山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (4): 96-196.doi: 10.6040/j.issn.1673-3770.0.2024.219
• 论著 • 上一篇
张晓1,刘海红1,刘薇1,李颖1,陈敏1,刘冰1,白杰1,张杰1,郑军2,杨扬1
ZHANG Xiao1, LIU Haihong1, LIU Wei1, LI Ying1, CHEN Min1, LIU Bing1, BAI Jie1, ZHANG Jie1, ZHENG Jun2, YANG Yang1
摘要: 目的 探讨先天性单侧聋(single-sided deafness, SSD)患儿就诊原因/发现途径、听力学特点、影像学特点,归纳总结单侧聋患儿临床特点及干预策略。 方法 回顾性分析2020年6月至2022年6月间就诊于北京儿童医院耳鼻喉科诊断为先天性SSD患儿的临床资料,包括患儿一般资料、就诊原因/发现途径,听性脑干反应、纯音测听、耳蜗微音器电位(cochlear microphonics, CM)、耳声发射(otoacoustic emission, OAE)、声导抗等检查;颞骨CT和/或内听道MRI影像学检查,总结其临床特点,并对干预治疗的患儿进行随访。 结果 共112例患儿纳入本研究,其中男66例、女46例;左耳61例、右耳51例;0~13岁,中位数年龄 4岁6个月;OAE:聋耳均未引出;CM:38例聋耳可引出;对侧正常耳OAE、CM均正常引出;声导抗均为A型曲线;因新生儿听力筛查未通过就诊的患儿比例最高(41.1%);影像学显示结构异常75例(66.9%),其中比例最高为单纯蜗神经孔狭窄/蜗神经发育不良62例(82.7%);SSD患儿接受外科干预治疗2例,其中不伴蜗神经发育不良行人工耳蜗植入1例、伴蜗神经发育不良行骨桥植入1例。术后6个月,2例患儿均方根误差(root-mean-square error, RMSE)、定位偏侧BIAS值均有改善,声源定位能力提高。 结论 先天性单侧聋患儿内耳结构异常比例较高,以蜗神经孔狭窄/蜗神经发育不良多见。儿童单侧聋不易被发觉,应重视新生儿听力筛查与入园听力体检及定期听力检查,警惕预防潜在的交通事故风险发生。针对当前先天性SSD干预率极低的现状,应提高对疾病特点的认识,给予个体化、科学性干预。
中图分类号:
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