Влияние недоношенности на становление слуховой функции

Abstract

Prematurity is a high risk factor for the development of somatic and neurological diseases, as well as pathology of sensory systems. Premature babies are susceptible to the development of peripheral or central, congenital or acquired hearing impairments, which usually form in the first months or years of a child’s life. Their timely detection and correction is facilitated by the introduction of neonatal audiological screening. However, due to the presence of a wide range of comorbidities, mainly neuropsychiatric disorders, which specialists and parents focus on, these children, having successfully passed the screening procedure, may later “slip away” from the field of vision not only of the audiologist, but also of the otorhinolaryngologist, despite on the hearing impairment that is developing in them. At the same time, the delay and / or impairment of auditory speech and language development, associated cognitive impairment, as a rule, is attributed to neuropsychiatric deficits, rather than auditory sensory deprivation. The aim of the study was to assess the state of auditory function in premature infants who have reached the age of 10 years. We examined 16 children aged 10 years with an average gestational age at birth of 27,6 ± 2,9 weeks, with an average body weight of 1104 ± 448 g. There was no information about acute otitis media in the past in any of the cases. Traditional ENT examinations with otomicroscopy and a comprehensive audiological examination with an assessment of speech intelligibility were carried out, if necessary, radiation diagnostic methods were used. In 12 children, the otoscopic picture and auditory function were within normal limits. Four subjects had otoscopic and audiological signs of adhesive otitis media, verified by multispiral computed tomography of the temporal bones, which was regarded as the outcome of recurrent / persistent exudative otitis media (EOM) that occurred in the past. All 4 patients were diagnosed with grade I hearing loss, in equal proportions conductive and mixed. Most babies were born deeply premature, with many risk factors for the development of EOM. The examination of hearing and speech function showed impairment of speech intelligibility, which was significantly worse compared to children without peripheral hearing loss, which, in all likelihood, was one of the reasons for the academic failure of children, complaints about which their parents made. Due to the fact that EOM in premature babies can be asymptomatic and unrecognized, at the same time, it has a negative effect on hearing and speech development, the need for regular preventive examinations of such children by an otorhinolaryngologist with the obligatory involvement of tympanometry at least twice a year until they reach age 9–10 years.