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目的综合评估外周性脑积水伴感音神经性聋小儿临床听力学特点及选择适宜的听力评估参数。方法选取我院神经康复科住院患儿,年龄不超过2岁,听觉脑干诱发电位(ABR)波V阈值≥50dBHL且排除中耳功能异常,并经神经康复科医师综合评估确诊为外周性脑积水者57例95耳,平均年龄7.21个月。入选的小儿,根据ABR波V阈值的不同分为二组:波V阈值<80dBHL组和波V阈值≥80dBHL组。另设同年龄段正常对照组。各组受试者均进行畸变产物耳声发射(DPOAE)的测试。结果外周性脑积水患儿ABR波V阈值<80dBHL耳所占比例高达78.95%;各组间的DPOAE检出率无显著性差异;波V阈值<80dBHL组和≥80dBHL组的DPOAE异常率分别为21.33%和35%,二者的差异有显著性意义;波V阈值<80dBHL组和≥80dBHL组与正常对照组的DPOAE幅值存在显著性差异;但前二者间的DPOAE幅值则无显著性差异。结论外周性脑积水主要表现为轻中度的听力损害;听觉系统受损部位主要表现在蜗后,但也有一小部分的耳蜗功能受损;在评估外周性脑积水患儿听力的参数中,ABR波V阈值与DPOAE异常率更能准确反映外周性脑积水听力损失的听力学特点。
Objective To comprehensively evaluate the clinical audiological features of peripheral hydrocephalus with sensorineural deafness and to select suitable hearing evaluation parameters. Methods Children hospitalized in neurology and rehabilitation department of our hospital were selected and their age was less than 2 years old. The ABR wave threshold (V threshold) ≥50dBHL and exclusion of middle ear dysfunction were diagnosed as peripheral brain by the comprehensive evaluation of neuro-rehabilitative physicians 57 cases of 95 patients with water, the average age of 7.21 months. The selected children were divided into two groups according to the ABR wave V threshold: wave V threshold <80dBHL group and wave V threshold ≥80dBHL group. Another set the same age group normal control group. Subjects in each group were tested for distortion product otoacoustic emissions (DPOAE). Results The frequency of ABR wave V wave was less than 80dBHL in children with peripheral hydrocephalus as high as 78.95%. There was no significant difference in the detection rate of DPOAE among the groups. The abnormal rate of DPOAE in wave V threshold <80dBHL group and ≥80dBHL group 21.33% and 35%, respectively. There was a significant difference between the two groups in the amplitude of DPOAE. There was a significant difference in DPOAE amplitude between wave V threshold <80dBHL group and ≥80dBHL group and normal control group; Significant difference. Conclusion Peripheral hydrocephalus mainly manifests as mild to moderate hearing impairment. The damaged parts of auditory system mainly appear after cochlea, but a small part of cochlear function is impaired. In evaluating the hearing parameters of children with peripheral hydrocephalus , ABR wave V threshold and DPOAE abnormal rate more accurately reflect the auditory characteristics of peripheral hearing loss of hydrocephalus.