听力正常婴幼儿短音听性稳态反应的研究

Normal Auditory Steady-State Responses in Children

陈静;莫玲燕;刘辉;黄丽辉;

1:首都医科大学附属北京同仁医院北京市耳鼻咽喉科学研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)

摘要

目的建立听力正常婴幼儿短音听性稳态反应正常值,并探讨年龄的影响。方法单、双耳听力正常婴幼儿53名(78耳),男36名,女17名,年龄在142月,中位数为4月龄。根据年龄将受试者分为2组,142月,中位数为4月龄。根据年龄将受试者分为2组,16月龄组55耳和≥6月龄组23耳。听性稳态反应(ASSR)刺激信号为0.56月龄组55耳和≥6月龄组23耳。听性稳态反应(ASSR)刺激信号为0.54 k Hz的倍频程短音(tone pip)。0.5 kHz刺激信号上升、下降时间均为4 ms,1、2、4 kHz为2 ms。0.5、1、2、4 k Hz刺激信号的刺激速率左耳分别为77、85、93、101 Hz,右耳为79、87、95、103 Hz。双耳八个频率的刺激信号同时通过ER-3A插入式耳机给出,系统自动判定并记录反应。结果①78耳0.54 k Hz的倍频程短音(tone pip)。0.5 kHz刺激信号上升、下降时间均为4 ms,1、2、4 kHz为2 ms。0.5、1、2、4 k Hz刺激信号的刺激速率左耳分别为77、85、93、101 Hz,右耳为79、87、95、103 Hz。双耳八个频率的刺激信号同时通过ER-3A插入式耳机给出,系统自动判定并记录反应。结果①78耳0.54 k Hz ASSR反应阈值分别为50.20±7.73、41.30±6.96、36.46±6.16、39.60±8.48 dB SPL;②双因素方差分析(频率×年龄),两组间及各频率间反应阈值差异均有显著统计学意义(P=0.000和P=0.001);③两组间0.5 k Hz反应阈值差异有显著统计学意义,其余频率反应阈值间差异无显著统计学意义;④≥6月龄组0.5 kHz反应阈值显著高于其他各频率,其余频率反应阈值之间差异无显著统计学意义;14 k Hz ASSR反应阈值分别为50.20±7.73、41.30±6.96、36.46±6.16、39.60±8.48 dB SPL;②双因素方差分析(频率×年龄),两组间及各频率间反应阈值差异均有显著统计学意义(P=0.000和P=0.001);③两组间0.5 k Hz反应阈值差异有显著统计学意义,其余频率反应阈值间差异无显著统计学意义;④≥6月龄组0.5 kHz反应阈值显著高于其他各频率,其余频率反应阈值之间差异无显著统计学意义;16月龄组0.5 kHz反应阈值显著高于其他各频率,此外2 k与4 k Hz反应阈值之间差异具有显著统计学意义(P=0.035)。结论短音具有一定的频率特异性,以短音作为刺激信号所记录到的听性稳态反应阈值与调幅调制声或混合调制声信号的听性稳态反应结果近似,也是婴幼儿听力诊断的可靠方法。年龄因素对0.5 Hz ASSR阈值的影响最大。

关键词

婴幼儿;听性稳态反应;短音

基金项目(Foundation):

作者

陈静;莫玲燕;刘辉;黄丽辉;

参考文献

1 Stapells DR,Herdman A,Small SA,et al.Current status ofthe auditory steady-state responses for esti mating an infant'saudiogram[M].In:Seewald RC,Bamford J,Eds.A soundfoundation through early amplitication.Basel:Phonak AG,2004.43~59.

2 Luts H,Desloovere C,Wouters J.Clinical application of di-chotic multiple-sti mulus auditory steady-state responses inhigh-risk newborns and young children[J].Audiol Neuro-otol,2005,11:24.

3 Rance G,Roper R,Symons L,et al.Hearing threshold esti-mationininfants using auditory steady-state responses[J].JAm Acad Audiol,2005,16:291.

4 Herdman AT,Picton TW,Stapells DR.Place specificity ofmultiple auditory steady-state responses[J].Journal of theAcoustical Society of America,2002,112:1 569.

5 Picton T,John M,Di mitrijevic A,et al.Human auditorysteady-state responses[J].International Journal of Audiolo-gy,2003,42:177.

6 John MS,Di mitrijevic A,Picton TW.Auditory steady-stateresponses to exponential modulation envelopes[J].Ear andHearing,2002,23:106.

7 Sturzebecher E,Cebulla M,Neumann K.Click-evoked ABRat high sti mulus repetition rates for neonatal hearing screening[J].Int J Audiol,2003,42:59.

8莫玲燕,刘辉,陈静,等.同步多频听觉稳态诱发反应在小儿听力诊断中的应用[J].中国耳鼻咽喉头颈外科,2004,11:309.

9 Cone-Wesson B,Rickards FW,Poulis C,et al.The auditorysteady-state response,Ⅲ:Clinical applicationsininfants andchildren[J].Journal of the American Academy of Audiology,2002,13:270.

10 Aoyagi M,Kiren T,Furuse H,et al.Pure-tone thresholdprediction by 80-Hz amplitude-modulation following re-sponse[J].Acta Otolaryngologica,Suppli mental,1994,511:7.

11 Herdman AT,Stapells DR.Thresholds determined using themonotic and dichotic multiple auditory steady-state responsetechnique in normal-hearing subjects[J].Scandinavian Au-diology,2001,30:41.

12 Lins OG,Picton TW.Auditory steady-state responses tomultiple si multaneous sti muli[J].Electroencephalographyand Clinical Neurophysiology,1995,96:420.

13 Lins OG,Picton TW,Boucher BL,et al.Frequency-specificaudiometry using steady-state responses[J].Ear and Hear-ing,1996,17:81.

14 Picton TW,Durieux-Smith A,Champagne SC,et al.Ob-jective evaluation of aided thresholds using auditory steady-state responses[J].Journal of the American Academy of Au-diology,1998,9:315.

15 Levi EC,Folsom RC,Dobie RA.Coherence analysis of enve-lope-following responses(EFRs)and frequency-followingresponses(FFRs)in infants and adults[J].Hearing Re-search,1995,89:21.

16 Rance G,Rickards F.Prediction of hearingthresholdininfants u-sing auditory steady-state evoked potentials[J].Journal of theAmerican Academy of Audiology,2002,13:236.

17 Rickards FW,Tan LE,Cohen LT,et al.Auditory steady-state evoked potential in newborns[J].Br J Audiol,1994,28:327.

18 Savio G,Cardenas J,Perez Abalo M.The lowand high fre-quency auditory steady-state responses mature at differentrates[J].Audiology and Neurootology,2001,6:279.

19 Rance G,Tomlin D.Maturation of auditory steady-state re-sponses in normal babies[J].Ear Hear,2006,27:20.

20 John MS,Brown DK,Muir PJ.Recording auditory steady-state responsesin younginfants[J].Ear and Hearing,2004,25:539.

21 Katz J.Handbook of clinical audiology.5th edition[M].Balti-more:The Williams&Wilkins,2002.298~322.

22 Picton TW,Di mitrijevic A,Perez-Abalo MC.Esti matingaudiometric thresholds using auditory steady-state respon-ses[J].J Am Acad Audiol,2005,16:140.

23 Luts H,Desloovere C,Wouters J.Clinical application of di-chotic multiple-sti mulus auditory steady-state responsesinhigh-risk newborns and young children[J].Audiol Neuro-otol,2006,11:24.

本文信息

PDF(152K)

本文关键词相关文章

婴幼儿听性稳态反应短音

本文作者相关文章

陈静莫玲燕刘辉黄丽辉