Establishment of Early Detection For Infantile Hearing Loss Using Distortion product otoacoustic emissions (DPOAEs)

本研究比较了畸变产物耳声发射（DPOAEs）和听性脑干反应（ABR）对新生儿（从重症监护病房的新生儿到青少年）听力损害的诊断价值，其中新生儿36例（67耳），儿童43例（62耳），成人10例（20耳）。DPOAE和ABR均在同一天进行。使用Scout（Bio-logic Co.）记录DPOAE。当ABR波V阈值为 * 45 dB HL（儿童和成人为 *35 dB）时，我们定义新生儿听力正常。(1)我们用DPOAE测定了DP的革兰氏噪声本底（NF），在成人中我们获得了所有频率的DPOAE，但由于本底噪声较高，在新生儿中不能获得f2=977 Hz的DPOAE，在听力正常的儿童中不能获得f2=537，684 Hz的DPOAE。DPOAE记录时间比ABR短36 min，（2）正常DPOAE在1416 ~ 7959 Hz的6个f2频率上，有4个频率达到DPOAE本底4dB;（3）ABR和DPOAAE正常阈值相同者占68.7%，差异者占6.0%。DPOAEs未在有分泌性中耳炎的儿童中获得，无论正常的ABR。我们的研究表明，DPOAIEs代表一个简单的程序，可以很容易地在新生儿重症监护室进行，以获得可靠的结果，在高危新生儿。DPOAIEs的结果与ABR的结果相当，DPOAE可用于听力损伤的检测。

This study compares the clinical usefulness of distortion product otoacoustic emissions (DPOAEs) with the auditory brainstem response (ABR) for children (from neonates in the neonatal intensive care unit to adolescents) for the evaluation of hearing impairment.Subjects were 36 neonates (67 ears), 43 children (62 ears) and 10 adults (20 ears). Both DPOAEs and ABR were performed on the same day. DPOAEs were recorded using the Scout (Bio-logic Co.). We defined neonates as having normal hearing when the thresholds of wave V of ABR were* 45 dB HL (*35 dB in children and adults). (1) We decided DP gram - noise floor (NF) with DPOAE.In adults we obtained DPOAEs in all frequencies, but could not obtain DPOAEs at f2=977 Hz in neonates and f2=537, 684 Hz in children with normal hearing because of high noise floors. DPOAE recording time was 36 minutes shorter than that of ABR ; (2) We defined as normal DPOAEs, the number of frequencies which showed the DPgram-noise floor*4 dB was *four at six f2 frequencies, from 1, 416 Hz to 7, 959 Hz ; (3) Normal thresholds of ABR and normal DPOAEs showed the same percentages, i.e. 68.7%, but the percentage of different results between ABR and DPOAIEs was 6.0%. DPOAEs were not obtained in children with otitis media with effusion regardless normal ABR.Our study indicates that DPOAIEs represent a simple procedure, which can be easily performed in the NICU to obtain reliable results in high risk neonates. Results obtained by DPOAIEs were comparable to those obtained by the more complex procedure of ABR.DPOAE can be useful for detecting of hearing impairments.