Relationship between Evoked Auditory Steady-state Responses and Pure Tone Audiometry in Children with Different Levels of Hearing Loss / 听力学及言语疾病杂志

Objective To study the clinical significance of Chirp-ASSR and the characteristics of hearing loss patients by ASSR(auditory steady-state responses) under Chirp stimulation.Methods A total of 136 hearing loss children (5～10 years old) with 272 ears were distributed into four groups based on 500 Hz,1 000 Hz,2 000 Hz and 4 000 Hz auditory threshold arithmetic average:20～dB HL,40～dB HL,60～dB HL,and≥80 dB HL groups.To compare the correlation of the PTA and Chirp-ASSR in different frequencies domain through SPSS statistics 19.0 software,the data were used T-test and Pearson analysis.Results ①The group(≥80 dB HL) achieved a statistically significant higher reaction threshold than pure tone threshold.②The correlation index γ'of PTA and Chirp-ASSR showed a decline along with the hearing loss increase;It increased along with the test frequency,there was a significant difference between 500 Hz and 4 000 Hz(P＜0.05).Conclusion Chirp-ASSR is a frequency-specific electrophysiological test method,it could reflect the truthful listening ability,especially in mild,moderate,and severe hearing loss children.

Comparison and analysis of ASSR test in sensorineural hearing loss children with cochlear lesion and retrocochlear lesion / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the auditory steady-state response (ASSR) test data of severe sensorineural hearing loss children with cochlear lesion and those with retrocochlear lesion and find some specific phenomena of retrocochlear lesion in ASSR, then to improve diagnostic accuracy in clinical practice.@*METHOD@#Between 2008 to 2012. 96 children (179 ears) were diagnosed with "retrocochlear auditory nerve lesion" and recieved ASSR test (" retrocochlear lesion" group). Eighty-one (143 ears) the same age children (143 ears) were diagnosed as "cochlear auditory nerve lesion" and selected them as the "cochlear lesion" group. Twenty-six (50 ears) normal hearing children at the same age who had ASSR test records selected from the pediatric hearing center database of our hospital were selected as "normal control" group. Compare the difference of ASSR threshold, ASSR elicit rate and ASSR audiogram among the three groups.@*RESULT@#(1) ASSR threshold: Compared each frequency threshold in ASSR test with cochlear.lesion group, the retrocochlear lesion group with wave V and wave I had no significant difference in 500 Hz and 1000 Hz but had significant difference in 2000 Hz and 4000 Hz. As for the retrocochlear lesion group without wave V and wave I, there was a decline in 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz compared with cochlear lesion group. (1) ASSR elicit rate: When compared to retrocochlear lesion group, the cochlear lesion group had a significance lower elicit rate in the four frequency. (3) Number of elicit reactions in ASSR test . In the retrocochlear lesion group, the elicit reactions in all the four frequency in ASSR test was significantly higher than ochlear lesion group. (4) ASSR audiogram type. The proportion of rising curve audiogram in retrocochlear lesion group was 26.83% (with wave I and wave V), 40% (with wave I and without wave V ) and 33.80% (without wave I and wave V).@*CONCLUTION@#(1) Children with a severe hearing loss in ABR test and a rise type audiogram in ASSR test should be most possibly considered as retrocochlear lesion. (2) ASSR threshold cannot be used in determinate the severity of hearing loss in children with retrocochlear lesion.

Audiologic assessment of the children with cleft lip/palate / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the audiologic characteristics of the children with cleft lip and/or palate.@*METHOD@#Sixty-two children with cleft lip/palate were enrolled in the study. Tympanometry, DPOAE, ABR were tested in all the chidren.@*RESULT@#Regarding the ABR threshold as the diagnostic criteria, 51 (41.13%) ears had hearing loss, mainly moderate. Sixty-three (59.43%) ears had abnormal tympanometry, which meant the disorder function of the middle ear. Twenty-six (56.52%) ears didn't pass the DPOAE.@*CONCLUSION@#The proportion of the hearingloss in the children with cleft lip/palate was large. There was a good coherence among the three objective examinations when assess the children with cleft lip/palate.

The effect of low-temperature coblation under endoscopy on infantile subglottic hemangioma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect of low-temperature coblation on subglottic hemangioma under endoscopy.@*METHOD@#Clinical data of 5 patients whom were diagnosed as subglottic hemangioma treated with low-temperature coblation under endoscopy were retrospectively studied. Two cases of the patients were treated after tracheotomy.@*RESULT@#Hemangioma vanished completely in the 5 patients. All patients were followed-up from 3-6 months,no recurrence was found, and the 2 cases were extubated successfully.@*CONCLUSION@#Endoscopic surgery u sing low-temperature coblation for subglottic hemangioma after tracheotomy can relief the airway obstruction quickly, shorten the nature course of hemangioma and the period of wearing trachea,also no complication such as subglottic stenosis which is thought to be a safe and effective therapy for large size hemangioma. While for small size hemangioma, endoscopic surgery using low-temperature coblation under good total anesthesia without tracheotomy combined is effective, less injure, and suitable. Endoscopic surgery using low-temperature coblation for subglottic hemangioma has following advantages such as simplicity, minimal invasion and so on. It is a viable surgical method for the treatment of subglottic hemangioma.

Clinical features of sudden hearing loss in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical features and prognosis of sudden hearing loss in children, so that to guide clinical diagnosis and treatment.@*METHOD@#A retrospective review of medical records of 12 hospitalized children (21 ears) suffering from sudden hearing loss was conducted.@*RESULT@#The study comprised 8 males and 4 females with a mean age of 6.28 years old, among which 25% had a unilateral hearing loss and 75% exhibited bilateral hearing loss. The mean onset time was 5.42 days. Four children had tinnitus and 3 patients showed dizziness. For the possible etiology. 2 cases had mumps. 6 cases had definite upper respiratory infections history, one experienced trauma, and another one took ototoxic drugs. Five patients were proved to come down with the large vestibular aqua duct syndrome by the CT scan. Among the 21 ears. 7 ears were diagnosed severe hearing loss and 14 ears were diagnosed profound hearing loss. After the treatment of 7 days, 6 ears were cured, one car showed effective change. and 14 cars came out to be ineffective, with the total effective rate of 33.3%. After the 14 days' treatment, there was no improvement for 5 patients.@*CONCLUSION@#CT scan should he performed on all of the children with hearing loss to exclude the inner ear malformation. Most of the children with sudden hearing loss underwent some clear etiology, showing more severe hearing loss and had a poorer prognosis.

Efficacy and safety of sublingual immunotherapy with house dust mite extract in poly allergen sensitized children with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the efficacy of sublingual immunotherapy (SLIT) with standardized house dust mite extract in mono sensitized and polysensitized children with allergic rhinitis.@*METHOD@#One hundred and fifty-seven children who were sensitized to house dust mites and treated with SLIT for house dust mites for at least 1 year were studied. The monoallergen sensitized group included patients who were sensitized to Dermatophagoides pteronyssinus and/or Dermatophagoides farinae (n=92). The polyallergen sensitized group included patients who were simultaneously sensitized to house dust mites and other allergens (n = 65). A standardized extract of house dust mites was used for immunotherapy. Antiallergic medication and the total nasal symptom score (TNSS) were evaluated before and 1 year after SLIT.@*RESULT@#One hundred and twenty-five children completed 1-year SLIT. The TNSS improved significantly after SLIT in both groups, with monoallergen sensitized group 11.42 +/- 1.60 vs 3.55 +/- 1.57 (t=30.03, P0.05). The AMSs were decreased significantly after SLIT in both groups, with monoallergen sensitized group 1.62 +/- 0.44 vs 0.56 +/- 0.37 (t=15.01, P0.05).@*CONCLUSION@#In polysensitized allergic rhinitis patients, SLIT for D pteronyssinus and/or D farinae produced improvements in both nasal symptoms and rescue medication scores comparable to those in mono sensitized patients. SLIT for D pteronyssinus and/or D farinae should be considered in polysensitized allergic rhinitis patients.

An analysis of tympanometry in 0-1 year old infants / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the characteristics of infants middle ear function of children (0-1 year old) with 226 Hz, 1000 Hz tympanometry.@*METHOD@#Tympanometric data using 226 Hz, 1 000 Hz probe tones were gained from 150 children (300 ears) aged 0-1 year old with a GSI tympstar middle ear analyzer. All of them were term birth, divided into 5 groups of 30 patients, the neonatal period (0-28 days), 6 weeks (+/- 3 days), 3 months (+/- 6 d), 6 months (+/- 6 days), 7-12 months. To analyse the middle ear function of children with 226 Hz, 1000 Hz tympanometric data.@*RESULT@#226 Hz,1000 Hz probe tone tympanometric data were normal for the normal group, which respectively were: 76.7%, 80%, 86.7%, 90%, 93.3%. 226 Hz, 1000 Hz detection tympanometric data were not sound normal to abnormal group, the proportion in each group were: 13.3%, 8.3%, 5.0%, 3.3%, 1.6%. The contradiction between the two groups were divided into two subgroups: 226 Hz normal, 1000 Hz unusual in the proportion of each group were 6.7%, 6.7%, 5.0%, 3.3%, 1.6%; 1000 Hz normal, 226 Hz unusual in the proportion of each group were 5.0%, 5.0%, 3.3%, 3.3%, 3.3%.@*CONCLUSION@#The sensitivity and specificity of the 1000 Hz probe tone tympanometry was better.

Analysis of inhaled allergen spectrum of children with allergic rhinitis in Guangzhou / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the inhaled allergen distribution of children with allergic rhinitis in Guangzhou area and to analyze the relevant factors.@*METHOD@#Six hundred and twenty-six cases children in Guangzhou region diagnosed with allergic rhinitis from January 2009 to December 2011 in our outpatient department were tested with skin prick test (SPT). Ten of standardized common inhaled allergens were analysed. The variety of allergens positive rate was calculated. And the gender, age, living environment,history of asthma, eczema, history and family history of clinical data were analyzed.@*RESULT@#The positive rate of SPT was 84.82% (531/626). The dust mites(76.36%) and the house dust mite(72.84%) have the highest positive rate, then the positive rate of the dog hair (11.98%), cat hair (7.03%) and Blattella germanica (4.31%) was degressively. The positive rate was significantly correlated with family history, history of eczema and asthma. The positive rate was correlated with the gender, independent of the living environment. The intensity of the test has no significant correlation with gender, and was significantly correlated with other factors. The positive rate of SPT has significant difference in ages and the highest positive rate of SPT was in the 10-14 age group, the SPT rate was 93.8%. Three groups have significant differences in the positive rate of mite, dog hair and cat hair.@*CONCLUSION@#The main inhaled allergen in children with allergic rhinitis in Guangzhou area tested by SPT was mite, dog hair and cat hair, respectively. The different ages, living environment, family history, history of eczema and allergic rhinitis children with asthma were related with the pathogenesis and development of AR in childhood. Our results have the contribution to early diagnosis and intervention of children with allergic rhinitis in Guangzhou area.

Evaluation of the audiological characteristics of 3251 cases who failed the newborn hearing screening in Guangzhou / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the audiological characteristics of the cases who failed the newborn hearing screening under the two hearing screening programs (OAE and AABR) in two different screening population(with or without high-risk of hearing loss).@*METHOD@#Three thousand two hundred and fifty-one babies (6502 ears) who failed the hearing screening twice or more and then failed in the audiological evaluation are included in the research. The cases were divided into two groups by the time accepting the screening, or = 6 months (568 cases), and then analyze the effect of age on the audiological characteristics. Compare the sensitivity and specificity of different hearing screening programs, OAE or AABR. Evaluate the audiological characteristics between the groups with or without the high-risk factors of hearing loss. Total of them were performed detailed audiological evaluation including in ABR, DPOAE, acoustic immittance, and some of them accepted ASSR test and computer tomography.@*RESULT@#85.30% to 86.54% infants accepted initial screening in Guangzhou city, and less than 64. 10% infants underwent rescreening. 0.0282% or 0.0220% infants needed immediately early intervention. The group without high-risk factors was less likely to suffer from mild to profound hearing loss than those with high-risk factors. According to different hearing screening programs, more cases passed the OAE hearing screening and more cases were diagnosed profound hearing loss under AABR screening.@*CONCLUSION@#AABR screening technology is better than OAE screening. The target population is the infants with risk factors, so perinatal history record is very important. The percentage of population who need immediately early intervention is more than 0.0282%-0.0220%.

Pathogenic bacteria distribution and drug susceptibility in children with acute otitis media in Pearl River Delta / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the pathogenic bacteria distribution and drug susceptibility in children with acute otitis media (AOM) in different age and different season in the Pearl River Delta region.@*METHOD@#Four hundred and forty-two children diagnosed as AOM were divided into three groups by age factor and four groups by season factor. Midge ear pus collecting and culturing were used for bacteria and antimicrobial susceptibility test.@*RESULT@#(1) Strains of bacteria were isolated from 356 children with the positive rate of 80.5%. Streptococcus pneumoniae (39.2%), staphylococcus aureus (25.9%) and haemophilus influenzae (7.4%) were the most frequently isolated pathogens. (2) Streptococcus pneumoniae was the main pathogenic bacteria in 0-1 year group and > 1-3 years group (P 3 years group (P 0.05). Staphylococcus aureus was the main pathogen in January-March group (P < 0.05); (4) Drug sensitivity shown that linezolid and ofloxacin were most sensitive to streptococcus pneumoniae and staphylococcus aureus, and macrolides had a good therapy effect to haemophilus influenzae.@*CONCLUSION@#The pathogens distribution and drug susceptibility in children with AOM were varies in different age and different season. As a result, a treatment should be done based on the climate, environment, and pathogens distribution of a region.

Evaluation of infant hearing loss with high-risk factors after failed hearing screening / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the characters and hearing changes of the infants failed in hearing screening with high-risk factors for hearing loss.@*METHOD@#Two hundred and forty-four infants (488 ears) who failed in the hearing screening or with the different results between the first and second screening, were tested by auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement in this study.@*RESULT@#(1) A little proportion results among the three DPOAE screening was variable, the pass rate in the right-ear was higher than that in the left-ear. (2) Forty-five of 184 ears which had passed the third DPOAE evaluation had the abnormal ABR results, the discrepancy rate between the two methods was 24.5% (45/184); 20 of 304 ears which failed in the hearing screening had a normal ABR results, with the discrepancy rate of 6.6% (20/304). (3) The highest proportion of abnormal result of the ABR in each groups was mild hearing loss, normal ABR in each groups also had a large proportion. The proportion of moderate hearing loss in the group of no more than three months old infants was significantly increased compared with the other two groups (P 0.05). (4) More than 70% of type A tympanogram was found in each groups (P > 0.05), the ratio of type B in moderately abnormal group was higher than other groups. Type C was only detected in one ear with severe hearing loss. (5) 29.5% infants had suffered the hyperbilirubinemia, which was much higher than the other risk factors (P < 0.05).@*CONCLUSION@#The hearing loss of infants with high-risk factors are mostly mild, and show some indication of fluctuating. Some moderate hearing loss have the tendency to changes better. The combined use of electrophysiological measures can improve the accuracy of hearing evaluation.

Comparison of the residual hearing on the profound hearing-impaired children with the hearing aids and cochlear implants / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the hearing test data of the profound hearing-impaired children with the hearing aids and with cochlear implants; to find out the useful method to measure the residual hearing.@*METHOD@#Twenty-two profound hearing-impaired children participated in the study with complete set of hearing test and verbal rehabilitation file. Ten children fitted hearing aids and underwent verbal rehabilitation more than 3 months. Among the other 12 children with cochlear implants, 10 children fell in the same year range with the hearing aid patients. The children with hearing aids were divided into two groups according to the achievement of the verbal rehabilitation. ASSR threshold and pure- tone threshold were compared between the groups.@*RESULT@#(1) ASSR test: 7 children (14 ears) with hearing aids achieved good verbal representation, in which ASSR threshold can be recorded on 2.71 frequency on average [(110.92 +/- 7.43) dB HL]. Among 3 children with hearing aids representing poor verbal achievement and 5 children with additional cochlear implant because of the poor verbal achievement with hearing aids, only 1.06 frequency had response of ASSR test [(110.88 +/- 48.52 ) dB HL]. (2) Pure tone audiometry: the average threshold of the 7 children with good representation was (96.11 +/- 7.81) dB HL, and the threshold on 3 frequency were less than 100 dB HL on average. The average threshold of the other 3 children with poor verbal achievement was (112.19 +/- 5.15) dB HL, and none of the frequency threshold was 100 dB HL.@*CONCLUSION@#The number of the frequency with the response of ASSR and the threshold < or =100 dB HL of pure tone audiometry is an effective indication of the useful residual hearing.

The characteristics of auditory brainstem response in preterm very low birth weight babies / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics.@*METHOD@#Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies.@*RESULT@#The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave I, III and V latencies I - III, III - V and I - V intervals and postconceptional age. Wave I and V latencies, I - III and III - V intervals differed significantly between the two groups.@*CONCLUSION@#The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

The audiological characteristics of infants failed in hearing screening / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.@*METHOD@#802 infants (1,179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE). However, they failed in the first or and second hearing screening. Auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.@*RESULT@#Among 802 cases (1,179 ears), the ratio of single-ear (53.2%) is higher than both-ears (39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation; 25.8% infants once suffered from hypercholesterolemia failed in the hearing screening,which was higher than the other known risk factors. P<0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk factors group (10.8%); 56.9% of the infancy who did not pass the hearing screening were found none risk factors, 42.3% of the infancy who had high risk factors was normal hearing level; 96 cases (138 ears) undergone twice assessment, in moderate disorder group, more cases (74.3%) changed better, and less disorder group (40.9%), severe disorder group (33.3%). Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases (12 ears) diagnosis auditory neuropathy.@*CONCLUSION@#The important factors make the follow-up decision including perinatal history, hearing level and age. Maybe some high-factors we did not realized. Gene screening should be paid more attention in the future work.

The audiological characteristics of infants failed in hearing screening / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the characteristic and the hearing change of hearing thresholds of the infants failing in the hearing screening.Method:802 infants(1179 ears) with hearing screening record were reviewed in the study. They had hearing screened by otoacoustic emissions (OAE).However, they failed in the first or & and second hearing screening. Auditory brainstem response (ABR) , distortion product otoacoustic emissions(DPOAE) and acoustic immittance measurement were examined. Subjects with abnormal hearing-evaluation were retested during the following 1-3 months (before 6-month-old). To analysis the characteristic and the hearing change of hearing thresholds of the tests.Result:Among 802 cases(1179 ears),the ratio of single-ear(53.2%) is higher than both-ears(39.5%), P<0.05. And there are no significance between the two groups in the ration of severe abnormal hearing-evaluation ;25.8% infants once suffered from hypercholesterolenia failed in the hearing screening,which was higer than the other known risk factors.P＜0.05; Threatened abortion group has found no cases of severe hearing abnormalities; The ratio of severe abnormal hearing-evaluation in family history hearing loss group (40.9%) was higher than other high-risk factors, followed by two or more risk fators group(10.8%);56.9% of the infance who did not pass the hearing screening were found none risk factors, 42.3% of the infances who had high risk factors was normal hearing level;96 cases(138 ears) undergone twice assesement, in morderat disorder group, more cases(74.3%) changed better , and less disorder group(40.9%), severe disorder group (33.3%).Seven ears became worse; Among abnormal hearing induced by different high-risk factors, the proportion of hearing improvement in children with moderate abnormal hearing was higher than that in children with slight abnormal hearing. Ten cases(12 ears) diagnosised auditory neuropathy.Conclusion:The important factors make the follow-up decision incluing perinatal history,hearing level and age.Maybe some high-factors we did not realized. Gene screening should be paied more attention in the future work.

The characteristics of auditory brainstem response in preterm very low birth weight babies / 临床耳鼻咽喉头颈外科杂志

Objective:To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. Method: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. Result:The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave Ⅰ,Ⅲ and Ⅴ latencies Ⅰ-Ⅲ ,Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals and postconceptional age. Wave Ⅰ and Ⅴ latencies, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals differed significantly between the two groups. Conclusion:The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

Analysis of clinical manifestations and misdiagnosis of congenital vallecular cyst / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical manifestations and the cause of misdiagnosis of congenital vallecular cyst.@*METHOD@#Nineteen cases of congenital vallecular cysts were collected and reviewed retrospectively. Their clinical manifestations and diagnosis were analyzed.@*RESULT@#Their clinical manifestations included inspiratory stridor, respiratory distress, inspiratory dyspnea, feeding difficulty etc. Among 19 cases, 15 cases were misdiagnosed as neonate pneumonia (9 cases), bronchial pneumonia (5 cases), and laryngitis (1 case), respectively. All cases were diagnosed as congenital vallecular cysts by fibrolaryngoscope. The diagnosis was confirmed by pathological examination.@*CONCLUSION@#Congenital vallecular cyst is fairly uncommon. To cure these patients on time, early examination of upper airway is recommended for patients with inspiratory stridor and inspiratory dyspnea. Fibrolaryngoscope would be useful for diagnosis and timely treatment.

Evaluation of the infants' hearing loss in hearing screening / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the confusing factors and clinical and audiological characteristics of ABR and tympanometry in infants who failed the first and second hearing screening.@*METHOD@#Between August 2005 and November 2007, 94 infants (144 ears) with detailed birth record and hearing screening record were reviewed in the study. The age of this series ranged from 48 days to 6 months. They received hearing screening with otoacoustic emissions (OAE), and all failed in the first and second hearing screening. The birth history, high-risk factors of hearing-impaired during newborn period and pregnancy history of subjects were fully detailed. Subjects were classified according to the age: 1 to 3 months old infants were considered as group 1, while 4 to 6 months old infants were considered as group 2. Auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAE) and acoustic immittance measurement were examined.@*RESULT@#(1) The 226 Hz tympanograms of 144 ears showed type A of a single-peaked tympanogram in 77 ears (53.4%), a double-peaked tympanogram in 23 ears (16.0%), type Ad of a single-peaked tympanogram in 20 ears (13.9%), type As of a single-peaked tympanogram in 16 ears (11.1%), a flat-shaping tympanogram (type B) in 6 ears (4.2%), and others shapes (including C and D type) in 2 ears (1.4%). (2) The results of ABR showed that there were 64 ears (44.4%) with normal hearing (according to the threshold of ABR), 58 ears (40.3%) with mild hearing loss, 12 ears (8.3%) with moderate hearing loss, 3 ears (2.1%) with severe hearing loss, 7 ears (4.9%) with profound hearing loss. And the proportion of mild hearing loss was increased in the group, while the proportion of moderate and severe hearing loss was decreased. (3) The proportion of type A tympanogram was 50% (32 ears) in normal hearing subjects, which implied that the 226 Hz probe tones to record tympanogram would lead to a high false negative rate. And type proportion of type B tympanogram was higher in normal (4.7%) and mild hearing loss (3.4%) groups than in moderate and severe group.@*CONCLUSION@#Middle ear function and development of auditory system in infants may be confusing factors in hearing screening. The 226 Hz probe tones to record tympanogram are unreliable for accurate assessment of middle ear status of infants. Therefore the results of hearing screening should be interpreted appropriately.

Hearing evaluation in children with congenital malformations of the external ear / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical and audiological characteristics of children with congenital malformations of the external ear.@*METHOD@#One hundred and ten patients with congenital malformations of the external ear ranged from 2002 to 2006 were involved in this study. The mean age was one year and four months. The children were divided into three groups according to the appearance of the external ear. The first group consisted of 94 patients with auricle malformation and atresia of the external auditory meatus. The second group consisted of 8 patients with abnormal external auditory meatus (no atresia) and auricle malformation. The other 8 patients only with auricle malformation were included in the third group. All children underwent ABR tests, while some of these children accepted DPOAE and Acoustic-immittance measurements.@*RESULT@#(1) Severe abnormal results of ABR were observed in 79 abnormal ears (78.22%) in children of first group, while moderate or severe abnormal results of ABR were observed only in 8 opposite side ears (normal ears). (2) Sixty-two and a half percent (5 ears) of ears of the second group (8 ears) had severely abnormal ABR results. (3) Severe abnormal ABR results occurred in 44.44 percent (4 ears) of ears of the third group (9 ears). Moderate or severe abnormal results of ABR were not observed in the opposite side ears (normal ears) in second and third groups.@*CONCLUSION@#Congenital malformations of the external ear is an important factor affecting children's hearing. Auditory nerve impairment can be observed in children with congenital malformations of the external ear.

Roentgenographic cephalometry in children with obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To elucidate the relationship between different cephalometric measurements and the severity of childhood OSAHS, then analyze the value of cephalometric measurements in predicting the severity of OSAHS in children.@*METHOD@#Sixty-one patients received PSG examination and standard lateral neck roentgenography including cervical trachea. Cephalometric measurements include adenoid size, adenoidal-nasopharyngeal ratio, narrowest posterior airway space of nasopharynx, ratio of the narrowest posterior airway space of nasopharynx and trachea diameter. Statistical analysis was made to study the relationship between the data of Cephalometric measurements and PSG.@*RESULT@#Cephalometric measurements were all associated with AHI and AI (P 0.01).@*CONCLUSION@#PAS/TD is useful and simple in predicting the severity of OSAHS in children, but no use in predicting the severity of arterial oxygen saturation.