人工耳蜗植入术后阈值与舒适阈特性的分析  

Characteristics of threshold and comfortable levels after artificial cochlear implantation

作　　者：陈雪清[1] 韩德民[1] 赵啸天[2] 孔颖[1] 刘莎[1] 莫玲燕[1] 刘博[1] 郑军[2] 李永新[2] 王硕[1] 吴燕君[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所,北京市100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科,北京市100730

出　　处：《中国临床康复》2004年第32期7145-7147,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:患者接受人工耳蜗植入术后三四周需返回医院,由听力学专业人员为患者安装体外设备并进行阈值及舒适阈测试。方法:对使用不同人工耳蜗系统患者236例的阈值、舒适阈进行分析。于1996-02/2003-06接受手术,手术年龄为1岁半至52岁。170例使用澳大利亚Cochlear人工耳蜗Nucleus24型。43例使用美国Clarion人工耳蜗。23例使用奥地利Medel人工耳蜗。术后4周左右安装体外设备并进行心理物理测试。心理物理测试主要包括阈值和舒适阈的测试。使用与患者年龄相适应的方法进行测试。结果:经单因素方差分析,使用澳大利亚人工耳蜗系统的患者,1号与20号电极的阈值和舒适阈的差异有显著性意义(P<0.05)。使用美国和奥地利人工耳蜗系统的患者,不同电极阈值和舒适阈的差异均无显著性意义(P>0.05)。经单因素方差分析,3号、10号和20号电极的阈值在开机后1年内的差异无显著性意义(P>0.05)。经单因素方差分析,3号电极、10号电极和20号电极在开机时的舒适阈与开机后2周、3周、2个月、3个月、6个月、9个月、1年的舒适阈的差异均有显著性意义(均为P<0.01)。结论:不同患者其阈值、舒适阈数值差异较大。自蜗底至蜗顶的电极,其阈值、舒适阈测试的数值逐渐降低。随术后开机时间的增加,患者的阈值、舒适阈测试值呈增加的趋势。不同部?AIM: The patients should return to hospital three or four weeks after the artificial cochlear implantation. Audiologists install external equipment for the patients, and measure the threshold(T) and the comfortable levels(C Levels). METHODS: The threshold and comfortable level of 236 patients using different artificial cochlear system were analyzed. The patients received surgery at the age of 1.5 to 52 years from February 1996 to June 2003. Of these patients, 170 were inserted with Australian artificial cochlear of type Nucleus24, 43 with American Clarion artificial cochlear and 23 with Austrian Medel artificial cochlear. The external instrument was installed on the fourth week after operation, and psychophysical tests were performed. The psychophysical tests included tests of T and C Levels. The methods used in the test were suitable for the age of the patients. RESULTS: The T and C Levels between No.1 and 20 electrodes were significantly different for the patients with Nucleus artificial cochlear system analyzed by the single factor analysis of variance(P< 0.05). The T and C Levels between all the electrodes were insignificantly different for the patients with Medel and Clarion artificial cochlear system(P >0.05).The single factor analysis of variance showed that there was no significant difference in the T Levels of the No. 3, 10 and 20 electrodes within one year after switch on(P >0.05), and the C Levels of the No. 3, 10 and 20 electrodes when switch on and 2 weeks, 3 weeks, 2 months, 3 months, 6 months, 9 months, and 1 year after switch on were significantly different(P< 0.01). CONCLUSION: There are great differences in the T and C Levels of different patients. The T and C Levels decrease from basal electrodes to the apical electrodes and slightly increase with the increasing time of switch on. The electrodes in the different parts show the same tendency. It is difficult to estimate T and C levels in any patient accurately before switch on.

关 键 词：人工耳蜗植入术 阈值 舒适阈 心理物理测试 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]