人工耳蜗术后客观调机过程中电诱发听觉脑干反应、电诱发听神经复合动作电位和电诱发蹬骨肌反射的指导作用  

Objectively adjusting cochlear implant processor postoperatively using electrically evoked auditory brainstem response,electrically evoked auditory compound action potential,and electrically elicited stapedius reflex

作　　者：王亮[1] 董明敏[1] 

机构地区：[1]郑州大学第一附属医院耳鼻咽喉科,河南省郑州市450052

出　　处：《中国组织工程研究与临床康复》2007年第9期1713-1715,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:探讨使用电诱发听觉脑干反应、电诱发听神经复合动作电位和电诱发蹬骨肌反射指导人工耳蜗术后客观调机的可行性。方法:测试于2002-07/2004-06在郑州大学第一附属医院测听室进行。①对53例Nucleus24型人工耳蜗植入者进行主观阈值以及最大舒适阈值测试,同一天进行电诱发听觉脑干反应、电诱发听神经复合动作电位和电诱发蹬骨肌反射测试。②将主观阈值和最大舒适阈值与电诱发听觉脑干反应、电诱发听神经复合动作电位阈值间进行相关性分析;同时将根据电诱发听觉脑干反应、电诱发听神经复合动作电位阈值推测得出的主观阈值和最大舒适阈值与实际值进行相关性分析。结果:53例受试者均进入结果分析。①电诱发听觉脑干反应阈值和电诱发听神经复合动作电位阈值与主观阈值和最大舒适阈值相关(r=0.585,0.555,0.592,0.630,P<0.001)。②3种检测的阈值在不同患者间变异均较大。但所有电诱发听觉脑干反应阈值和电诱发听神经复合动作电位阈值均大于主观阈值,所有电诱发蹬骨肌反射阈值均低于不舒适阈值。③由电诱发听觉脑干反应、电诱发听神经复合动作电位阈值推测得出的主观阈值和最大舒适阈值与实际值均显著相关(r=0.918,0.924,0.934,0.883,P<0.001)。结论:电诱发听觉脑干反应、电诱发听神经复合动作电位和电诱发蹬骨肌反射测试可用于指导人工耳蜗植入者主观阈值和最大舒适阈值的调试。AIM： To study the feasibility of objectively adjusting cochlear processor postoperatively using electrically evoked auditory brainstem response （EABR）, electrically evoked auditory compound action potential （ECAP）, and electrically elicited stapedius reflex （ESR）. METHODS： The experiment was accomplished in the Hearing Test Room of the First Affiliated Hospital of Zhengzhou University from July 2002 to June 2004.（1）Subjective hearing threshold value （T-level）, subjective maximum comfortable threshold value （C-level）, EABR, ECAP, and ESR were recorded in 53 cases who received Nucleus 24 cochlear implant. （2）Correlation analysis was carried out between T-level, C-level and EABR, ECAP, ESR, between T-level, C-level predicted from EABR threshold or ECAP threshold and actual value. RESULTS： All 53 subjects were involved in the result analysis. （1）The EABR threshold and ECAP threshold were correlated with T-level and C-level （r =0.585, 0.555, 0.592, 0.630, P 〈 0.001 ）.（2）EABR threshold, ECAP threshold, and ESR threshold all had significant variability in different patients. EABR thresholds and ECAP thresholds in all cases were higher than T-level. ESR threshold in all cases were lower than uncomfortable level.（3）The T-level and C-level predicted from EABR threshold or ECAP threshold were significantly correlated with actual T-level and actual C-level （r =0.918, 0.924, 0.934, 0.883, P〈 0.001）. CONCLUSION; T-level and C-level can be adjusted objectively using EABR, ECAP, and ESR tests.

关 键 词：人工耳蜗 言语处理器调试 电诱发听觉脑干反应 电诱发听神经复合动作电位 电诱发镫骨肌反射 

分 类 号：R318[医药卫生—生物医学工程]