The audiological characteristics of large vestibular aqueduct syndrome in infants and young children
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摘要: 目的:回顾性分析大前庭水管综合征患儿的临床听力学检测结果,探讨其听力学检测"异常征兆",提示检测人员及临床医生及时排查大前庭水管综合征,为早期诊断提供帮助。方法:124例大前庭水管综合征患儿,通过颞骨CT或内耳MRI及声导抗测试排除中耳异常,入组248耳,对患儿行听性脑干反应、小儿行为测听和(或)听性稳态反应测试,分析其听力曲线类型、听力损失程度、声诱发短潜伏期负反应和ABR骨导与气导反应阈差值。结果:①248耳听力曲线类型分布:高频下降型44.8%(111/248),平坦型19.0%(47/248),上升型13.7%(34/248),U型3.6%(9/248)和无法判别19.0%(47/248);②听力损失程度分布:极重度73.4%(182/248),重度16.9%(42/248),中度6.9%(17/248)和轻度2.8%(7/248);③ABR测试中出现声诱发短潜伏期负反应占27.4%(68/248);④出现ABR骨导与气导反应阈差值占24.6%(61/248),平均差值为(19.3±14.2) dB nHL。结论:听力学检测中出现高频下降型听力损失、ABR测试中声诱发短潜伏期负反应和骨导及气导反应阈差值等"异常征兆"时,检测人员与临床医生应及时排查大前庭水管综合征。
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关键词:
- 大前庭水管综合征 /
- 听力损失 /
- 听力曲线 /
- 骨导、气导ABR反应阈值
Abstract: Objective: To investigate the audiological characteristics of large vestibular aqueduct syndrome(LVAS) in infants and young children, and to provide suggestion for the early diagnosis and early intervention.Method: One hundred and twenty-four cases diagnosed as LVAS were enrolled in our study. Acoustic immittance, pediatric audiometry and(or) auditory steady-state responses and auditory brainstem response test were tested to analyze the degree and configuration of hearing loss, and air-bone threshold difference and short latency negative response in auditory brainstem response.Result: The configuration of the hearing loss, includes 44.8%(111/248) of high frequency loss, 19.0%(47/248) of flat, 13.7%(34/248) of rising, 3.6%(9/248) of U type, and 19.0%(47/248) of the configuration which cannot be distinguished. The distribution of the degree of the hearing loss in total 124 cases (248 ears) includes 73.4%(182/248) of profound hearing loss, 16.9%(42/248) of severe hearing loss, 6.9%(17/248) of moderate hearing loss, and 2.8%(7/248)of mild hearing loss. The acoustically evoked short latency negative response in ABR accounted for 27.4%(68/248). The emergence of ABR air-bone threshold difference accounted for 24.6%(61/248), and the mean difference was(19.3±14.2) dB nHL.Conclusion: Infants and young children with large vestibular aqueduct syndrome mostly has the characteristics of high frequency hearing loss curve, acoustically evoked short latency negative response in ABR and ABR bone-air threshold difference, that will remind clinicians of LVAS. -
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