Analysis the relationship between the found ways and first diagnosis age for large vestibular aqueduct children
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摘要: 目的:探讨前庭导水管扩大患儿的发现途径与首诊年龄,以及二者与听力损失程度之间的关系。方法:2009-01-2014-04期间,在我院儿童听力诊断中心就诊、确诊为前庭导水管扩大的122例患儿,按发现途径分为筛查组与未筛查组:筛查组分为双耳未通过组、单耳未通过组及双耳通过组;未筛查组分为声音不敏感组、言语发育不良组、突发性听力下降及其他组。分析各组发现途径与首诊年龄之间的关系,并分别对各组的发现途径及首诊年龄与听力损失程度的关系进行统计学分析。结果:筛查组84例(68.85%),平均首诊年龄(17.24±17.08)个月;未筛查组37例(31.15%),平均首诊年龄(30.92±18.21)个月,筛查组较未筛查组的首诊年龄提早,差异有统计学意义(P<0.01)。筛查组中,双耳通过占14.29%(12/84),双耳或单耳未通过占85.71%(72/84),其中双耳未通过占67.85%(57/84),单耳未通过占17.86%(15/84),3组平均首诊年龄差异有统计学意义(χ2=15.616,P<0.01),两两比较显示双耳通过组较双耳未通过组的首诊年龄晚(P<0.01);未筛查组中,对声音不敏感组的首诊年龄[(19.69±11.16)个月]较言语发育不良组[(37.13±15.62)个月]和突发性听力下降组[(47.40±24.70)个月]提早,差异有统计学意义(P<0.01)。筛查组和未筛查组听力损失程度比较差异无统计学意义(P>0.05),而未筛查组中轻中度听力损失比极重度听力损失的首诊年龄晚(P<0.01)。结论:研究提示,绝大部分前庭导水管扩大患儿可以通过新生儿听力筛查得到早期发现和早期诊断,但部分患儿表现为迟发性或渐进性听力损失,尤其是轻中度听力损失发现较晚,值得临床关注。Abstract: Objective:To explore the found ways and first diagnosis age of children with large vestibular aqueduct, and their relations with hearing loss. Method:Medical histories of 122 cases of children diagnosed with large vestibular aqueduct by HRCT or MRI had been collected from January 2009 to April 2014 in our hospital children's hearing diagnosis center clinic.Found ways comprise of accepting universal newborn hearing screening (UNHS) group and unaccepting UNHS group. Accepting UNHS children were divided into two ears unpassing group, single ear unpassing group and passing group. The patients inunaccepting UNHS group were divided into not sensitive to sounds, speech stunting, sudden hearing loss, and other group. Analysis the relationship between the found ways and first diagnosis age and their relations with hearing loss. Result:There are 84 cases (68.85%) accepting UNHS , the average age of first diagnosis was (17.24 ±17.08) months; 37 cases(31.15%) are not accepting UNHS. The average age of first diagnosis was (30.92±18.21) months. The average first diagnosis age of accepting UNHS group was more earlier than the unaccepting UNHS group.The difference was statistically significant (P<0.01). There were 57 cases (67.85%) whose two ears not pass UNHS; 15 cases (17.86%)single ear not pass; namely the referral rate was 85.71%; 12 cases (14.29%) pass the test. The first diagnosis age of passing UNHS group was more later than two ears unpassing group(P<0.001). In the unaccepting UNHS group, the average first diagnosis age of not sensitive to sounds group (19.69±11.16 months) was more earlier than words dysplasia group (37.13±15.62 months) and sudden hearing loss group (47.40±24.70 months) (P<0.01). The difference in the degree of hearing loss between accepting UNHS and unaccepting UNHS group had no statistical significance (P>0.05). In unaccepting UNHS group ,the average first diagnosis age of the mild-to-moderate hearing loss group was later than the very severe hearing loss group (P<0.01). Conclusion:Most of large vestibular aqueduct children can be found and receive diagnosis early by UNHS.But part of these patients with late-onset or progressive hearing loss, especially these with mild-to-moderate hearing loss cannot be found early, which should arouse our attention.
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Key words:
- large vestibular aqueduct /
- the found ways /
- first diagnosis age /
- hearing loss level
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