CONGENITAL HYPOTHYROIDISM AS A RISK FACTOR FOR CENTRAL HEARING PROCESS DISORDERS

ABSTRACT Objective: To investigate the presence of central auditory processing disorder symptoms in children with congenital hypothyroidism. Methods: An exploratory, descriptive, cross-sectional study of 112 patients with congenital hypothyroidism aged ≥5 years old. An interview was held with the parents/caregivers at the time of the medical consultation. Patients with other medical conditions were excluded. As a research instrument, the structured protocol of anamnesis was used to evaluate the auditory processing routinely used by audiologists. For statistical analysis, the chi-square test was used. Results: Sex distribution was similar in both boys and girls (girls: 53.3%). The most prevalent phenotypic form of congenital hypothyroidism was no dysgenesis (88.4%), and 65.3% of the children had an episode of irregular serum thyroid-stimulating hormone (TSH) levels. Among the manifestations of the most frequent central auditory processing disorder symptoms, problems were reported with regard to cognitive functions, as they related to hearing, such as figure-background ability (83.0%), auditory attention (75.9%) and auditory memory (33.0%). Complaints related to school performance were reported in 62.3% of the cases. Conclusions: The data obtained show a high frequency of lag symptoms in cognitive functions related to central auditory processing, particularly with regard to auditory attention, figure-background ability and auditory memory in patients with congenital hypothyroidism.

摘要 研究目的：探讨先天性甲状腺功能减退症（congenital hypothyroidism）儿童是否存在中枢听觉处理障碍（central auditory processing disorder）相关症状。
研究方法：本研究为探索性描述性横断面研究，共纳入112例年龄≥5岁的先天性甲减患者。在门诊诊疗咨询期间，对患儿家长或照料者开展访谈。本研究排除合并其他基础疾病的受试者，采用听力学医师临床常规使用的结构化问诊方案作为研究工具，对受试者的听觉处理能力进行评估。统计学分析采用卡方检验（chi-square test）。
研究结果：受试者性别分布均衡，女性占比53.3%。先天性甲减最常见的表型为甲状腺非发育不全型（88.4%），65.3%的患儿曾出现血清促甲状腺激素（thyroid-stimulating hormone, TSH）水平异常波动。在最常见的中枢听觉处理障碍症状表现中，与听觉相关的认知功能问题较为突出，具体包括图形-背景听觉分辨能力受损（83.0%）、听觉注意力缺陷（75.9%）及听觉记忆障碍（33.0%）。62.3%的病例存在学业表现不佳相关的临床主诉。
研究结论：本研究数据显示，先天性甲减患者中与中枢听觉处理相关的认知功能滞后症状发生率较高，尤以听觉注意力、图形-背景听觉分辨能力及听觉记忆方面的异常最为显著。