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目的:分析前庭水管扩大(EVA)患儿行纯音测听检查时出现低频骨气导差的比例,探讨纯音测听检查辅助临床诊断EVA的意义。方法:所有患儿均经小儿行为测听或纯音测听、声导抗检查,并行颞骨CT扫描或耳蜗磁共振水成像检查了解中耳及内耳的发育情况。结果:声导抗检查:78例(154耳)中耳鼓室声导抗曲线均为A型,其中单纯A型126耳,As型25耳,Ad型3耳;15耳引出声反射。纯音测听检查:在250Hz处,126耳(81.8%)存在骨气导差,按听力损失程度分类:轻度1耳,中度12耳,中重度18耳,重度38耳,极重度57耳;在500Hz处,102耳(66.2%)存在骨气导差,按听力损失程度分类:轻度0耳,中度9耳,中重度17耳,重度35耳,极重度41耳。结论:进行纯音测听检查时,在中耳功能正常(中耳声导抗鼓室图为A型)情况下,若发现明显的低频骨气导差,可有66.2%~81.8%的概率提示患儿存在EVA。
OBJECTIVE: To analyze the proportion of low frequency osteotomy induced by pure tone audiometry in children with vestibular aqueduct (EVA) and to explore the significance of pure tone audiometry in clinical diagnosis of EVA. Methods: All children were measured by pediatric audiometry or pure tone audiometry, acoustic conductivity test, parallel temporal CT scan or cochlear MRI water imaging to understand the development of the middle ear and inner ear. Results: Acoustic impedance test showed that the acoustic impedance curves of middle ear drum in 78 cases (154 ears) were type A, including 126 cases of A type, 25 ears of As type and 3 ears of Ad type. Pure tone audiometry examination: at 250 Hz, 126 ears (81.8%) there is poor bone conduction, according to the degree of hearing loss classification: mild 1 ear, moderate 12 ears, moderate and severe 18 ears, severe 38 ears, very severe 57 ears; At 500 Hz, 102 ears (66.2%) had osteoporosis with a classification of hearing loss of mild 0, moderate 9, moderate 17, severe 35, and very severe 41. CONCLUSIONS: In pure tone audiometry, in the case of normal middle ear function (middle ear acoustic guidance tympanogram is type A), if a clear low frequency osteotomy is found, a probability of 66.2% ~ 81.8% EVA exists.