[Analysis of audiological features in infants with unilateral hearing loss].

Objective:To investigate the audiological characteristics and possible causes of unilateral hearing loss in infants and young children. Methods:105 infants from Beijing Maternal and Child Health Care Institution who failed the newborn hearing screening and were referred to the Children's Hearing Diagnosis Center of PLA General Hospital for hearing diagnosis. They were diagnosed with unilateral hearing loss and underwent clinical data collection. A full set of audiological examinations included ABR, 40 Hz auditory event related potential, ASSR, DPOAE, tympanometry. Results:①In initial diagnosis, 45 cases（42.86%） had mild hearing loss, 19 cases（18.10%） had moderate hearing loss, 14 cases（13.33%） had severe hearing loss, and 27 cases（25.71%） had severe hearing loss; Among them, 65 cases（61.90%） were conductive hearing loss or mixed hearing loss, and 40 cases（38.10%） were sensorineural hearing loss. ②83 of 105 cases had follow-up visits: 24 cases were normal, 15 cases with mild hearing loss, 4 cases with moderate hearing loss, 12 cases with severe hearing loss, and 26 cases with extremely severe hearing loss, 2 cases of hearing loss in both ears. ③From the initial diagnosis to the follow-up diagnosis, the change of mild hearing loss was the largest, followed by moderate hearing loss, severe and extremely severe hearing loss basically did not change; the number of mild and severe conductive hearing loss which recovered to normal hearing was most, the number of sensorineural hearing loss changed little. Conclusion:The infants who failed the newborn hearing screening and were diagnosed with unilateral hearing loss were mainly mild to moderate conductive hearing loss and severe to extremely severe sensorineural hearing loss. The hearing of children with hearing loss gradually improved, and severe and extremely severe sensorineural hearing loss remained unchanged.

[Application of behavioral audiometry in subjective hearing assessment of children].

Objective:To explore the value and influencing factors of behavioral audiometry in subjective hearing assessment of children. Methods:The results of behavioral audiometry（visual reinforcement audiometry or play audiometry） of 1944 children（3888 ears） in the outpatient department from January 2012 to December 2015 were retrospectively analyzed. The subjective performance（" good ", "moderate", "poor", " unfinished "） was compared according to age and hearing level. SPSS 27.0 software was used for statistical analysis. Results:The subjective performance of children was "good" in 2791 ears（71.8%）, "moderate" in 411 ears（10.6%）, "poor" in 309 ears（7.9%） and " unfinished " in 377 ears（9.7%）. In visual reinforcement audiometry, the proportion of children who subjectively performed as "good" gradually increased with age, reaching the peak at 2 years old, and decreased with age after 2 years old. In play audiometry, the proportion of children who subjectively performed as "good" gradually increased with age, peaking at 4-5 years of age. The children who did not finish the test were mainly 1-3 years old. The reasons included uncooperation for 148 ears, crying for 95 ears, refusing to wear headphones for 57 ears, fatigue for 42 ears, lack of interest for 20 ears, not understanding for 14 ears, and distraction for 1 ear. Conclusion:Behavioral audiometry was helpful to assess children's subjective hearing, and children's subjective performance was good. In clinical work, more novel and attractive test materials and methods should be adopted or developed according to the physical and mental characteristics of young children.

[The follow-up study on patients of children with auditory neuropathy].

Objective:To analyse the audiological characteristics of patients of children with auditory neuropathy（AN） for gaining a better understanding of the audiological characteristics prognosis of patients with AN. Methods:58 patients（108 ears） of children with AN were enrolled, all of whom had received further consultation within 10 years after the first consultation. Behavioral audiometry test, tympanogram test, distortion product otoacoustic emission（DPOAE）, auditory brainstem response（ABR）, cochlear microphonics（CM）, auditory steady-state response（ASSR） were performed on these patients. Results:①There were no significant changes in behavioral audiometry threshold between first and further consultation（P>0.05）；②Tympanograms were mostly of type A or As； ③The patients had worse DPOAE results in the further consultation, while the elicitation rate of other frequencies were higher except for the lower elicitation rate of 750 Hz and 1000 Hz；④There were 7 ears that had present ABR and CM in the first consultation, while three ears had present ABR and CM in the further consultation；⑤Except for 500 Hz, other frequency thresholds of ASSR in the further consultation were statistically significant compared with those in the first consultation（P<0.01）；⑥The threshold of behavioral audiometry at 4000 Hz was higher than that of ASSR, and there was no obvious correlation between the other frequencies（P>0.05）. Conclusion:There is a tendency of hearing deterioration in patients of children with AN. Patients with no DPOAE elicitation and no ABR elicitation or serious abnormalities need CM test to avoid misdiagnosis. The hearing status and speech communication ability of patients should be continuously monitored. Parents should pay attention to the changes in the behavioral ability of the children in daily life and make regular subsequent visits.

[Correlation between phonetically balanced maximum and pure tone auditory threshold among 106 auditory neuropathy patients].

OBJECTIVE: To estimate correlation between phonetically balanced maximum (PB max) and pure tone auditory threshold in auditory neuropathy (AN) patients. METHODS: One hundred and six AN patients were identified using multiple criteria including PB max, a metric for speech recognition, pure tone auditory threshold, acoustic emission test, distortion products otoacoustic emission (DPOAE) and auditory brainstem response (ABR). SPSS statistical software was used to estimate the Pearson's correlation between PB max and pure tone auditory threshold and to test whether pure tone auditory threshold, or auditory configuration had a significant impact on PB max. RESULTS: Even the patients had the same or similar values for pure tone auditory threshold or auditory configuration, varied values of PB max were found in two hundreds and twelve ears for 106 patients. Analysis of the data for 106 patients revealed a negative correlation (r = -0. 602, P <0. 01) between PB max and pure tone auditory threshold, i. e. hearing loss at a mild relates to a lower PB max. By using analysis of variance (ANOVA) method, it was found that both pure tone auditory threshold and auditory configuration had a significant (P <0.01) impact on the patients' PB max. CONCLUSIONS: This analysis implicated the promise and potential of pure tone auditory threshold and auditory configuration for predicting PB max of the AN patients, and improving the diagnosis of AN.

[The characteristic of enlarged vestibular aqueducts syndrome in pure tone audiometry: low frequency air-bone gap].

OBJECTIVE: The purposes of this study was to analyse the significant of low frequency air-bone gap in enlarged vestibular aqueduct (EVA) patients according to the pure tone audiogram and the benefit for clinic diagnosis of the EVA. METHOD: The audiology testing include (1) play audiometry or pure tone audiometry, tympanometry, middle ear muscle reflex thresholds and stapedius muscle reflex; (2) High-resolution computed tomography (CT) scan of the temporal bone and magnetic resonance imaging was used for diagnoses the EVA. RESULT: All the 78 patients (154 ears) were diagnosed as the typical EVA by CT or MRI. Inner ear malformations were found in 3 ears otherwise the structures of middle ear in all the patients were absolutely normal. The audiology analysis showed 154 ears were type A tympanogram including 126 ears with typical A, 25 ears with As, 3 ears with Ad type. In the 250 Hz pure-tone test:A-B gap were observed in 126 ears(126/154,81. 8%) with the different hearing loss degree: 1 ear mild, 11 ears moderate, 19 ears moderate severe, 40 ears severe and 53 ears profound. In the 500 Hz pure-tone test: A-B gap were found in 102 ears(102/154, 66. 2%) with the different hearing loss degree: 9. ears moderate, 17 ears moderate severe, 35 ears severe and 41 ears profound. CONCLUSION: Our study suggested a 66. 2% -81. 8% possibilities to find the EVA through the pure-tone audiometry firstly in the basis of the normal tympanograms with the significant A-B gap.