Hearing screening of high-risk newborns with brainstem auditory evoked potentials: a follow-up study.
Hearing screening of high-risk newborns with brainstem auditory evoked potentials: a follow-up study.
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通过脑干听觉诱发电位对高危新生儿进行听力筛查：一项后续研究。
作者：
D. Shannon;Jacob K. Felix;Allan Krumholz;Phillip J. Goldstein;Kenneth C. Harris
许多技术已经被用来试图找到一种可靠和有效的筛查方法来确定新生儿的听觉功能。脑干听觉诱发电位(BAEP)是为此目的而倡导的最新方法。BAEP被评估为对168名年龄在35到45周之间的高危新生儿的听力筛查测试。其中134例(80%)在1年后(平均17.3个月)获得随访。正常听力被定义为双耳对25分贝正常听力水平(NHL)短声刺激的可重复性反应；21名婴儿(12.5%)未能通过初步筛查测试。随访19/21例，18例听力正常，1例双侧听力损失80dBNHL。一名筛查试验异常的婴儿在复查前死亡，另一名婴儿失去了随访，但只有单方面的BAEP异常。在BAEP筛查正常的婴儿中，没有一人在重新测试时有听力损失的证据。BAEP的敏感性为100%，特异性为86%，阳性预测值为5.26%，阴性预测值为100%。在我们的人口中，重大听力损失的发生率介于0.75%(1/134名婴儿确诊)和2.24%(3/134名婴儿)之间，包括未通过筛查但失去随访的婴儿。脑干听觉诱发电位是早期识别听力受损新生儿的敏感方法。然而，在使用BAEP进行新生儿听力筛查的其他研究中，显著听力异常的发生率低于其他研究。
Numerous techniques have been used in attempts to find a reliable and efficient screening method for determining auditory function in the newborn. The brainstem auditory evoked potential (BAEP) is the latest method advocated for that purpose. The BAEP was evaluated as a hearing screening test in 168 high-risk newborns between 35 and 45 weeks of conceptual age. Follow-up data were obtained after 1 year (mean 17.3 months) on 134 of the infants (80%). Normal hearing was defined as a reproducible response in both ears to a 25 dB normal hearing level (nHL) click stimulus; 21 infants (12.5%) failed the initial screening test. Follow-up on 19/21 infants revealed 18 infants with normal hearing and one infant with an 80 dB nHL bilateral hearing loss substantiated. One infant with an abnormal screening test died before retesting, and the other infant was lost to follow-up but had only a unilaterally abnormal BAEP. None of the infants with a normal BAEP screening study had evidence of hearing loss on retesting. Sensitivity of the BAEP was 100%, specificity was 86%, predictive value of a positive test was 5.26%, and the predictive value of a negative test was 100%. The incidence of significant hearing loss in our population was between 0.75% (1/134 infants) confirmed, and 2.24% (3/134 infants) including infants who failed screening but were lost to follow-up. The BAEP is a sensitive procedure for the early identification of hearing-impaired newborns. However, the yield of significant hearing abnormalities was less than predicted in other studies using BAEP for newborn hearing screening.