来自大型儿科队列的儿童不对称听力损失的临床特征
Clinical characteristics of asymmetric hearing loss in children from a large pediatric cohort.
文献信息
| PMID | 42791331 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Laura E Hahn |
| 作者单位 | Department of Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. hahn.laura@yahoo.com. |
| 期刊 | Communications medicine |
| SCI 分区 | Q1 |
| IF | 7.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 不对称听力损失（HL）是一种常见的儿科疾病，其特征是双耳HL严重程度存在差异。受影响儿童的病史和听力学特征资料稀少，阻碍了循证临床指南的制定。
方法： 从德国永久性HL儿童登记处回顾性获取双侧和单侧不对称HL儿童的临床特征。队列按侧别（单侧/双侧）和是否存在合并症（有/无）进行分层。使用绝对标准化均值差评估组间差异。
结果： 在此我们显示，在单侧和双侧组中，约25%的儿童报告有HL家族史，40%-50%的儿童有合并症。双侧HL儿童中产前/围产期危险因素（如缺氧、人工通气）的比例高于单侧HL儿童。遗传性HL在双侧HL儿童中更常见，而不明原因的HL在单侧病例中更频繁。感音神经性HL在各组中占主导；传导性或混合性HL在单侧HL伴合并症的儿童中更常见。下降型和平坦型听力图构型在各组中常见，尽管许多儿童也表现出其他形状。值得注意的是，60%的双侧HL儿童左耳和右耳表现出不同的听力图构型。
结论： 不对称HL儿童代表了一个具有多样临床特征的异质性人群。本研究强调需要进行全面的听力学检查和量身定制的技术干预。与单侧病例相比，双侧不对称可能带来更大的临床挑战，因为合并症和危险因素的发生率更高，以及听力图构型的耳间差异发生率高。
英文摘要
BACKGROUND: Asymmetric hearing loss (HL) is a common pediatric condition, characterized by differences in HL severity between both ears. Anamnestic and audiologic profiles of affected children are sparse, hindering development of evidence-based clinical guidelines.
METHODS: Clinical characteristics for children with bi- and unilateral asymmetric HL were retrospectively obtained from a register of children with permanent HL in Germany. Cohorts were stratified by laterality (uni-/bilateral) and presence of comorbidities (with/without). Between-group differences were assessed using absolute standardized mean differences.
RESULTS: Here we show, across uni- and bilateral groups, family history of HL is reported for approximately 25% and comorbidities for 40%-50% of children. Children with bilateral HL have a higher proportion of pre-/perinatal risk factors (e.g., hypoxia, artificial ventilation) than children with unilateral HL. Hereditary HL is more common in children with bilateral HL, whereas unexplained causes of HL is more frequent in unilateral cases. Sensorineural HL is predominant across groups; conductive or combined HL occurs more often in children with unilateral HL and comorbidities. Sloping and flat audiogram configurations are common across groups, though many children also exhibit other shapes. Notably, 60% of children with bilateral HL present different audiogram configurations in their left and right ears.
CONCLUSION: Children with asymmetric HL represent a heterogeneous population with diverse clinical characteristics. This study highlights the need for comprehensive audiologic examination and tailored technical intervention. Bilateral asymmetries may pose greater clinical challenges compared to unilateral cases, due to higher incidence of comorbidities and risk factors as well as the high incidence of inter-aural differences in audiogram configurations.