Audiology characteristics in newborns and infants who failed in the hearing screening by transiently evoked otoacoustic emissions: 89 cases study / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The present study was to evaluate the audiological characteristics of infants with normal auditory brainstem response thresholds in click and abnormal transiently evoked otoacoustic emissions. Relationships between test results of distortion product otoacoustic emissions (DPOAE) and other hearing testing methods were also evaluated.</p><p><b>METHODS</b>The participants consisted of eighty-nine infants, with a total of 123 ears. All participants' TEOAE screening results were abnormal but diagnostic click ABR results were normal. The participants were classified into the following groups based on the test results from distortion product otoacoustic emissions: group A (normal all-frequency), group B (abnormal low-frequency), group C (abnormal high-frequency), and group D (abnormal all-frequency).</p><p><b>RESULTS</b>Obtained from these groups were compared to results of other hearing tests including the latency of ABR wave I, 40 Hz auditory event related potential (40 Hz AERP), 226 Hz and 1000 Hz tympanometry, and acoustic reflex. Results In six hearing tests in the 123 ears, seven ears (5.7%) were normal, while 116 ears (94.3%) were abnormal. No significantly differences were detected between boys (93.9%) and girls (95.1%), as well as between left (93.1%) and right ears (95.4%). The proportion of abnormal test results ranked as follows: 59 ears in group D (48.0%), 34 ears in group B (27.6%), 20 ears in group A (16.3%), and 10 ears in group C (8.2%). The highest abnormal rates in groups A, B and D were acoustic reflex, which were 40.0% for group A, 55.9% for group B and 66.1% for group D respectively. The highest abnormal rate in group C was the latency of ABR wave I (50.0%). Distribution of low-frequency hearing loss in each group was mainly mild. However, one ear in group B was moderate hearing loss, six ears in group D were moderate hearing loss, and one ear in group D was severe hearing loss.</p><p><b>CONCLUSIONS</b>The present study showed that, of which infants with normal thresholds of ABR failed the hearing screening, comprehensively audiology assessment is needed. And of which infants with normal DPOAE in full frequency or abnormal in high frequency region or low frequency region need to be followed up.</p>

Comparison of sensitivity of audiological tests to identify otitis media with effusion in newborn infants / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the sensitive factors which were used in routine audiological tests to find out otitis media with effusion (OME) in newborn infants.</p><p><b>METHODS</b>Subjects of this study were 48 infants, including 31 males and 17 females, who failed in the universal newborn hearing screening. The age ranged from 1.5 to 12 months with the average age of 4.3 months. All subjects accepted temporal bone CT and routine audiological assessments, including air-conduction and bone-conduction auditory brainstem response (ABR), 40 Hz-auditory event related potential (40 Hz-AERP), distortion-product otoacoustic emission (DPOAE), acoustic reflex, tympanometries using 226 Hz and 1000 Hz probe tone. Nine factors were statistically analyzed using Kappa test, Univariate chi(2) test and multivariate condition Logistic stepwise regression analysis, which included the results of acoustic immittance, the air-conduction and bone-conduction ABR thresholds, the difference between air-conduction and bone-conduction ABR thresholds, the latency of ABR wave I, duration between ABR wave I and V, 40 Hz-AERP thresholds, amplitudes and thresholds of DPOAE, and acoustic reflex thresholds (ART).</p><p><b>RESULTS</b>Seventy-seven ears were diagnosed with OME, and 19 ears were normal. CT scan of temporal bone was set as a comparative standard. Kappa test indicated that the results of tympanometry with 1000 Hz probe tone (Kappa = 0.745, P < 0.001), the air-conduction ABR threshold (Kappa = 0.453, P < 0.001), the latency of ABR wave I (Kappa = 0.430, P < 0.001), the threshold of 40 Hz-AERP (Kappa = 0.582, P < 0.001), and DPOAE (Kappa = 0.495, P < 0.001) had agreement with the results of temporal bone CT on evaluating the function of middle ear. Univariate analysis indicated that sensitive factors of middle ear function in newborn infants were tympanometry with 1000 Hz probe tone (P < 0.001), ART (P < 0.001), the air-conduction ABR threshold (P < 0.001), the difference between air-conduction and bone-conduction ABR thresholds (P < 0.001), the latency of ABR wave I (P < 0.001), the threshold of 40 Hz-AERP (P < 0.001) and DPOAE (P < 0.001). And multivariate conditional Logistic stepwise regression model showed that tympanometry with 1000 Hz probe tone (P < 0.001) and 40 Hz-AERP threshold (P = 0.004) can be substituted into Logistic stepwise regression equation.</p><p><b>CONCLUSIONS</b>Tympanometry with 1000 Hz probe tone and are sensitive factors to find out OME in newborn infants. The air conduction ABR threshold, ABR wave I latency, 40 Hz-AERP threshold and DPOAE could reflect the middle ear function of newborn infants effectively.</p>

Outcome of cochlear implantation in prelingual pediatric auditory neuropathy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the electrophysiological results and rehabilitation outcome of two prelingually deafened pediatric cochlear implant patients with auditory neuropathy.</p><p><b>METHODS</b>Preoperative audiological evaluation, intra-postoperative electrically evoked auditory brainstem response (EABR) and neural response telemetry (NRT) record for the two cases were conducted in Beijing Tongren Hospital. A one year follow-up was performed. Data collected before and at 6,12-month intervals after implantation were compared with that from control pediatric cochlear implant patients matched for the same duration of implant use as this two cases.</p><p><b>RESULTS</b>The two children implanted had not had any postoperative medical or cochlear implant device complications. Intraoperative EABR and NRT were elicited in case 1 with unrepeatable waveforms. After 12 months of training, Case 1 had shown significant improvements in sound detection, speech perception abilities and communication skills, which was better than the control group, and the electrophysiological results became normal. Case 2 had also benefited from cochlear implantation, even though no recognizable NRT was found until he returned 12 month after the operation. CONTUSIONS: The desynchronization of auditory path had been changed after the electrical stimulation ongoing 12 months for children with auditory neuropathy. The two children had not had any complications postoperatively, and each child had shown improved listening and communication skills. Cochlear implantation could help patients with auditory neuropathy to improve their communication skill and go back to the main stream.</p>

Computer assisted application of mandarin speech test materials / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To design an intelligent speech test system with reliability and convenience using the computer software and to evaluate this system.</p><p><b>METHODS</b>First, the intelligent system was designed by the Delphi program language. Second, the seven monosyllabic word lists recorded on CD were separated by Cool Edit Pro v2.1 software and put into the system as test materials. Finally, the intelligent system was used to evaluate the equivalence of difficulty between seven lists. Fifty-five college students with normal hearing participated in the study.</p><p><b>RESULTS</b>The seven monosyllabic word lists had equivalent difficulty (F = 1.582, P > 0.05) to the subjects between each other and the system was proved as reliability and convenience.</p><p><b>CONCLUSIONS</b>The intelligent system has the feasibility in the clinical practice.</p>

A comparison study of two different segmentation methods to measure intelligibility in Mandarin / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To confirm alternative methods for Mandarin hearing in noise test (MHINT) to get the performance-intensity (PI) function, and to set up right test rules for scoring sentence intelligibility for subjects.</p><p><b>METHODS</b>Sentence speech reception thresholds were obtained for 30 normally hearing subjects with the MHINT test using several adaptive rules based on either character or word segmentation of the sentences. Each adaptive rule was intended to measure the threshold at a different point on the PI function. By also measuring sentence intelligibility at each threshold, the accuracy with which the PI function was estimated could be evaluated for each type of segmentation. The results of different segmentation were compared.</p><p><b>RESULTS</b>There was no significant difference in the reception threshold of sentences (RTS) between the group which used character segmentation and the group which used word segmentation (P > 0.05); and also no significant difference in their speech recognition score (SRS, P > 0.05). When the same subject used both character segmentation and word segmentation to do the test, there was no significant difference in their RTS between character segmentation and word segmentation (P > 0.05); and also no significant difference in their SRS (P > 0.05).</p><p><b>CONCLUSIONS</b>This method could be used not only with normally hearing individuals and people with hearing loss to evaluate their sentence intelligibility, but also with people who had aided equipment.</p>

Development and equivalence evaluation of spondee lists of mandarin speech test materials / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To edit the spondee (disyllable) word lists as a part of mandarin speech test materials (MSTM). These will be basic speech materials for routine tests in clinics and laboratories.</p><p><b>METHODS</b>Two groups of professionals (audiologists, Chinese and Mandarin scientists, linguistician and statistician) were set up at first. The editing principles were established after 3 round table meetings. Ten spondee lists, each with 50 words, were edited and recorded into cassettes. All lists were phonemically balanced (3-dimensions: vowels, consonants and Chinese tones). Seventy-three normal hearing college students were tested. The speech was presented by earphone monaurally. Three statistic methods were used for equivalent analysis.</p><p><b>RESULTS</b>Related analysis showed that all lists were much related, except List 5. Cluster analysis showed that all ten lists could be classified as two groups. But Kappa test showed that the lists' homogeneity were not well.</p><p><b>CONCLUSIONS</b>Spondee lists are one of the most routine speech test materials. Their editing, recording and equivalent evaluation are affected by many factors. This also needs multi-discipline cooperation. All lists edited in present study need future modification in recording and testing in order to be used clinically and in research. The phonemic balance should be kept.</p>

Analysis of the found age and way for children age 0 to 6 with hearing loss / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the children with hearing loss from the age 0 to 6, and discuss the found age, found way and audiological characteristics.</p><p><b>METHODS</b>General information of found age and found way of 265 children, were investigated with self-made questionnaire and routine audiological evaluations, and then made statistical analysis.</p><p><b>RESULTS</b>The average (x +/- s) found age for the children with hearing loss was (23.21 +/- 10.02) months, and the first average coming age was (28.01 +/- 13.41) months. The found age of girls [(27.11 +/- 13.13) months] was 6.1 months later than the boys' [(21.03 +/- 12.32) months] and the countryside children [(28.27 +/- 11.09) months] later than the city's [(19.52 +/- 13.05) months] 8.65 months in the average found age. The found age of children who were found with speech disability was later than others. As the hearing loss degree of children went milder, the found age might later.</p><p><b>CONCLUSIONS</b>The popularization of knowledge in preventing from hearing loss must be strengthened. It is also necessary to popularize newborn hearing screening and early intervention while to enhance the parents' consciousness.</p>

Development and equivalence evaluation of monosyllable lists of mandarin speech test materials / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To find a good speech material in audiology routine tests and cochlear implant evaluation, the monosyllable lists which were a part of mandarin speech test materials (MSTM) were edited and recorded. The equivalence test was done for all the lists.</p><p><b>METHODS</b>The professional group was set up at first, which composed of specialists of Chinese, mandarin teaching, linguistics and statistics. The principles of word selection were established according to the coherence with international speech test materials and mandarin. Ten Monosyllable lists, each of which has 50 mandarin words according to phonemic balance and criteria of speech audiometry, were edited. The balance was 3-dimension: vowels, consonants and four Chinese tones. One cassette was recorded by a male speaker (radiobroadcaster). The 72 normal hearing subjects were tested monaurally with ten monosyllable lists and the materials were presented by the earphone. The equivalence evaluation was done at the level of about 50% correct scores.</p><p><b>RESULTS</b>Statistic analysis shows that 7 lists were equivalent in difficulty. They were ready for future research and clinical trial.</p><p><b>CONCLUSIONS</b>The mandarin monosyllable lists were edited in terms of international standard and Chinese 3-dimension phonemic balance. Seven of them met the demands for research and clinical application.</p>

Edit and evaluation of Mandarin sentence materials for Chinese speech audiometry / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To edit the sentence list for mandarin speech test materials (MSTM) and to test their equivalence in order to use the list as routine clinical speech tests for evaluation of cochlear implants and hearing aids in different stages of the intervention and rehabilitation.</p><p><b>METHODS</b>Firstly, two groups of professionals were set up: one for establishing the principles of the edit, another for experiments. The criteria to guide the selection of spoken sentences were as following: (1) suitable for everyday speech audiometry, esp. clinically usage; (2) a normal sampling of everyday spoken sentences in mandarin. Totally, 300 sentences were selected in 30 lists for the experiment. The record cassette was used by a male speaker. The college students (54 persons,54 ears) with normal hearing participated in the equivalence test. Two statistic methods were used for equivalence analysis. RESULTS Through speech tests and statistic analysis, 2 sets with 29 lists (290 sentences) were selected as our equivalent lists for further evaluation and clinical trial.</p><p><b>CONCLUSIONS</b>By setting up the strict criteria of selecting sentences, speech test method and statistic analysis, 2 sets of 29 lists (290) sentences were chosen as our speech evaluation materials, but it was necessary for further analysis in different laboratories and clinics. The sentence lists should also get used for hearing impaired subjects, hearing aid users and cochlear implant recipients.</p>