术中电听性脑干反应测试在聋儿人工耳蜗植入中的应用  

Application of intraoperative EABR in the cochlear implantation for the deaf children

作　　者：许政敏[1] 

机构地区：[1]上海儿童医学中心

出　　处：《中国听力语言康复科学杂志》2005年第1期11-13,共3页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的术中记录电听性脑干反应(EABR)值用来判断聋幼儿人工耳蜗植入后的效果及调试言语处理器的优越性。方法 二例聋幼儿,一例2周岁,另一例3周半,均被植入法国DIGISONIC人工耳蜗,术中采用MXM DIGISTIM电刺激器刺激,刺激电极为15,13,10,7,和4,由法国专用PC机记录到电听性脑干诱发电位波形图。术后采用MXM PDX10V1.72软件对言语处理器进行调试,阈值设置以及采用开放式及关闭式言语识别率评估。结果从术中EABR波形图可很清楚分辨出Ⅲ和Ⅴ波,术后测得行为听阈值及术后2年半观察言语识别率呈递增性上升和术中预测的效果一致。男孩各电极的EABR阈值分别是;15μs×60μv,20μs×60μv,25μs×60μv,30μs×60和30μs×60μv。3岁半患儿各电极的EABR阈值为;15μs×50μv,20μs×50μv,25μs×50μv,20μs×50和20μs×50μv。言语处理器振幅阈值(μv)应设置在小于15-20μv的电听性脑干诱发电位刺激振幅阈值。时间阈值设置,在电极15阈值的设置与电诱发刺激时间阈值(puls widths)一致,每降低一个电极号码,增加阈值2-3dB,而设置舒适阈与阈值相差3-5dB。结论术中电听性脑干诱发电位应用不但可以预测人工耳蜗植入后的效果,而且为术后快速精确调试言语处理器提供客观依据。Objective To investigate the intraoperative EABR in assessing the results and fitting the cochlear implant. Methods Intraoperative EABRs were recorded from two young children receiving the digisonic DX cochlear implant. EABRs for electrodes NO. 15, 13, 10, 7 and 4 were recorded using digital stimulation mode. Results Wave Ⅲ and Ⅴ were clearly observed in intraoperative EABR. the behavioral speech perception thresholds obtained after the implantation were similar to those predicted previously. In one child, electrodes NO. 15, 13, 10, 7 and 4 were investigated using Digistim Stimulation Mode with pulse widths of 15, 20, 25, 30 and 30 μ s, and amplitude of 60 μ v for EABR thresholds. The other child (3 years), the thresholds of EABR were measured at electrodes 15, 13, 10 and 7 with stimulation of pulse widths of 15, 20, 25, and 20 μ s, and a amplitude of 50 μ v. Based upon the stimulation parameters (pulse widths and amplitude) for EABR thresholds, the amplitude before being fitted was set at the15-20 μ v differences between the Digisonic PDX10 and the EABR stimulation. Conclusion The intraoperative EABR is able to estimate the results of receiving Cl, and also provides clinical evidence for the later programming of the device.

关 键 词：术中 人工耳蜗植入 听性脑干反应 术后 听性脑干诱发电位 调试言语处理器 言语识别率 聋幼儿 聋儿 结论 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]