足月正常新生儿自发性耳声发射特性分析

The Characteristics of Spontaneous Otoacoustic Emissions in Full-term Newborns

亓贝尔;程晓华;恩晖;顾延庆;黄丽辉;

1:首都医科大学附属北京同仁医院

2:北京市耳鼻咽喉科研究所

3:耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)

4:北京市上地医院

摘要
目的探讨足月新生儿自发性耳声发射(spontaneous otoacoustic emission,SOAE)的特性。方法采用丹麦尔听美公司Capella全功能耳声发射仪,对147例(236耳)通过瞬态诱发耳声发射(TEOAE)筛查的足月新生儿进行SOAE测试,分析SOAE的检出率、反应幅值、反应峰值以及频率分布特性。结果 1147例236耳中,SOAE总检出率为56.77%(134/236),其中女婴检出率69.23%(90/130)明显高于男婴(41.51%,44/106)(P<0.05),右耳检出率(64.17%,77/120)明显高于左耳(49.14%,57/116)(P<0.05)。2SOAE平均幅值为11.78±8.36dB SPL,其中男婴11.73±8.25dB SPL,女婴11.81±8.43dB SPL;左耳11.97±8.56dB SPL,右耳11.65±8.22dB SPL;无性别和耳间差异(P>0.05)。3SOAE频率集中分布于3 2123 718 Hz,其中男婴2 9303 718 Hz,其中男婴2 9303 409Hz,女婴3 3533 409Hz,女婴3 3533 863Hz;左耳3 2123 863Hz;左耳3 2123 718Hz,右耳3 1513 718Hz,右耳3 1513 638Hz;男婴的频率分布低于女婴(P<0.01)。4SOAE反应峰值均数为3.70±2.75个/耳,其中男婴3.86±2.87个/耳,女婴3.62±2.70个/耳;左耳3.70±3.02个/耳,右耳3.70±2.55个/耳;无性别和耳间差异(P>0.05)。结论足月新生儿SOAE检出率女婴高于男婴,右耳高于左耳,频率分布趋于高频,反应呈现多峰的特点,并且检出率及频率分布特性在女婴中更明显。
关键词
足月新生儿;自发性耳声发射;听力筛查
基金项目(Foundation):
卫生公益性行业科研专项基金(201202005);; 首都临床特色应用研究专项基金(Z131107002213123);; 首都医学发展科研基金项目(2009-1049);; 首都医科大学基础临床合作基金(12JL07)联合资助
作者
亓贝尔;程晓华;恩晖;顾延庆;黄丽辉;
参考文献

1 韩德民,许时昂,主编.听力学基础与临床[M].北京:科学技术文献出版社,2004.366~366.

2 Ryan S,Kemp DT,Hinchcliffe R.The influence of contralateral acoustic stimulation on click evoked otoacoustic emissions in humans[J].Br J Audiol,1991,25:3912.

3 李富德,周祥宁.自发性耳声发射的研究进展[J].听力学及言语疾病杂志,2002,10:195.

4 Collet L,Gartner M,Veuillet E,et al.Evoked and spontaneous otoacoustic emissions.A comparison of neonates and adults[J].Brain Dev,1993,15:249.

5 Lamprecht Dinnesen A,Pohl M,Hartmann S,et al.Effects of age,gender and ear side on SOAE parameters in infancy and childhood[J].Audiol Neurootol,1998,3:386.

6 徐进,刘鋋,郭连生,等.自发性耳声发射与耳蜗传出调控的关系探讨[J].中华耳鼻咽喉科杂志,2001,36:436.

7 Morlet T,Lapillonne A,Ferber C,et al.Spontaneous otoacoustic emissions in preterm neonates:prevalence and gender effects[J].Hear Res,1995,90:44.

8 Snihur AW,Hampson E.Sex and ear differences in spontaneous and click-evoked otoacoustic emissions in young adults[J].Brain Cogn,2011,77:40.

9 Wright A,Davis A,Bredberg G,et al.Hair cell distributions in the normal human cochlea.A report of a European working group[J].Acta Otolaryngol,1987,436(Suppl):15.

10 Martin GK,Probst R,Lonsbury-Martin BL.Otoacoustic emissions in human ears:normative findings[J].Ear Hear,1990,11:106.

11 Eckel LA,Arnold,AP,Hampson E,at al.Sex differences in the brain:from genes to behavior[M].New York:Oxford University Press,2008.35~61.

12 Forest MG,De Peretti E,Bertrand J.Hypothalamic pituitary gonadal relationships in man,from birth to puberty[J].Clinical Endocrinology,1976,5:551.

13 Pujol R,Avigne Rebillard M.A textbook of audiological medicine:clinical aspects of hearing and balance[M].London:Dunitz,2003.147~156.

14 McFadden D,Mishra R.On the relation between hearing sensitivity and otoacoustic emissions[J].Hear Res,1993,71:208.

15 Khalfa S,Collet L.Functional asymmetry of medial olivocochlear system in humans.Towards a peripheral auditory lateralization[J].Neuroreport,1996,7:993.

16 McFadden D.A speculation about the parallel ear asymmetries and sex differences in hearing sensitivity and otoacoustic emissions[J].Hearing Research,1993,68,143.

17 Kuroda T.Clinical investigation on spontaneous otoacoustic emission(SOAE)in 447ears[J].Auris Nasus Larynx,2007,34:29.

18 Westwood GF,Bamford JM.Probe-tube microphone measurements with very young infants[J].Br J Audiol,1992,26:143 .