| Objective: To analyze hearing screening results of 129 children aged 3-10 with obstructive sleep apnea hypopnea syndrome(OSAHS), explore the main and risk factors which affects the hearing losing with OSAHS, and to analyze the impact of risk factors on hearing. 2.To explore the different intervention measures according to the different causes of children with obstructive sleep apnea hypopnea syndrome. Analysis the change of PSG monitoring results and hearing screening results before and after the intervention of children with obstructive sleep apnea hypopnea syndrome.Methods: The cases were diagnosized through collection of medical history, physical examination, nasal endoscopy and polysomnography(PSG), and according to the draft guidelines for the diagnosis and treatment of children with OSAHS. The incidence rate of children hearing decline in various of accompanying diseases was found, and its correlation with the incidence of OSAHS in children according to the analysis results of the hearing screening was analyzed. The cases in Affiliated Hospital of North Sichuan Medical College which were diagnosed with OSAHS were selected as the research object, different intervention methods were adopted according to the different factors of children with OSAHS, the PSG monitoring indicators and the results of hearing screening before and after the intervention were comparised.Results: 1. After analysis the age distribution, patients at the age of 5 ~ 8 accounted for 65.1%(84/129), of which 6 year old children accounted for 21.7%(28/129). In this study,for the age distribution among 129 cases of children, OSAHS high-risk age was 5 to 8 years old, and 6 year’old was the highest incidence age; 2.The patients were treated with comprehensive intervention. After treatment, the cure rate was 70.5%(91/129), significantly effective rate of 14%(91/129), the effective rate was 9.3%(12/129), ineffective rate of 6.2%(8/129). After the intervention,children with snoring, throat choking, mouth breathing and other apnea symptoms disappeared; restless sleep, daytime sleepiness, enuresis and other symptoms were improved significantly. With the statistical analysis of intervention curative effect, treated with tonsillectomy and adenoidectomy was the main way to the children with OSAHS, and the comprehensive intervention effect is better than the single way of intervention. With 75% ~ 85% LSa O2 before intervention, and 92% ~ 98% after the intervention, an average increase is 14.2%; AHI and OAI were significantly decreased, the difference was statistically significant(P < 0.05); 3.The PSG results of 71 cases of male children,and 58 cases of female children before and after intervention were analyzed(Table 7). Comparison values is the AHI and La SO2 difference value before and after the intervention. Through the T test, P value of Delta AHI, Delta LSa O2 between men and women was greater than or equal to 0.05, so there was no difference in the curative effect of comprehensive intervention on children with different gender; 4. Hearing screening results showed that 26 ones(38 ears) of 129 cases of OSAHS patients with varying degrees of hearing loss, accounting for 21.7%. Among whom, 12 cases of both ears,14 cases of single ear, 23 cases of secretory otitis media(35 ears).The main reason for hearing loss of Children was secretory otitis media; 5.Through the comparison,in different degree of adenoid hypertrophy cases, 21 cases were with secretory otitis media.The ratio difference for adenoid hypertrophy in children between incorporated and unincorporated secretory otitis media was analyzed. With the chi square test, X2=9.217, P=0.010, the difference was significant between at least two groups. Between mild and moderate groups,X2=0.779, P=0.377; Between mild and severe groups,X2=5.895, P=0.015;Between moderate and severe groups,X2=4.356, P=0.037, the difference was significant, which demonstrated that in children with severe adenoid hypertrophy, secretory otitis media were severe.That was positively correlated between higher incidence of adenoid hypertrophy and severe degree of secretory otitis media; 6.In 26 cases of children with hearing loss(38 ears), 12 cases of both ears, 14 cases of single ear. Acoustic immittance examination showed: type B was in 36 ears, type C was in 2 ears. Before the intervention, results for pure tone audiometery(PTA) were 9d B HL to 55 d B HL, the average was 34.76 + 12.25 d B HL; After the intervention, results for PTA were 2d B HL to 33 d BHL, average 16.2 + 9.09 d BHL(t = 6.822, P < 0.05). the auditory threshold in 35(35/38,92.1%) ears reduced, the auditory threshold in 2 ears raised, the auditory threshold in 1 ear with no improvement, the average hearing threshold decreased for 18.56 d B HL.Conclusions: 1. High incidence age of Children with OSAHS is 5 to 8, the symptoms are disappeared or reduced after 6 months’ effective intervention. Comprehensive intervention is better than a single intervention, and there is no evident difference of treatment in different gender of children; 2.It’s usual to find hearing loss symptoms in Children with OSAHS,and whose main reason is secretory otitis media. In addition, adenoid hypertrophy is positively correlated with secretory otitis media; 3. Combined with tympanic tube insertion as comprehensive intervention for the children with hearing loss, whose symptoms recover significantly, the threshold also significantly decreased. |
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