新生儿226、1000Hz探测音镫骨肌声反射的研究

The Acoustic Stapedial Reflex with 226Hz and 1000Hz Probe Tones in Newborns

李梦茵;郑芸;李刚;王恺;

1:四川大学华西医院耳鼻咽喉-头颈外科听力中心/听觉言语科学实验室

摘要

目的探讨新生儿的226、1 000Hz探测音镫骨肌声反射(acoustic stapedial reflex,AR)的引出情况及其在新生儿听力诊断中的临床价值。方法对双耳通过畸变产物耳声发射(DPOAE)筛查、无听力损失高危因素的174例2～7天龄的新生儿进行226、1 000Hz探测音声导抗测试,记录其鼓室导抗图分型及AR引出率。结果 174例(340耳)新生儿完成声导抗测试,226、1 000Hz探测音AR引出率分别为29.71%、65.29%,后者高于前者,差异有统计学意义(P<0.01)。226Hz探测音单峰型和双峰型鼓室导抗图者AR引出率分别为26.23%、33.76%,二者间差异无统计学意义(P=0.130);1 000Hz探测音单峰型和其他型鼓室导抗图者AR引出率分别是67.49%、23.53%,前者显著高于后者,差异有统计学意义(P<0.01)。结论新生儿宜采用1 000Hz探测音进行AR测试,在对新生儿进行听力学评估时,AR测试结果应结合其他听力学检查结果综合解释。

关键词

新生儿;畸变产物耳声发射;鼓室导抗图;镫骨肌声反射

基金项目(Foundation):

作者

李梦茵;郑芸;李刚;王恺;

参考文献

1 Rosenfeld RM,Culpepper L,Doyle KJ,et al.Clinical practice guideline:otitis media with effusion[J].Otolaryngology-Head and Neck Surgery,2004,130:S95.

2 Boone RT,Bower CM,Martin PF.Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population[J].International Journal of Pediatric O-torhinolaryngology,2005,69:393.

3 Kei J,Allison-Levick J,Dockray J,et al.High-frequency(1000Hz)tympanometry in normal neonates[J].Journal of the American Academy of Audiology,2003,14:20.

4 Silva KAL,Novaes BACC,Lewis DR,et al.Tympanometry in neonates with normal otoacoustic emissions:measurements and interpretation[J].Revista Brasileira de Otorrinolaringolo-gia,2007,73:633.

5 Wet Swanepoel D,Werner S,Hugo R,et al.High frequency immittance for neonates:a normative study[J].Acta Oto-laryngologica,2007,127:49.

6 Garcia MV,Azevedo MF,Testa JR.Accoustic immitance meas-ures in infants with 226and 1000Hz probes:correlation with oto-acoustic emissions and otoscopy examination[J].Revista Brasileira de Otorrinolaringologia,2009,75:80.

7 Joint Committee on Infant Hearing.Year 2007position state-ment:Principles and guidelines for early hearing detection and intervention programs[J].Pediatrics,2007,120:898.

8 Weatherby L,Bennett M.The neonatal acoustic reflex[J].Scandinavian Audiology,1980,9:103.

9 Sutton GJ.Usefulness of acoustic reflexes still unproven in newborns and young infants[J].Journal of the American A-cademy of Audiology,2007,18:187.

10 Rhodes MC,Margolis RH,Hirsch JE,et al.Hearing screening in the newborn intensive care nursery:comparison of methods[J].Otolaryngology-Head and Neck Surgery,1999,120:799.

11 Mazlan R,Kei J,Hickson L,et al.High frequency immit-tance findings:Newborn versus six-week-old infants[J].International Journal of Audiology,2007,46:711.

12 Mazlan R,Kei J,Hickson L.Test-retest reliability of the acoustic stapedial reflex test in healthy neonates[J].Ear and Hearing,2009,30:295.

13 Mazlan R,Kei J,Hickson L,et al.Test-retest reliability of acoustic reflex test in 6-week-old healthy infants[J].Australian and New Zealand Journal of Audiology,2009,31:25.

14商莹莹,倪道凤,刘世琳.低频和高频探测音鼓室声导抗测试在婴儿中耳功能诊断中的作用[J].中华耳鼻咽喉头颈外科杂志,2006,41:326.

15胡艳玲,王智楠,陈平.婴儿1 000Hz探测音鼓室导抗测试结果分析[J].听力学及言语疾病杂志,2009,17:457.

16 Kei J,Mazlan R,Hickson L,et al.Measuring middle ear ad-mittance in newborns using 1000Hz tympanometry:A com-parison of methodologies[J].Journal of the American Acad-emy of Audiology,2007,18:739.

本文信息

PDF(122K)

本文关键词相关文章

新生儿畸变产物耳声发射鼓室导抗图镫骨肌声反射

本文作者相关文章

李梦茵郑芸李刚王恺