目的:本研究探讨了线性听性脑干反应(ABR)阈值在评估被诊断为听觉神经病变谱系障碍(ANSD)的儿童的听阈中的价值。
方法:共有20名患有ANSD的儿童(40耳,年龄1.5-7.0岁,中位年龄4.5岁)和31名患有感音神经性听力损失(SNHL)的儿童(52耳,0.9-8.0岁,中位年龄3.7岁)。此外,25名正常儿童(50耳,0.8-7.5岁,中位年龄4.6岁)作为对照。三组儿童同时进行Chirp-ABR和行为测听,允许比较通过两种方法获得的阈值。
结果:在ANSD儿童中,从Chirp-ABR获得的阈值与500-4000Hz的行为测听之间的相关性(r值)分别为0.84,0.67,0.59和0.60.在500-4000Hz下,两种方法之间的平均阈值差异在9.7至13.3dB的范围内。值得注意的是,20%的耳朵(8/40)在某些频率下表现出相当大的阈值差异(>30dB)。对于SNHL儿童,两种方法的r值分别为0.84,0.89,0.92和0.93.两种方法之间的平均阈值差异在500-4000Hz时为5.7-8.2dB。同样,在正常儿童中,两种方法之间的平均阈值差异范围为6.1dB至7.7dB,在500-4000Hz时,r值为0.81、0.78、0.80和0.80,分别。
结论:Chirp-ABR阈值不适用于预测ANSD儿童的行为测听阈值。当Chirp-ABR阈值和听力损失的行为测听阈值之间存在显著差异(>30dB)时,应高度怀疑ANSD。
OBJECTIVE: This study explored the value of Chirp-auditory brainstem response (ABR) thresholds in assessing the hearing threshold of children diagnosed with auditory neuropathy spectrum disorder (ANSD).
METHODS: A total of 20 children with ANSD (40 ears, aged 1.5-7.0 years, median age 4.5 years) and 31 children with sensorineural hearing loss (SNHL) (52 ears, aged 0.9-8.0 years, median age 3.7 years) were included. Besides, 25 normal children (50 ears, aged 0.8-7.5 years, median age 4.6 years) were used as controls. Chirp-ABR and behavioral audiometry were performed simultaneously among three groups of children, allowing for a comparison of the thresholds obtained through both methods.
RESULTS: In ANSD children, the correlation (r-values) between the thresholds obtained from Chirp-ABR and behavioral audiometry at 500-4000 Hz were 0.84, 0.67, 0.59, and 0.60, respectively. The average threshold differences between two methods ranged from 9.7 to 13.3 dB at 500-4000 Hz. Notably, 20 % ears (8/40) exhibited considerable discrepancies (>30 dB) in thresholds at certain frequencies. For SNHL children, the r-values between two methods were 0.84, 0.89, 0.92, and 0.93, respectively. The average threshold differences between two methods were 5.7-8.2 dB at 500-4000 Hz. Similarly, in normal children, the average threshold differences between two methods ranged from 6.1 dB to 7.7 dB, the r-values were 0.81, 0.78, 0.80, and 0.80 at 500-4000 Hz, respectively.
CONCLUSIONS: Chirp-ABR threshold is not suitable to predict the behavioral audiometry threshold in ANSD children. When there is a significant discrepancy (>30 dB) between Chirp-ABR thresholds and behavioral audiometry thresholds in hearing loss, ANSD should be highly suspected.