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目的:通过回顾性比较分析极重度感音神经性聋患儿接受佩戴助听器和人工耳蜗植入手术2种不同干预方式人群的听力学评估参数,探讨极重度感音神经性聋患儿有效残余听力的临床判断方法。方法:选取听力学评估和言语康复训练资料完整的22例双耳极重度感音神经性聋患儿,其中10例佩戴助听器并接受超过3个月的言语康复训练,另外12例接受人工耳蜗植入手术,其中有10例年龄区间与佩戴助听器组一致。佩戴助听器组患儿,根据言语康复训练效果分为良好(7例)和较差(3例),分别统计其佩戴助听器前ASSR和听力言语康复训练期间裸耳纯音测听在500、1000、2000、4000Hz4个频点的听阈阈值情况。年龄与佩戴助听器组一致的10例接受人工耳蜗植入术患儿,根据术前有否佩戴助听器情况,分为曾佩戴助听器但听力言语康复效果差者(5例)和未接受佩戴助听器者(5例),分别统计其佩戴助听器前和(或)手术前的ASSR在500、1000、2000、4000Hz4个频点的听阈阈值情况。结果:①ASSR的阈值情况。佩戴助听器且言语康复训练效果良好的7例(14耳)患儿,平均每耳有2.71个频点可引出ASSR反应,所引出的ASSR平均阈值为(110.92±7.43)dBHL;佩戴助听器言语康复训练效果较差的3例患儿,再加上曾佩戴助听器但听力言语康复效果差而接受人工耳蜗植入术的5例,共8例(16耳),平均每耳只有1.06个频点可引出ASSR反应,所引出的ASSR平均阈值为(110.88±8.52)dBHL。②裸耳纯音测听情况。佩戴助听器且言语康复训练效果良好的7例(14耳)患儿,所测频点的平均听阈为(96.11±7.81)dBHL;其中,每耳平均有3个频率点的裸耳纯音测听阈值≤100dBHL。而在效果差的3例(6耳)患儿中,所测频点的平均听阈为(112.19±5.15)dBHL,裸耳纯音测听阈值≤100dBHL耳的数量为0。结论:500、1000、2000、4000Hz各频率引出ASSR的频点数量和裸耳纯音测听阈值≤100dBHL的数量,是临床上判断极重度感音神经性聋患儿有否存在可利用助听残余听力的有效指标。
OBJECTIVE: To retrospectively analyze the audiological assessment parameters of two groups of patients with severe sensorineural hearing loss wearing hearing aids and cochlear implants, and to explore the effective residual hearing ability in children with severe sensorineural hearing loss The clinical judgment method. Methods: A total of 22 children with severe bipolar hearing loss and severe hearing loss were enrolled in the Audiology assessment and speech rehabilitation training. 10 of them received hearing aid and received speech rehabilitation training for more than 3 months. Another 12 patients received cochlear implant Into surgery, of which 10 age range and wearing hearing aids group. Wearing hearing aid group children, according to speech rehabilitation training results were divided into good (7 cases) and poor (3 cases), respectively, statistics before wearing hearing aids ASSR and audition speech rehabilitation training naked ear pure tone audiometry at 500,1000,2000 , 4000Hz4 frequency threshold hearing threshold situation. According to whether there were preoperative hearing aids or not, 10 children with age and wearing hearing aids group were divided into children who had been wearing hearing aids but had poor hearing and speech rehabilitation effects (5 cases) and those who did not receive hearing aids 5 cases), respectively, before wearing hearing aids and (or) preoperative ASSR hearing threshold threshold at 500, 1000, 2000, 4000Hz frequency. Results: ① threshold value of ASSR. A total of 7 ears (14 ears) with hearing aids and good verbal rehabilitation training performed ASSR response with an average of 2.71 frequencies per ear, which led to an average ASSR threshold of (110.92 ± 7.43) dBHL; wearing hearing aids speech rehabilitation training In 3 cases with poor outcomes, 5 cases (16 ears) received cochlear implantation after wearing hearing aids but had poor hearing and speech rehabilitation skills, with an average of only 1.06 frequencies per ear ASSR reaction, the average ASSR derived threshold (110.88 ± 8.52) dBHL. ② naked ears audiometry situation. The mean hearing threshold was 96.11 ± 7.81 dBHL in 7 cases (14 ears) with hearing aid and good verbal rehabilitation training. Among them, there were 3 naked ears pure tone audiometry threshold ≤ 100dBHL. In 3 cases (6 ears) with poor effect, the average hearing threshold of measured frequency points was (112.19 ± 5.15) dBHL, and the number of pure ear audiometry thresholds ≤100 dBHL was 0. Conclusion: The frequency of ASSR and the number of pure ear audiometry audiometry threshold ≤100dBHL at each frequency of 500,1000,2000,4000Hz are clinically significant for hearing loss in hearing-impaired hearing-impaired children Effective indicators of hearing.