多频稳态听觉诱发电位在新生婴幼儿听力筛查中的作用

Function of auditory steady-state responses for newborns and infants hearing screening

关键词:  听力筛查  婴儿  听觉脑干诱发电位  多频稳态听觉诱发电位

Key words:  hearing screening  infant  auditory brain-stem response  auditory steady-state responses

摘要:

目的　探讨多频稳态听觉诱发电位（auditory steady-state responses, ASSR）在新生婴幼儿听力筛查中的作用。　方法　用短音诱发听觉脑干诱发电位（click-auditory brainstem responses, click-ABR）和ASSR，对已经通过听力筛查的婴幼儿进行听力测试，记录获得双耳客观听阈所需时间及ASSR在不同强度声音刺激下的引出率，并进行听力学跟踪随访至5岁。　结果　ASSR每个强度检测所需时间与click-ABR检测至该强度听阈所需时间相比有明显差异，可缩短8 min（P<0.05）。通过比较ASSR各强度引出率发现，强度越高引出率越高，50 dBSPL与60 dBSPL声强刺激引出率无明显差异（P>0.05），均＞85%，且明显高于40 dBSPL声强刺激引出率（P<0.05）。　结论　ASSR可快速准确检测双耳8个频率客观听阈，可以尝试以50 dBSPL声强刺激ASSR检测技术，进行新生婴幼儿听力筛查，用以弥补耳声发射和click-ABR听力筛查技术的不足。

Abstract:

Objective　To explore the function of auditory steady-state responses (ASSR) in the newborn infant hearing screening.　Methods　Using click-auditory brainstem responses (click-ABR ) and ASSR to test infants who have passed through hearing screening, record the time for obtaining the binaural hearing thresholds and the extraction rate of ASSR in different intensity of sound stimulus, and audiological follow-up to 5 years of age.　Results　ASSR can detect binaural 8 frequencies simultaneously therefore there was the obvious differences between the time required of each intensity of ASSR and the time required click-ABR detection to the intensity threshold .It can be shortened to 8 minutes for ASSR detection (P<0.05). By comparing the extraction rate of the ASSR intensity, it was found that the higher intensity the higher extraction rate was .It was no significant difference of the rate between 50 dBSPL and 60 dBSPL which sound intensity stimulation were greater than 85% (P>0.05), and significantly higher than the 40 dBSPL (P<0.05).　Conclusion　ASSR can be fast and accurate detection of binaural hearing thresholds of 8 frequency, we can try to use 50 dBSPL sound intensity stimulation of ASSR detection technology for new infants hearing screening, to compensate for the otoacoustic emission and click-ABR hearing screening technology.