PDF(Pubmed)
Abstract：
With widespread agreement on the importance of early identification of hearing loss, universal newborn hearing screening (UNHS) has become the standard of care in several countries. Despite advancements in screening technology, UNHS and early hearing detection and intervention programs continue to be burdened by high referral rates of false-positive cases due to temporary obstruction of sound in the outer/middle ear at birth. A sensitive adjunct test of middle ear at the time of screening would aid in the interpretation of screening outcomes, minimize unnecessary rescreens, and prioritize referral to diagnostic assessment for infants with permanent congenital hearing loss. Determination of middle ear status is also an important aspect of diagnostic assessment in infants. Standard single-frequency tympanometry used to determine middle ear status in infants is neither efficient nor accurate in newborns and young infants. A growing body of research has demonstrated the utility of wideband acoustic immittance (WAI) testing in both screening and diagnostic settings. Wideband power absorbance (WBA), a WAI measure, has been shown to be more sensitive than tympanometry in the assessment of outer/middle ear function in newborns. Furthermore, age-graded norms also support successful application of WBA in young infants. Despite its merits, uptake of this technology is low among pediatric audiologists and hearing screening health workers. This report describes normative data, methods for assessment and interpretation of WBA, test-retest variations, and other factors pertinent to clinical use of WAI in newborns and infants. Clinical cases illustrate the use of WAI testing in newborn and infant hearing assessment.
摘要：
人们普遍同意早期识别听力损失的重要性，通用新生儿听力筛查（UNHS）已成为几个国家的护理标准。尽管筛查技术有了进步，由于出生时外耳/中耳的声音暂时阻塞，UNHS和早期听力检测和干预计划继续受到假阳性病例高转诊率的困扰。筛查时对中耳进行敏感的辅助测试将有助于解释筛查结果，尽量减少不必要的重新筛选，并优先考虑对患有永久性先天性听力损失的婴儿进行诊断评估。中耳状态的确定也是婴儿诊断评估的重要方面。用于确定婴儿中耳状态的标准单频鼓室测定法在新生儿和幼儿中既不有效也不准确。越来越多的研究证明了宽带声导抗（WAI）测试在筛查和诊断环境中的实用性。宽带功率吸收(WBA),WAI措施，在评估新生儿的外耳/中耳功能方面，已被证明比鼓室法更敏感。此外，年龄分级标准也支持在小婴儿中成功应用WBA.尽管有其优点,在儿科听力学家和听力筛查卫生工作者中，这项技术的使用率很低。这份报告描述了规范数据，WBA的评估和解释方法，测试-重测变化，以及与新生儿和婴儿临床使用WAI相关的其他因素。临床病例说明了WAI测试在新生儿和婴儿听力评估中的应用。
