以幼兒行為聽力閾值探討電生理檢查及行為觀察聽力檢查用於早期聽力診斷之準確性

To Explore the Accuracy of Electrophysiological Examinations and Behavioral Observation Hearing Examinations for Early Hearing Diagnosis With Children's Behavioral Hearing Threshold

易鼎淳(Ting-Chun Yi) ； 程淑珠(Shu-Chu Cheng) ； 高玉純(Yu-Chun Kao) ； 葉文英(Wen-Ying Yeh)

《台灣聽力語言學會雜誌》 44期 (2021/06) Pp. 63-75

https://doi.org/10.6143/JSLHAT.202106_(44).0003

摘要

因應國內全面新生兒聽力篩檢施行，為提供轉介三軍總醫院之新生兒聽力確診個案良好的後續追蹤及療育，在個案尚未能配合行為聽力檢查之前，透過行為觀察取得準確評估結果，是其中至關重要的一環。本研究欲比較嬰幼兒聽力確診之聽性腦幹反應（auditory brainstem response, ABR）、行為觀察聽力檢查（behavior observation audiometry, BOA）、視覺增強聽力檢查（visual reinforcement audiometry, VRA）與制約遊戲式聽力檢查（conditioned play audiometry, CPA）評估結果相關性及準確性。本研究於三軍總醫院2012～2020年新生兒確診異常之82例個案中，排除64例，其餘18例，共計30耳納入分析。收集18例個案於本院所做寬頻音刺激ABR（click ABR）、窄頻音刺激ABR（tone burst ABR）、BOA、VRA、CPA結果，使用皮爾森相關分析法比較其相關性。結果顯示，除1.0 kHz BOA及CPA未達顯著相關，其餘皆達顯著相關。BOA與CPA於0.5、2.0、4.0 kHz相關性達0.768以上，但於1.0 kHz相關性為0.622，未達顯著相關。VRA與CPA相關性皆達0.641以上且有顯著相關。Click ABR與CPA相關性皆達0.829以上且有顯著相關。整體來說，於本院所施測之電生理檢查、BOA及VRA，能高度預測嬰幼兒在具行為能力後之聽力閾值。

關鍵字

電生理檢查 ； 行為聽力檢查 ； 行為觀察聽力檢查 ； 嬰幼兒聽力診斷

並列摘要

In response to the implementation of comprehensive newborn hearing screening in Taiwan, in order to provide good follow-up and treatment of newborn hearing confirmed cases referred to the Tri-Service General Hospital, accurate assessment results through behavioral observation before the cases are not able to cooperate with the behavioral hearing test, is one of the most important things. This study intends to compare the correlation and accuracy of the assessment results of auditory brainstem response (ABR), behavior observation audiometry (BOA), visual reinforcement audiometry (VRA), and conditioned play audiometry (CPA) for infants and young children with hearing diagnosis. In the study, there are 64 cases of abnormal hearing in the Tri-Service General Hospital were excluded from 82 newborns between 2012 and 2020. The remaining 18 cases, with total of 30 abnormal ears, were included in the analysis. Collecting 18 cases of click ABR, tone burst ABR, BOA, VRA, CPA results, and using Pearson correlation analysis to compare their correlation as the study method. The result shows that, except for 1.0 kHz BOA and CPA which did not reach a significant correlation, the others all reached a significant correlation. The correlation between BOA and CPA is above 0.768 at 0.5, 2.0, and 4.0 kHz, but the correlation at 1.0 kHz is 0.622, which is not significant. The correlation between VRA and CPA is above 0.641, and there is a significant correlation. The correlation between click ABR and CPA is above 0.829, and there is a significant correlation. On the whole, the electrophysiological and behavioral observation examinations performed in this hospital can highly predict the hearing threshold of infants and young children after they have become behavioral.

並列關鍵字

Electrophysiological examination ； Behavioral examination ； Behavioral observation audiometry ； Infant hearing diagnosis

參考文獻

Joint Committee on Infant Hearing. (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120, 898-921. doi:10.1542/peds.2007-2333

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