嬰幼兒聽力篩檢

Screening of Infant Hearing

林鴻清(Hung-Ching Lin) ； 徐銘燦(Min-Tsan Shu) ； 張克昌(Ke-Chang Chang) ； Sharon M. Bruna

《中華民國耳鼻喉科醫學雜誌》 35卷6期 (2000/12) Pp. 376-382

https://doi.org/10.6286/2000.35.6.376

摘要

背景；約有1/500 之出生嬰兒，其具有先天性兩側性聽障；必須與以聽力輔助器。科技之進步，使得全面性之嬰幼兒聽力篩檢辯得更簡單、正確又有效率。並且研究資料已顯示，只篩檢聽障高危險群嬰兒，只能發現一半之先天性聽障兒。這些聽障幼兒，若能於6個月大前予以診斷治療時，其將來可以達到正常之語言何其他身心發展。反之，若遲至6個月後才予以診斷時，將造成其語言和社會技巧之明顯遲緩。本研究目的是建立嬰幼兒聽力篩檢之常模，及令先天性聽障幼兒早其治療之可行性
方法: 本院及雅文兒童聽語文教基金會，共同執行此一全面性嬰幼兒聽力篩檢計畫。使用之篩檢儀器是短暫誘發耳聲傳設。本院出生之嬰兒，及為受檢對象。研究期間為1998年11月至2000年3月。
結果 : 期間共計有4707名嬰兒接受篩檢。其中，有4436名(佔94.2%)，確定其兩耳之耳聲傳射均通過，聽屬兩聽力正常者。另外有271名(佔5.8%)無法確認兩耳之耳聲傳射均屬正常，均予以轉介做聽性腦幹反應追蹤。至2000年7月止，從中步發現了8名雙耳聽障者，佔0.17%(8/4707)。及10名單耳聽障者，佔0.38%(10/4707)。雙耳聽障者均於3個月大時，開始接受廳語復健。
結論 : 由此研究顯示，以耳聲傳射做篩檢工具時，可早期找出輕、重度聽障之嬰兒。能令這些先天性聽障之幼童，於3個月大前予以較確定之診斷；並早期進行適當之治療計畫。如此對聽障兒之未來發展將有極大助益。

關鍵字

耳聲傳射 ； 嬰幼兒聽力篩檢 ； 先天性聽障

並列摘要

BACKGROUND: One in every 500 infants is born with a bilateral congential hearing loss requiring amplification. Technological advances in equipment for the screening of hear-ing have made the implementation of universal newborn screening easier, more accurate and cost effective. Selective screening based on high risk criteria currently fails to detect half of all infants with congenital loss. Children identified at birth with mild to severe hearing loss and who receive intervention befors six months achieve language and social development within the normal range. Conversely. Children with hearing loss iden-tified after six months of age experience significant in both language and social skills The purpose of this study was to establish a moder for screening of newborn hear-ing in Taiwan.
METHODS: The proposed universal screening of infant hearing project is a cooperative effort by the Mackay Memorial Hospital and the Children’s Hearing Foundation(CHF). The screening method assessed evoked otoacoustic emissions with an Otodynamics ILO 292. The subjects were newborns at Mackay Memorial Hospital prior to discharge. Infants were screened between Octodber 1998 and March 2000.
RESULTS: 4707 newborns were screened. Of these, 271 babies(5.8%) failed the screen-ing test. The 271 babies were referred for further assessmant with auditory brainstem response testing. Eight babies with biateral hearing loss and ejghteeen babies with unilat-eral hearing loss were ultimately identified. The estimated of congenital bilat-eral hearing loss is 0.17% and of unilateral hearing loss 0.38%. All babies with bilat-eral hearing loss were referred to CHF for ongoing managemant.
CONCLUSIONS: In conclusion, universal screening of infant hearing that employ otoa-coustic emissions can identify newborns with hearing loss prior to three months of age, allowing appropriate intervention to be arranged. Immediate, early identification of hear-ing loss followed by immediate intervention reduces the economic impact of hearing impaiment on the individual and society.

並列關鍵字

Otoacousic emissions ； infant hearing screeing ； congenital hearing loss