新生儿中耳共振频率的初步研究

何荣萍; 郑芸; 李刚

doi:10.13201/j.issn.1001-1781.2016.19.001

新生儿中耳共振频率的初步研究

- 四川大学华西医院耳鼻咽喉头颈外科听力中心/听觉言语实验室(成都, 610041)
基金项目:
国际合作基金(No:312130182)

四川省学术和技术带头人培养基金(No:JH2014016)

四川省科技支撑计划项目(No:2014JY0237)

详细信息

通讯作者: 郑芸,E-mail:shirleyzy@189.cn

中图分类号: R764

收稿日期: 2016-02-29

A preliminary study of middle ear resonance frequency in normal hearing neonates

- Hearing Center, Department of Otorhinolaryngology, West China Hospital, Sichuan University, Chengdu, 610041, China

More Information

Corresponding author: ZHENG Yun, E-mail: shirleyzy@189.cn

Received Date: 29 February 2016

摘要

摘要: 目的:重点研究新生儿中耳共振频率(RF)正常值范围,为新生儿听力筛查及新生儿中耳功能的评估提供参考依据。方法:采用Titan 3.0测试符合纳入标准的正常中耳功能状态的新生儿中耳RF,统计分析其平均值、标准差、95%的参考值范围。结果:61例(103耳)3~21 d的新生儿的中耳RF均值为(283.32±37.87)Hz,95%的参考值范围209.09~357.55 Hz;3~7 d组、8~14 d组、15~21 d组间的中耳RF差异无统计学意义(P>0.05);且在性别、耳别及分娩方式间差异均无统计学意义(P>0.05)。结论:新生儿中耳RF的正常值低于学龄儿童及成人,提示该年龄阶段中耳正处于一个发育阶段。由于新生儿中耳RF正常值范围数值较低,如果出现中耳炎异常,其下降值有限,其应用于新生儿中耳疾病检测的敏感性和特异性有待进一步研究。
- 共振频率 /
- 中耳 /
- 新生儿
Abstract: Objective:This study aims at establishing normative resonance frequency(RF) data in healthy neonates with normal middle ear function in order to provide reference values for evaluation of neonatal middle ear function in babies who failed newborn hearing screening.Method:Normative resonance frequency(RF) data was tested by Titan3.0. The mean, standard deviation, 95% of the reference range were analyzed.Result:A total of 61 infants(103 ears) aging from 3-21 days were enrolled in the study. The average value of middle ear RF is(283.32±37.87) Hz, 95% of the reference range is(209.09,357.55)Hz. There was no statistically significant difference among the three age groups(P> 0.05) (Group Ⅰ:3-7 days; Group Ⅱ:8-14 days; Group Ⅲ:15-21 days). In addition, no significant differences(P>0.05) were found between the genders, the ears and the two delivery modes.Conclusion:The average value of middle ear RF in normal-hearing neonates is lower than that in schoolchildren and adults, suggesting that neonatal middle ear is still in the process of maturation. The low value of normative neonatal RF might reduce the clinical value of middle ear RF in terms of diagnosing otitis media due to the fact that the lower middle ear RF value in otitis media may overlap with the normal range in neonates. Further study needs to be done to address this question in the near future.
- resonance frequency /
- middle ear /
- neonate

HTML全文

参考文献(23)

[1]	HUNTER L L,FEENEY M P,LAPSLEY MILLER J A,et al.Wideband reflectance in newborns:normative regions and relationship to hearing-screening results[J].Ear Hear,2010,31:599-610.
[2]	AMERICAN ACADEMY OF PEDIATRICS,JOINT COMMITTEE ON INFANT HEARING.Year 2007position statement:Principles and guidelines for early hearing detection and intervention programs[J].Pediatrics,2007,120:898-921.
[3]	KEI J,ZHAO F.Assessing Middle Ear Function in Infants[M].1st ed.San Diego:Plural Publishing,2012:163-177.
[4]	SANFORD C A,KEEFE D H,LIU Y W,et al.Sound-conduction effects on distortion-product otoacoustic emission screening outcomes in newborn infants:test performance of wideband acoustic transfer functions and 1kHz tympanometry[J].Ear Hear,2009,30:635-652.
[5]	MARGOLIS R H,SCHACHERN P L,FULTON S.Multifrequency tympanometry and histopathology in chinchillas with experimentally produced middle earpathologies[J].Acta Otolaryngol,1998,118:216-225.
[6]	JACK K.Handbook of clinical audiology[M].5th ed.New York:Lippincott,Williams,and Wilkins,2001:175-202.
[7]	PROBST R.Audiological Evaluation of Patients with Otosclerosis[J].Adv Otorhinolaryngol,2007,65:119-126.
[8]	VLACHOU S,FEREKIDIS E,TSAKANIKOS M,et al.Prognostic value of multiple-frequency tympanometry in acute otitis media[J].ORL J Otorhinolaryngol Relat Spec,1999,61:195-200.
[9]	LYRA E SILVA KDE A,NOVAES BDE A,LEWIS D R,et al.Tympanometry in neonates with normal otoacoustic emissions:measurements and interpretation[J].Braz J Otorhinolaryngol,2007,73:633-639.
[10]	殷兰,吕建忠,夏文如,等.新生儿中耳多频率声导纳图[J].临床耳鼻咽喉科杂志,1992,6(3):135-140.
[11]	张劲,韩治国,陆金山,等.正常新生儿多频声导抗特征分析[J].听力学及言语疾病杂志,2011,19(6):518-521.
[12]	ANDRE K D,SANCHES S G,CARVALLO R M.Middle ear resonance in infants:Age effects[J].Int Arch Otorhinolaryngol,2012,16:353-357.
[13]	KEMP D T.Otoacoustic emissions,their origin in cochlear function,and use[J].Br Med Bull,2002,63:223-241.
[14]	KEI J,ZHAO F.Assessing Middle Ear Function in Infants[M].1st ed.San Diego:Plural Publishing,2012:17-37.
[15]	AITHAL S,KEI J,DRISCOLL C,et al.Normative wideband reflectance measures in healthy neonates[J].Int J Pediatr Otorhinolaryngol,2013,77:29-35.
[16]	AITHAL V,KEI J,DRISCOLL C,et al.Normative sweep frequency impedance measures in healthy neonates[J].J Am Acad Audiol,2014,25:343-354.
[17]	王昕,梁传余,LAHR S J.四川地区青年人鼓室导抗筛查的正常值[J].听力学及言语疾病杂志,2003,11(4):266-269.
[18]	邹剑,王恺,郑芸.儿童分泌性中耳炎声导抗测试结果分析[J].听力学及言语疾病杂志,2005,13(5):374-375.
[19]	刘志莹,刘辉,赵冀兵,等.多频率扫描声导抗测试对中耳病变的诊断价值[J].听力学及言语疾病杂志,2000,8(1):4-6.
[20]	周莲,彭皎皎,冯宁宇,等.共振频率对中耳病变的诊断意义[J].四川医学,2009,30(4):477-479.
[21]	赖丹,刘世喜.中耳共振频率对鼓室积液的诊断价值[J].临床耳鼻咽喉头颈外科杂志,2008,22(7):298-300.
[22]	KEI J,MAZLAN R,HICKSON L,et al.Measuring middle ear admittance in newborns using 1000 Hz tympanometry:a comparison of methodologies[J].J Am Acad Audiol,2007,18:739-748.
[23]	温瑞金,罗仁忠,王美芬.226Hz探测音下婴儿双峰型鼓室导抗图分析[J].听力学及言语疾病杂志,2003,11(3):209-210.