儿童单侧感音性听力损失的听力学及影像学特征149例分析

doi:10.6040/j.issn.1673-3770.0.2021.418

摘要/Abstract

摘要： 目的探讨儿童单侧感音性听力损失的听力学和影像学表现,分析其病因。方法回顾性分析149例1月龄~14岁的单侧感音性听力损失患者的就诊途径、听力学和颞骨影像学检查结果。结果 149例患者95.97%为重度、极重度听力损失,即单侧聋。38.26% 就诊患儿是由于听力筛查未通过被发现,20.13%患儿自觉单侧听力差就诊发现。影像学检查正常47例,异常102例,其中内耳结构/蜗神经发育异常96例(64.43%),颞骨骨折6例。结论儿童单侧感音性听力损失多为重度及极重度聋,影像学检查发现蜗神经发育异常及内耳发育异常比例较高,可认为儿童单侧感音性听力损失与先天发育异常关系密切,因此儿童单侧感音性听力损失患儿应常规行影像学检查以明确病因。

关键词: 单侧感音性听力损失, 儿童, 听力检查, 影像学

Abstract: Objective To analyze the clinical audiological data and imaging manifestations of unilateral sensorineural hearing loss(USHL)in children, and explore its etiology. Methods A total of 149 patients with USHL, aged from one month to 14 years, were analyzed retrospectively. Results 95.97% of the analyzed patients had severe or extremely severe hearing loss, namely single-sided deafness. 38.26% of the patients with USHL were detected through hearing examinations after their hearing screenings were not passed suffered from unilateral hearing loss as per the findings 20.13% children were found by perceiving unicat eral hearing loss. No obvious imaging abnormalities were found in 47 patients. Among the other 102 patients with imaging abnormalities, one had complete dysplasia(Michel malformation), one had dysplasia of the cochlea, and three had common cavity malformation. Two patients had dysplasia of the cochlea and seven patients had dysplasia of the cochlea. These included four patients with IP-Ⅰ malformation, two with IP-Ⅱ malformation, and one with IP-Ⅲ malformation. Seven patients had vestibular aqueduct enlargement, while 28 patients had bony internal auditory canal stenosis or cochlear foramina stenosis. One patient had internal auditory canal enlargement, while 46 patients had cochlear dysplasia, including 10 patients with cochlear nerve absence and 26 with cochlear nerve tenaciousness. Conclusion Most children with USHL experience severe and extremely severe deafness. The proportion of cochlear neurodysplasia and cochlear dysplasia are high in children with USHL. It is also closely related to congenital dysplasia. Therefore, routine temporal bone imaging examinations should be performed for children with USHL.

Key words: Unilateral sensorineural hearing loss, Children, Hearing examination, Imaging

中图分类号:

R764

胡春燕, 党攀红, 张睿, 樊孟耘. 儿童单侧感音性听力损失的听力学及影像学特征149例分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 31-36.

HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun. Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 31-36.

参考文献

[1] Anne S, Lieu JEC, Cohen MS. Speech and language consequences of unilateral hearing loss: asystematic review[J]. Otolaryngol Head Neck Surg, 2017, 157(4): 572-579. doi:10.1177/0194599817726326.
[2] 石颖, 李永新. 单侧耳聋患者人工耳蜗植入相关研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(12): 971-976. doi:10.13201/j.issn.1001-1781.2017.12.022. SHI Ying, LI Yongxin. Research progress on cochlear implantation in patients with unilateral deafness[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(12): 971-976. doi:10.13201/j.issn.1001-1781.2017.12.022.
[3] Lieu JEC, Tye-Murray N, Karzon RK, et al. Unilateral hearing loss is associated with worse speech-language scores in children[J]. Pediatrics, 2010, 125(6): e1348-e1355. doi:10.1542/peds.2009-2448.
[4] Greaver L, Eskridge H, Teagle HFB. Considerations for pediatric cochlear implant recipients with unilateral or asymmetric hearing loss: assessment, device fitting, and habilitation[J]. Am J Audiol, 2017, 26(2): 91-98. doi:10.1044/2016_AJA-16-0051.
[5] Sangen A, Royackers L, Desloovere C, et al. Single-sided deafness affects language and auditory development-a case-control study[J]. Clin Otolaryngol, 2017, 42(5): 979-987. doi:10.1111/coa.12826.
[6] Carew P, Mensah FK, Rance G, et al. Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection[J]. Child Care Health Dev, 2018, 44(1): 71-82. doi:10.1111/cch.12477.
[7] Friedmann DR, Ahmed OH, McMenomey SO, et al. Single-sided deafness cochlear implantation: candidacy, evaluation, and outcomes in children and adults[J]. Otol Neurotol, 2016, 37(2): e154-e160. doi:10.1097/MAO.0000000000000951.
[8] 王晓旭, 刘薇, 张杰. 儿童单侧耳聋的认识与诊治现状[J]. 中华耳科学杂志, 2020, 18(4): 658-662. doi:10.3969/j.issn.1672-2922.2020.04.005. WANG Xiaoxu, LIU Wei, ZHANG Jie. Recognition and diagnosis of single-side deafness in pediatric patients[J]. Chinese Journal of Otology, 2020, 18(4): 658-662. doi:10.3969/j.issn.1672-2922.2020.04.005.
[9] 沙炎,罗德红,李恒国. 头颈部影像学-耳鼻咽喉头颈外科卷[M]. 北京: 人民卫生出版社, 2014.
[10] Miyasaka M, Nosaka S, Morimoto N, et al. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve[J]. Pediatr Radiol, 2010, 40(9): 1509-1516. doi:10.1007/s00247-010-1609-7.
[11] Sennaroglu L, Bajin MD. Classification and current management of inner ear malformations[J]. Balkan Med J, 2017, 34(5): 397-411. doi:10.4274/balkanmedj.2017.0367.
[12] Vartiainen E, Karjalainen S. Prevalence and etiology of unilateral sensorineural hearing impairment in a Finnish childhood population[J]. Int J Pediatr Otorhinolaryngol, 1998, 43(3): 253-259. doi:10.1016/S0165-5876(98)00010-X.
[13] Fitzpatrick EM, Whittingham J, Durieux-Smith A. Mild bilateral and unilateral hearing loss in childhood: a 20-year view of hearing characteristics, and audiologic practices before and after newborn hearing screening[J]. Ear Hear, 2014, 35(1): 10-18. doi:10.1097/AUD.0b013e31829e1ed9.
[14] Lieu JEC. Permanent unilateral hearing loss(UHL)and childhood development[J]. Curr Otorhinolaryngol Rep, 2018, 6(1): 74-81. doi:10.1007/s40136-018-0185-5.
[15] Paul A, Marlin S, Parodi M, et al. Unilateral sensorineural hearing loss: medical context and etiology[J]. Audiol Neurootol, 2017, 22(2): 83-88. doi:10.1159/000474928.
[16] Taiji H, Morimoto N, Matsunaga T. Unilateral cochlear nerve hypoplasia in children with mild to moderate hearing loss[J]. Acta Otolaryngol, 2012, 132(11): 1160-1167. doi:10.3109/00016489.2012.696781.
[17] Kim SH, Choi HS, Han YE, et al. Diverse etiologies manifesting auditory neuropathy characteristics from infants with profound hearing loss and clinical implications[J]. Int J Pediatr Otorhinolaryngol, 2016, 86: 63-67. doi:10.1016/j.ijporl.2016.04.013.
[18] Miyasaka M, Nosaka S, Morimoto N, et al. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve[J]. Pediatr Radiol, 2010, 40(9): 1509-1516. doi:10.1007/s00247-010-1609-7.
[19] Clemmens CS, Guidi J, Caroff A, et al. Unilateralcochlear nerve deficiency in children[J]. Otolaryngol Head Neck Surg, 2013, 149(2): 318-325. doi:10.1177/0194599813487681.
[20] 梅玲, 陈向平, 杨军. 儿童单侧聋的发现途径及病因分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(16): 1252-1254.doi:10.13201/j.issn.1001-1781.2018.16.010. MEI Ling, CHEN Xiangping, YANG Jun. The study of detection and etiology of unilateral deafness in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(16): 1252-1254. doi:10.13201/j.issn.1001-1781.2018.16.010.
[21] 拱月, 魏兴梅, 李永新. 蜗神经发育不良患者人工耳蜗植入术前诊断与评估[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(10): 794-798. doi:10.13201/j.issn.1001-1781.2018.10.017. GONG Yue, WEI Xingmei, LI Yongxin. Preoperative diagnosis and evaluation of cochlear implantation in patients with cochlear nerve deficiency[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(10): 794-798. doi:10.13201/j.issn.1001-1781.2018.10.017.
[22] Cama E, Inches I, Muzzi E, et al. Temporal bone high-resolution computed tomography in non-syndromic unilateral hearing loss in children[J]. ORL, 2012, 74(2): 70-77. doi:10.1159/000335586.
[23] Masuda S, Usui S, Matsunaga T. High prevalence of inner-ear and/or internal auditory canal malformations in children with unilateral sensorineural hearing loss[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(2): 228-232. doi:10.1016/j.ijporl.2012.11.001.
[24] Tebruegge M, Curtis N. Epidemiology, etiology, pathogenesis, and diagnosis of recurrent bacterial meningitis[J]. Clin Microbiol Rev, 2008, 21(3): 519-537. doi:10.1128/CMR.00009-08.
[25] Kivekäs I, Vasama JP, Weitz-Tuoretmaa A, et al. Unilateral common cavity deformity: recurrent meningitis due to insufficient newborn hearing screening[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(6): 926-928. doi:10.1016/j.ijporl.2015.03.013.
[26] van Zon A, Peters JPM, Stegeman I, et al. Cochlear implantation for patients with single-sided deafness or asymmetrical hearing loss: a systematic review of the evidence[J]. Otol Neurotol, 2015, 36(2): 209-219. doi:10.1097/MAO.0000000000000681.

相关文章 15

[1]	朱希倩,王佳,孙祖贤,冯建秀,张梦佳,赵颖,王宏,姜敏敏. 上海市杨浦区2022—2024年6~9岁学龄儿童屈光状态分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 102-109.
[2]	宋艳玲,司元元,崔彦. 微量玻璃体切除治疗激光笔致儿童全层黄斑裂孔1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 144-147.
[3]	刘南仙,杨泽垠,韩琳,张爱英,赵宇亮,薛静,孙怡君,邵永良. 视频脑电图在儿童复发性眩晕诊断中的意义[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 20-25.
[4]	黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[5]	王华,张丰珍,龙婷,赵靖,李宏彬,王生才,王桂香. 后颅窝肿瘤术后儿童气管切开原因及预后转归分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 168-173.
[6]	乐冰艳,邹剑,雷蕾,文巧,钱应雪. 儿童扁桃体微生物群与免疫调节及疾病关联[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 193-200.
[7]	黄爱萍,王娟,王丽,耿江桥,王亚芳,温鑫. 儿童原发扁桃体Burkitt淋巴瘤累及上颌骨和肺1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 148-152.
[8]	刘畅,杨景朴,高雨,王文佳. 长春地区儿童变应性鼻炎变应原检测结果分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 51-58.
[9]	付圣尧,陈敏,庞文会,李娜. 内镜辅助个体化手术入路治疗儿童鼻中线囊肿及瘘管[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 65-71.
[10]	陈丹萍,何子键,虞幼军,周晓娓. 儿童突发性聋10年住院病例的疗效及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 16-22.
[11]	杨娜,柳荫,郭宝,纪尧峰,成晨,张琛,董丽娜. 高频超声在儿童鼻骨骨折闭合复位术的应用研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 41-45.
[12]	王登茂,温鑫,耿江桥,张光远,刘晓峰. 儿童咽鼓管毛息肉合并鼻咽部错构瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 105-109.
[13]	姚婷婷,张德伦,李兰. 婴儿下咽部胃黏膜异位症引发咽喉反流症状1例并文献回顾[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 126-130.
[14]	罗露,周恩,肖旭平,林志强,方志杰,吕晓虹. 等离子点状激发技术在儿童OSA扁桃体腺样体切除术联合围手术期快速康复中的应用[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 26-30.
[15]	沈嘉琪,李潇飒,毕燕龙,张敬法. 人工智能在DME筛查、诊断和预后中的应用[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 153-159.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed