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目的通过对腭裂患者行畸变产物耳声发射(Distortion Product Oto-acoustic Emission,DPOAE)、声导抗测试(Acoustic Immittance Measurement,AIM)、听性脑干反应(Auditory Brainstem Response,ABR)研究,探讨这类患者临床听力学特点,以及性别、年龄、手术等因素对患者听力的影响。方法回顾分析256例腭裂患者(术前243例、术后13例)临床听力学数据。将术前2岁内患者174例按性别分为男、女组,所有术前者243例按年龄分为≤2岁组(A组)、>2岁≤6岁组(B组)、>6岁组(C组),术后≥5年者13例编为D组。DPOAE检查选择1818、2730、3616、5434Hz 4个频点有≥3个频点通过即为该耳通过。AIM以A型图为正常,其它类型均为异常。ABR阈值检查以能重复引出V波的最小刺激强度为ABR阈值,ABR阈值>35 dB nHL即为该耳异常。结果腭裂患者不同性别间DPOAE、AIM、ABR阈值无明显差异(P>0.05),A组DPOAE、AIM、ABR阈值较C组差异显著(P<0.05),A、B组DPOAE、ABR检查差异显著(P<0.05),AIM无明显差异(P>0.05),B、C组DPOAE差异显著(P<0.05),AIM、ABR阈值无明显差异(P>0.05)。C、D组年龄相仿,AIM、ABR检查示差异显著(P<0.05),A、B、C组DPOAE检查较ABR异常率高(P<0.05),差异具有统计学意义。结论腭裂患者不同性别间听力无明显差异,随着年龄的增长,腭裂患者听力呈自愈趋势,腭裂修复术能在一定程度上促进腭裂患者听力的恢复。DPOAE可以作为唇腭裂婴幼者听力检查的手段,但仍需进一步结合AIM及ABR检查,以明确听力损害水平及类型。
Objective To investigate the effects of Distortion Product Oto-acoustic Emission (DPOAE), Acoustic Immittance Measurement (AIM) and Auditory Brainstem Response (ABR) on patients with cleft palate. Clinical hearing characteristics of patients, as well as gender, age, surgery and other factors on the hearing of patients. Methods The clinical audiology data of 256 patients with cleft palate (243 cases before and after operation) were retrospectively analyzed. A total of 174 patients with 2-year-old were divided into male and female groups according to sex. 243 cases of all patients were divided into two groups according to their age: ≤2 years old (group A),> 2 years old≤6 years old (group B),> 6-year-old group (C group), 13 cases of ≥ 5 years after operation were classified as D group. DPOAE check selection 1818,2730,3616,5434Hz 4 frequency points have ≥ 3 frequency points that is through the ear. AIM A-type figure is normal, the other types are abnormal. The minimum stimulus intensity of the ABR threshold test to reproduce the V-wave is the ABR threshold, and the ABR threshold> 35 dB nHL is the ear abnormality. Results The thresholds of DPOAE, AIM and ABR were not significantly different between cleft and palate patients (P> 0.05). The DPOAE, AIM and ABR thresholds in group A were significantly higher than those in group C (P <0.05) (P <0.05). There was no significant difference in AIM (P> 0.05). There was significant difference in DPOAE between groups B and C (P <0.05). There was no significant difference between AIM and ABR (P> 0.05). There were significant differences in AIM and ABR (P <0.05) between groups C and D, and the DPOAE in groups A, B and C were higher than those in ABR (P <0.05). The differences were statistically significant. Conclusion There is no significant difference in hearing between cleft palate patients and different genders. With age, cleft palate patients tend to self-heal, cleft palate repair to a certain extent, promote the recovery of hearing in patients with cleft palate. DPOAE can be used as a hearing test for infants and young children with cleft lip and palate, but further combined AIM and ABR tests are needed to determine the level and type of hearing impairment.