The Clinical Study Of Auditory Function On Children With Obstructive Sleep Apnea-hypopnea Syndrome Before And After Adenotonsillectomy

ObjectiveTo discuss the change of auditory function on the children from 4 to 7 years old with obstructive sleep apnea hypopnea syndrom(OSAHS),and the influence of auditory function on the children with midum and severe OSAHS after the operation of bilateral amygdala resection combined adenoidectomy under endoscope ablation.MethodsChoosing different disase degree of children from 4 to 7 years old with OSAHS as the research object,selecting the light OSAHS,the medium OSAHS and the severe OSAHS group according to PSG results,each group has 40 children.The three groups of children should be under PSG examination for at least seven hours and diagnosed as the light,the medium or the severe OSAHS,and the children with medium or severe OSAHS will do the surgery operation under general anesthesia.The healthy control group is 40 healthy children(the parents confirmed that their children had no sleep snoring and related history of disease history and hearing related history).The study group all do the PSG,PTA,ABR and DPOAE.The children of the medium OSAHS group and severe OSAHS group will reexamine the PSG,PTA,DPOAE and ABR after operation for half a year while the healthy control group needs to do the ABR?DPOA and ABR once again.Using multifactor variance analysis to make the comparison of experimental data between groups and the matching t test is used before and after surgery between the same group.Results1?Results of PSG:Befoe operation: The I,V wave of the incubatiton period and the I-V wave of interphase of the medium and severe OSAHS group is longe r than the light group and the healthy control group,whose difference is statistically significant(P < 0.05).The I,III,V wave of the incubation period and the I-III,III-V wave of interphase of the Severe OSAHS grou p is longer than the light group and the healthy control group,whose di fference is statistically significant(P < 0.05).The I,III,Vwave of the i ncubation period and the I-V,III-V wave of interphase of the severe OSA HS group is longer than the medium group,whose difference is statistic ally significant(P < 0.05).Difference between mild OSAHS group and health control group is not significant(P > 0.05).After operation: The I?V wave of the incubatiton period and the I-V wave of interphase of the medium OSAHS group after operation is shorter than before operation,whose difference is statistically significant(P < 0.05).The waves of the incubatiton period and the interphase of the severe OSAHS group are no significance(P > 0.05).The waves of the incubatiton period and the interphase of the medium OSAHS group are no significance(P > 0.05).The I,III,V wave of the incubation period and the I-III ? III-V wave of interphase of the severe OSAHS group after operation is longer than the healthy control group,whose difference is statistically significant(P < 0.05).2?Results of DPOAE(prevalence):Befoe operation: The extraction rate of the Medium and the severe OSAHS group is lower than the mild OSAHS group and healthy control OSAHS group during(0.5 kHz ~ 8 kHz)six frequency,whose difference is statistically significant(P < 0.05).The extraction rate of all frequency of severe OSAHS group is lower than the mild OSAHS group.whose difference is statistically significant(P < 0.05).Difference between mild OSAHS group and health control group is not significant(P > 0.05).After operation: Medium and severe OSAHS group was(0.5 kHz ~ 8 kHz)six frequency derivation rate are lower than in mild OSAHS group and healthy control group,the difference was statistically significant(P < 0.05);The frequency of each frequency of the severe OSAHS was lower than that of the moderate group,and the difference was statistically significant(P < 0.05).The difference between mild and healthy controls was not statistically significant(P > 0.05).3?Results of PTA:Befoe operation: The hearing threshold of the medium and severe OSAHS group at 2000 Hz,4000Hz,8000 Hz are higher than the light and healthy control group(P < 0.05).The hearing threshold of the heavy OSAHS at 4000 Hz and 8000 Hz are higher than the moderate groups(P < 0.05).There was no statistical significance(P > 0.05)in the listening threshold between the mild and healthy controls.After operation: There is no difference between the medium and severe OSAHS group before and after operation(P > 0.05).The hearing threshold of the medium and severe OSAHS group at 2000 Hz,4000Hz,8000 Hz are higher than the healthy control group,the difference is statistically significant(P < 0.05).4?The surgical results: Six months after the operation of the moderate OSAHS group of patients with the PSG,38 cases were cured and 2 cases were effective.,Six months after the operation of the severe OSAHS group of patients with the PSG,36 cases were cured and 4 cases were developed(P > 0.05).Conclusion: Medium and severe OSAHS can impaire the listening function of the children from 4 to 7 years old,whose manifestation contains middle and high frequency hearing loss,the heavier of the OSAHS disease degree,the more severer the listening function affected.Using the bilateral amygdala resection combined adenoidectomy under endoscope ablation of adenoid hypertrophy has good effects on the children with OSAHS and merged tonsil hypertrophy,the operation will help improve cochlear function partly.