪组,差异有统计学意义(P<0.05),其余各强度比较,差异无统计学意义(P>0.05)。两组各强度下V波振幅比较,差异均无统计学意义(P>0.05)。正常组纯音平均阈值与非镇静ABR阈值呈正相关,(r=0.540,P<0.05);接噪组纯音平均阈值与非镇静ABR阈值呈正相关(r=0.688,P<0.01)。结论 在80 dB nHL刺激下Ⅰ波潜伏期延后,对噪声引起的隐性听力损失具有一定的参考价值。接噪组非镇静ABR与纯音测听的相关性高于正常组,两者交叉验证准确性更高。
文摘目的建立军事航空噪声性隐匿性听力损失(HHL)C57小鼠动物模型,并对其有效性进行评价,为军事航空噪声性HHL的研究提供稳定的小鼠动物模型构建方法。方法将听力正常的雄性C57BL/6J小鼠随机分成4组,分别给予不同强度的噪声暴露:105 dB 2 h,110 dB 2 h,110 dB 4 h,115 dB 4 h。将噪声暴露前的小鼠作为对照组,根据噪声暴露后不同时间分为噪声暴露后1 d组(NE-1 d)、噪声暴露后7 d组(NE-7 d)、噪声暴露后14 d组(NE-14 d)和噪声暴露后28 d组(NE-28 d)。各实验组进行相应强度的军用直升机噪声暴露,并在各时间节点进行听性脑干反应(ABR)测试。筛选出符合条件的噪声暴露强度,并进行该条件噪声暴露后基底膜的免疫荧光染色和带状突触计数验证。结果105 dB 2 h军用直升机噪声暴露后C57小鼠听阈阈移不明显;110 dB 4 h和115 dB 4 h军用直升机噪声暴露后小鼠听阈发生永久性阈移;110 dB 2 h军用直升机噪声暴露后,C57小鼠听阈暂时性阈移,ABR波Ⅰ幅值降低,耳蜗带状突触数量降低,满足HHL的功能学和形态学要求。结论110 dB 2 h军用直升机噪声暴露可作为军事航空噪声性HHL C57小鼠模型的理想刺激参数。
文摘目的构建小鼠隐匿性听力损失(HHL)和噪声性听力损失模型,分析军事航空噪声暴露对小鼠耳蜗核神经元激活状态的影响。方法将听力正常的雄性C57小鼠随机分成3组,分别给予110 dB 2 h噪声、115 dB 4 h噪声和不给噪声刺激。在噪声暴露后1、7、14、28 d进行听性脑干反应(ABR)测试和小鼠耳蜗核c-Fos蛋白免疫荧光染色。结果HHL组小鼠噪声暴露后听阈发生暂时性阈移,阈上刺激ABRⅠ波幅值降低,耳蜗核c-Fos蛋白表达阳性神经元数量增多。结论军事航空噪声引起小鼠HHL表现为听觉暂时性阈移、阈上刺激ABRⅠ波幅值降低,并且耳蜗核神经元出现过度激活。
文摘目的分析3岁听障儿童与同龄健听儿童语言细节句子测试结果,为提高康复教学效果提供参考依据。方法在康复机构和普通幼儿园选取听障儿童与健听儿童各30例,采用言语听觉反应评估(evaluation of auditory resporse to speech,EARS)中的语言细节句子测试表进行测试,比较两组儿童的句子和词汇水平得分。结果儿童的听力状况对语言细节句子测试得分影响显著(T句子(1,58)=3.36,P<0.01;T词语(1,58)=2.89,P<0.01),健听儿童句子和词汇水平得分(M句子=8.47,M词语=58.23)均显著高于听障儿童(M句子=7.03,M词语=56.63)(P<0.05)。结论与健听儿童相比,语言年龄达到3岁水平的听障儿童句法语法能力滞后,这可能与听障儿童输入性语言信息不足及输入环境有关。康复训练中应加强相应训练,拓展应用到生活场景中。
基金Funded through the Carlos Ⅲ Health Institute agreement to carry out non-commercial clinical trials involving human drugs,co-financed by the European Regional Development Fund(ERDF).
文摘Introduction and Objectives: The idiopathic sensorineural cochlear hearing loss is one of the most frequent human sensory deficits and there is no specific drug therapy for it. The possible hearing recovery is related with the reestablishment of normal ionic homeostasis of the endolymph controlled by the mineralocorticoid as could be demonstrate experimentally. The purpose of this clinical trial was to confirm the efficacy of mineralocorticoids to the recovery of hearing level in patients suffering idiopathic sensorineural hearing loss (SNHL) against the glucocorticoids and vasodilator drugs. Material and Methods: The research lasted three months and involved 90 patients allocated into four different groups: Placebo group, consisted of 20 patients (10 men and 10 women);the group consisting of 22 patients treated with glucocorticoid therapy (12 men and 10 female);the group treated with mineralocorticoid therapy encompassed 26 patients (13 males and 13 females) and the group of vasodilators formed by 22 patients (12 men and 10 women). The level of hearing loss was estimated by the tests Liminal Tone Audiometry (LTA) and Auditory Brainstem Response (ABR). Results: The main features in this research were overall better response in improving the hearing level with the mineralocorticoid therapy. This improvement in hearing levels was greater in women than in men, and a higher response was found in the left ear regardless of patient’s gender. Conclusions: The hearing gain was significantly superior in the mineralocorticoids group followed by the glucocorticoids group whereas the response to vasodilators was lesser and with no statistical significance.
基金National Natural Science Foundation of China,Grant/Award Number:81470700Beijing Municipal Natural Science Foundation,Grant/Award Number:7222185+1 种基金Key R&D program of Ministry of Science and Technology,Grant/Award Number:2022YFC2402704National Key Research and Development Program of China,Grant/Award Numbers:2020YFC2004001,2020YFC2005203。
文摘Background:Hearing loss(HL)is becoming increasingly common and is more commonly caused by noise,ototoxic substances,or a combination of ototoxic factors.However,so far,few studies have examined the mechanism by which compound factors cause HL.The only relevant study is about occupational ototoxic substances combined with environmental noise at 85-110 dB SPL.In this study,to address the shortcomings of existing research,we innovatively focused on HL induced by loud noise(impulse noise,>160 dB SPL)combined with common ototoxic drugs.The aim of this study was to establish and validate a mature animal model,and then to compare the characteristics of audiology,pathomorphology and molecular features,and to preliminarily predict pathogenesis in compound HL.Materials and Methods:We selected guinea pigs to construct in vivo HL model groups for different extents of exposure,including a blank control group,a single-drug group,a single-impulse noise group,and a compound group.The animal model of the mature compound HL group was established using gentamicin combined with impulse noise.We then performed audio-logical and pathological verification.We analyzed the auditory brainstem response(ABR),pathological morphology of the cochlea,and molecules(including important self-radicals,cytokines,and apoptosis signal trans-duction pathway proteins in the pathogenesis of drug-and noise-induced HL),compared the effect of different extents of exposure on HL,and preliminarily predict the pathogenic mechanism of compound HL.Results:Four groups of animal models were established successfully and verified by audiology and pathology.Regarding audiology,there were no sig-nificant differences in the ABR thresholds before exposure(p>0.05),but differences emerged among the groups after exposure.Notably,after 3,7,and 14 days of exposure,there were significant differences in the ABR thresholds between the compound group and both the drug and noise groups(p<0.01),and after 14 days,the HL of the compound group was much more severe(greater than the linear sum of single-factor HL group).Regarding the patho-morphology,compared with the control group,the cochleae were damaged to different degrees in the factor exposure groups.The drug group had the least severe HL,the noise group had serious HL(p<0.05),and the compound group had the most severe HL(p<0.01).The compound group's damage was greater than the linear sum of the single-factor group in many ways,such as the loss and damage of hair cells and cilia,disturbed morphology and arrangement of hair cells,protein metabolism,cell function,and structural defects on the epidermal plate(p<0.01).From a molecular perspective,the trend was similar to pathology and audiology,and the synergistic effect of ototoxic drugs and impulse noise significantly increased cytokine levels(IL-6,ICAM-1,8-OHDG,IL-1,and TNF-α),free radicals Malondialdehyde([MDA],▪OH,LPO,O•2ˉ),and the apoptosis signal transduction pathway protein.There were significant differences between the compound group and single-factor groups(p<0.05).Conclusion:Gentamicin,impulse noise,and compound factors were used to induce HL in animal models,which were verified by audiology and pathology,laying a foundation for future studies.After constructing the animal models,we found that 50 mg/kg of gentamicin for 10 days was a subinjury dose,and 50�impulse noise caused partial HL,but the two factors combined had a significant synergistic ototoxicity effect,which increased the level of oxidative stress and the waterfall response of inflammatory cytokines in the cochleae and enhanced the expression of apoptosis-related proteins,resulting in syn-ergistic pathomorphological and audiological injury.We preliminarily analyzed the pathogenic mechanism of compound HL,establishing the basis for further study of the mechanism,prevention,and treatment of this increasing global problem.
