低龄幼儿人工耳蜗植入后对侧耳继续佩戴助听器的听力学依据

杨烨; 高珺岩; 钱晓云; 管莹; 曹永晖; 赵宁; 黄杰; 高下

doi:10.13201/j.issn.1001-1781.2018.11.010

低龄幼儿人工耳蜗植入后对侧耳继续佩戴助听器的听力学依据

- 1. 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科江苏省医学重点学科南京鼓楼医院耳鼻咽喉研究所(南京, 210008);
- 2. 江苏省听力语言康复中心;
- 3. 南京大学医学院附属鼓楼医院医学信息科
基金项目:
江苏省科教强卫工程项目（No：ZDXKB2016015）；南京市卫生青年人才培训工程项目（第1层次）（No：QRX17012）；江苏省第14批"六大人才高峰"高层次人才项目（No：YY-073）

详细信息

通讯作者: 高下,E-mail:xiagaogao@hotmail.com

中图分类号: R764.43

收稿日期: 2018-03-22

Audiological basis of continuing to wear hearing aids in the contralateral ear of young children after cochlear implantation

- 1. Department of Otolaryngology Head and Neck Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Research Institute of Otolaryngology, Nanjing, 210008, China;
- 2. Jiangsu Rehabilitation Center for Hearing and Speech Impairment;
- 3. Department of Information, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School

More Information

Corresponding author: GAO Xia, E-mail: xiagaogao@hotmail.com

Received Date: 22 March 2018

摘要

摘要: 目的：研究以人工耳蜗植入术前多频稳态（ASSR）结果预估行为听阈的准确性，评估极重度聋的低龄幼儿在术后非手术耳继续佩戴助听器的听力基础。方法：选择手术时年龄<2岁的患儿作为研究对象，记录术前常规听力检查项目中ASSR的结果，测试频率为0.5、1.0、2.0及4.0 kHz，至患儿年龄超过3岁时进行游戏测听获得非手术耳的行为听阈，测试频率同为0.5、1.0、2.0及4.0 kHz，共纳入179例配合度较好、结果数据可靠的患儿，对所有患儿的非手术耳术前ASSR反应阈与年长后所得的相应频率行为听阈进行统计学比较。结果：各载波频率上ASSR反应阈与对应频率行为听阈差异均有统计学意义（P<0.01），后者均优于前者；0.5、1.0、2.0、4.0 kHz ASSR反应阈对应的行为测听预测率分别为49.7%、70.9%、59.2%和60.9%；各频率均存在ASSR未引出但有行为听阈的情况，分别占各频率ASSR未引出总数的比率为83.3%、75.5%、64.9%和45.1%，以0.5 kHz为最高。结论：鉴于极重度聋的低龄幼儿术前ASSR反应阈与年长后所得行为听阈存在偏差，低频较为显著，尤其是ASSR未引出时仍可能存在可测听阈，因此建议低龄极重度聋幼儿在人工耳蜗植入术后，对侧耳仍然继续佩戴助听器，待能够完成行为测听后再行判断是否继续使用助听器，以免错失双耳双模式助听时机。
- 聋 /
- 多频稳态 /
- 行为测听 /
- 耳蜗植入术 /
- 助听器
Abstract: Objective: To study the accuracy of preoperative-ASSR in predicting behavioral thresholds of children at low age with profound hearing loss and to evaluate the feasibility of using hearing aids in non-operating ear after the cochlear implantation. Method: Children aged less than 2 years old at the time of surgery were selected as study subjects. The preoperative ASSR response threshold in 0.5, 1.0, 2.0 and 4.0 kHz were recorded. The play audiometry test was used to get the non operative ear behavioral thresholds of the children after three years old. Altogether 179 children with good cooperation and reliable results were enrolled in this study. The results of behavioral thresholds were made a comparison with the results of ASSR response threshold with corresponding frequency before operation for statistical analysis. Result: The behavioral threshold is better than corresponding ASSR response threshold with significant differences (P<0.01). Prediction rates of ASSR response threshold corresponding to behavioral thresholds from 0.5 kHz to 4.0 kHz are 49.7%, 70.9%, 59.2% and 60.9%. There are cases at all frequencies where ASSR showed no reaction but a behavioral thresholds were detected. The proportions of undrawn ASSR reaction at each frequency were 83.3%,75.5%,64.9%,45.1%.Conclusion: In profound hearing loss, the deviation between preoperative ASSR response thresholds and postoperative behavioral thresholds exists, especially in low frequency. No ASSR reaction in clinic cannot represent that there is no measurable hearing threshold. We suggest children at low age continue to wear hearing aids in the non operative ear after cochlear implantation. Whether to give up hearing aids should be judged after gaining the behavioral audiometry to avoid missing the bimodal opportunity.
- deafness /
- audio steady-state response /
- behavioral audiometry /
- cochlear implantation /
- hearing aids

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