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目的 比较畸变产物耳声发射(DPOAE)及听性脑干反应(ABR)技术应用在新生儿听力筛选的敏感性。方法 对在上海第二医科大学附属上海儿童医学中心重症监护病房的99名新生儿(198耳),采用DPOAE及ABR技术进行听力初筛、复筛、以及确诊。结果 在所有198耳检测DPOAE中,有54耳(27％)未通过初筛。经复筛仍有14耳(7％)未通过。另外,26耳(12％)未通过ABR初筛,对未通过ABR初筛的进行复查,仍有9耳(4.5％)未通过。最后经诊断性听性脑干反应及声导抗检查,确诊2例患重度感觉神经性聋,1例为双侧性,一例为单侧性。ABR和DPOAE听力筛查的敏感性分别为99％及97％。结论 ABR技术在新生儿听力筛查的敏感性略高于DPOAE方法。采用二次筛查方法,可提高听力筛查的感性。选择新生儿听力筛查技术,不但考虑筛查技术的敏感性,而且要综合考虑其方便性、快速性、以及成本。
Objective To compare the sensitivities of distortion product otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) to neonatal hearing screening. Methods Ninety-nine newborns (198 ears) in intensive care unit of Shanghai Children’s Medical Center affiliated to Shanghai Second Medical University were enrolled in this study. The primary hearing screening, re-screening and diagnosis were performed with DPOAE and ABR techniques. Results 54 ears (27%) of all 198 ears of DPOAE did not pass the primary screening. There were still 14 ears (7%) failed to pass the screening. In addition, 26 ears (12%) did not pass ABR screening, and 9 ears (4.5%) did not pass the screening for those who did not pass ABR screening. Finally, diagnosed by auditory brainstem response and acoustic impedance test, diagnosed 2 cases of severe sensory nerve deafness, 1 case of bilateral, one case of unilateral. The sensitivity of ABR and DPOAE hearing screening was 99% and 97% respectively. Conclusion The sensitivity of ABR in neonatal hearing screening is slightly higher than that of DPOAE. The use of secondary screening methods can improve the sensitivity of hearing screening. Choose newborn hearing screening technology, not only consider the sensitivity of screening technology, but also to consider its convenience, speed, and cost.