听性脑干反应与多频稳态反应联合评估非综合征型婴幼儿腭裂患儿听力损失的相关性
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湖南省儿童医院

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湖南省出生缺陷协同防治科技重大专项(编号:2019SK1015)


Correlation Analysis of Hearing Loss in Non-Syndromic Infants with Cleft Palate Using Combined Auditory Brainstem Response and Multiple Frequency Steady-State Response Assessment
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1.Hunan Children'2.'3.s Hospital

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    摘要:

    目的:探讨非综合征型腭裂患儿(Non-syndromic cleft palate, NSCP)婴幼儿传导性听力损失的严重程度,并观察短声听性脑干反应(click auditory brainstem response,c-ABR)与多频稳态反应(auditory steady-state response,ASSR)联合评估非综合征型婴幼儿腭裂患儿传导性听力损失的相关性。 方法:回顾性分析2017年1月至2023年12月确诊的36月龄以下无法配合行为测听NSCP传导性听力损失严重程度,根据c-ABR检测中V波阈值判断严重程度,同时结合ASSR判断此类患儿听力损失频率损失分布,采用通过Spearman系数评估c-ABR与ASSR的相关性,并依据年龄、性别、腭裂程度进行分组比较。 结果:本研究筛选了588例NSCP,最终纳入330例(660耳),其中男婴103例,女婴227例。根据c-ABR将听力损失严重程度分为正常(118耳)、轻(442耳)、中(100耳)。以ASSR的结果补充低频听力,其中0.5KHz的未引出率较高。整体分析ABR与ASSR阈值相关性为2KHz相关性最高(r=0.359),按年龄分组,婴儿期患儿ABR与ASSR阈值相关性为1KHz相关性最高(r=0.350),幼儿期为2KHz相关性最高(r均为0.433);以性别与腭裂程度划分,ABR 与 ASSR 阈值均在 2 kHz 呈现一致且显著的相关性,其中,女性r值为0.386,男性为0.255;腭裂程度II度r=0.331,但III度为0.747。以上相关性均具有显著性(P< 0.01),但相关性相对较弱(r<0.5)。 结论:c-ABR与ASSR是NSCP听力学评估的重要工具,有助于NSCP传导性听力损失的早期诊断与干预,其中需重视0.5KHz的听力补充检查。另虽腭裂程度为III度ABR和ASSR高度相关,但整体相关性较弱,在临床检测中仍需互相补充,二者联合应用可更准确的评估NSCP。

    Abstract:

    Objective To investigate the severity of conductive hearing loss in infants with non-syndromic cleft palate (NSCP) and to evaluate the correlation between click auditory brainstem response (ABR) and auditory steady-state response (ASSR) in assessing conductive hearing loss in these patients. Methods A retrospective analysis was conducted on NSCP patients under 36 months of age diagnosed with conductive hearing loss who were unable to cooperate with behavioral audiometry between January 2017 and December 2023. The severity of hearing loss was determined based on the V-wave threshold in c-ABR testing, while ASSR was used to assess the frequency distribution of hearing loss. The correlation between c-ABR and ASSR was evaluated using Spearman's coefficient, with comparative analysis based on age, gender, and cleft severity. Results Among 588 screened NSCP cases, 330 cases (660 ears) were included, comprising 103 male and 227 female infants. Based on c-ABR results, hearing loss severity was categorized as normal (118 ears), mild (442 ears), and moderate (100 ears). ASSR supplementation revealed a higher non-response rate at 0.5KHz. The overall analysis showed the highest correlation between ABR and ASSR thresholds at 2KHz (r=0.359). Age-stratified analysis demonstrated the highest correlation at 1KHz (r=0.350) in infancy and at 2KHz (r=0.433) in early childhood. Gender and cleft severity analysis revealed consistent and significant correlations at 2KHz, with female (r=0.386), male (r=0.255), cleft degree II (r=0.331), and cleft degree III (r=0.747). All correlations were statistically significant (P<0.01) but relatively weak (r<0.5). Conclusion c-ABR and ASSR are essential tools for audiological assessment in NSCP, facilitating early diagnosis and intervention of conductive hearing loss. Particular attention should be paid to 0.5KHz hearing supplementation. Although ABR and ASSR show high correlation in degree III cleft cases, their overall correlation remains weak, necessitating complementary use in clinical assessments. The combined application of both methods enables more accurate evaluation of NSCP.

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  • 收稿日期:2025-08-06
  • 最后修改日期:2025-11-03
  • 录用日期:2025-11-13
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