保存的听觉稳定状态反应和严重脑干功能障碍的信封追随反应强调了对交叉检查的需要
Macarena Díaz1, Federico Lucchetti2, Paul Avan3
1Bio-, Electro- and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium.
Ear and hearing
|October 13, 2023
概括
听觉稳态反应 (ASSR) 测试可能会错过严重的儿科脑干功能障碍. 封面追随反应 (EFR) 和听觉脑干反应 (ABR) 测试对于诊断这些听觉通路问题更为敏感.
科学领域:
- 神经科学是一个神经科学.
- 听力学 听力学是指听力学.
- 儿科 儿科 儿科
背景情况:
- 听力稳态响应 (ASSR) 系统是客观儿科听力值评估的标准.
- 睡觉中的儿童的ASSR通常是皮质下起源的,下层结肠作为主要贡献者.
- 严重的脑干功能障碍会影响听觉通路的反应,需要敏感的诊断工具.
研究的目的:
- 评估ASSR,听觉脑干反应 (ABR) 和信封追随反应 (EFR) 在诊断严重儿科脑干功能障碍时的敏感性.
- 在睡觉的儿童中使用EFR来区分外周 (耳神经) 和中央 (大脑干) 听觉通路功能.
- 在脑干功能障碍的情况下,比较不同客观听觉电生理学测试的诊断效用.
主要方法:
- 对3名患有严重脑干功能障碍的睡眠儿童进行了神经生理学评估.
- 使用了标准的听力学测试,包括耳测量,扭曲产品的音响发射,点击唤起的ABR和ASSR.
- 使用水平 (EFR-H) 和垂直 (EFR-V) 通道记录EFR,并使用刺激相旋转技术来隔离和测量延迟和相锁定.
主要成果:
- 患有脑干功能障碍的儿童表现出异常的ABR中心波,但耳神经功能正常 (ABR波I,总结潜力,耳微声潜力).
- EFR-H记录显示耳神经功能正常,而EFR-V显示异常的延迟和相锁,表明中央听觉通路参与.
- 在两个案例中,ASSR听力图提供了正常或略高的值,无法检测潜在的脑干功能障碍,与ABR和EFR不同.
结论:
- ASSR测试对严重的儿科脑干功能障碍缺乏敏感性,可能导致错过诊断.
- 与ASSR相比,EFR记录,特别是EFR-V,在检测中央听觉通路异常方面表现出更高的灵敏度.
- 交叉检查原则,将ABR和EFR与ASSR一起或代替ASSR,对于疑似脑干功能障碍的儿科病例的全面听觉评估至关重要.
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