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目的分析腭裂患儿鼓室图、镫骨肌声反射和听性脑干反应(auditory brainstem besponse,ABR)检查的特点,探讨听力学检查对腭裂患儿的临床应用价值。方法采用中耳分析仪和听觉诱发电位仪测试,对40例(80耳)腭裂患儿进行听力学检查。结果鼓室图:B型37耳(46.25%),C型10耳(12.5%),A型22耳(27.5%),As型11耳(13.75%)。镫骨肌声反射:64耳(80%)消失,16耳(20%)存在。ABR结果:听力损失41耳(51.25%),均伴有V波潜伏期延长,其中鼓室图呈B型25耳(60.98%),C型9耳(21.95%)。此41耳中轻度听力损失21耳(51.22%),中度听力损失20耳(48.78%),无重度和极重度听力损失。80耳中V波潜伏期延长58耳(72.5%)。结论腭裂的解剖生理特点决定了患儿中耳炎的发病率较高。当鼓室图呈B型或C型曲线,同时出现ABR中V波听阈呈轻中度下降且V波潜伏期延长时,应高度警惕发生分泌性中耳炎,否则会严重影响患儿生活和学习。
Objective To analyze the characteristics of tympanogram, auditory brainstem response and auditory brainstem besponse (ABR) in pediatric patients with cleft palate and investigate the clinical value of audiological examination in children with cleft palate. Methods The middle ear analyzer and auditory evoked potentiometer were used to evaluate the hearing of 40 patients (80 ears) with cleft palate. Results Tympanogram: Type B 37 ears (46.25%), Type C 10 ears (12.5%), Type A 22 ears (27.5%), Type 11 ears (13.75%). Acoustic stapes reflex: 64 ears (80%) disappeared and 16 ears (20%) were present. ABR results: 41 ears (51.25%) had hearing loss, both of them had prolonged V wave latency. Tympanogram showed type B 25 ears (60.98%) and type C 9 ears (21.95%). The 41 ears had mild hearing loss of 21 ears (51.22%), moderate hearing loss of 20 ears (48.78%), no severe and severe hearing loss. The V-wave latency in 80 ears was prolonged by 58 ears (72.5%). Conclusion The anatomical and physiological characteristics of cleft palate determine the higher incidence of otitis media in children. When the tympanogram showed a B-type or C-type curve, while ABR V-wave threshold was mild to moderate decline and V wave latency, should be highly alert to the occurrence of secretory otitis media, otherwise it will seriously affect children’s life and learning.