兒童學前聽力篩檢中發現原因不明的傳導性聽力損失個案探討

透過學前聽力篩檢可以發現先天性、遲發性及漸進性聽損兒童，其中，也發現少數鼓膜完整、原因不明的傳導性聽力損失（unexplained conductive hearing loss, UCHL）個案。UCHL在兒童族群中並不常見，但因其診斷困難、病因多樣，常需經由多次追蹤與進一步檢查才能確診。本文針對兩位中耳共振頻率結果差異明顯的兩位個案作探討。透過病史、純音聽力圖、226 Hz鼓室圖、中耳共振頻率分析及影像學檢查，協助初步判斷及診斷出兒童及青少年耳硬化症及先天性聽小骨異常。結果顯示，中耳共振頻率測量能作為初步診斷的有力工具。同時，對語言發展中的兒童而言，微聽損也可能對其學習與社交能力造成影響，需高度關注與早期介入，並與家長密切合作以維持追蹤及妥善管理。

Keywords

兒童學前聽力篩檢；原因不明的傳導性聽力損失；中耳共振頻率；兒童及青少年耳硬化症；先天性聽小骨異常

Parallel abstracts

Preschool hearing screenings can help identify children with congenital, late-onset, and progressive hearing loss. Among those hearing loss, a small number of cases with unexplained conductive hearing loss (UCHL), characterized by intact tympanic membranes and unknown causes, have also been found. UCHL is uncommon in the pediatric population, but due to its diagnostic challenges and diverse etiologies, a confirmed diagnosis often requires multiple follow-ups and further examinations. This article discusses two cases with markedly different middle ear resonance frequency results. Through patient history, pure-tone audiometry, 226 Hz tympanometry, middle ear resonance frequency analysis, and imaging studies, juvenile otosclerosis and congenital ossicular anomalies were suspected and diagnosed. The results indicate that middle ear resonance frequency measurement can serve as a valuable preliminary diagnostic tool. Furthermore, even minimal hearing loss can impact a child's learning and social abilities during critical stages of language development. Therefore, early intervention, careful monitoring, and close collaboration with parents are essential for effective follow-up and management.

Parallel keywords

preschool hearing screenings ； unexplained conductive hearing loss ； middle ear resonance frequency ； juvenile otosclerosis ； congenital ossicular anomalies