人工耳蜗术后电诱发镫骨肌反射阈值与最大舒适阈值比较  

Comparison between most comfortable level and electrically evokedstapedius reflex threshold in post-cochlear implantees

作　　者：曹卫[1] 郑文雯[1] 王节[1] 张琨龄[1] 杨克林[1] 邱建新[1] 夏正毅[1] 

机构地区：[1]安徽医科大学第一附属医院耳鼻咽喉-头颈外科,安徽230022

出　　处：《中华耳科学杂志》2008年第2期186-189,共4页Chinese Journal of Otology

基　　金：安徽省教育厅自然科学研究项目(编号:2006KJ36613);安徽省卫生厅临床医学重点学科技术进步项目(编号:20042014)

摘　　要：目的探讨电诱发镫骨肌反射(electrically evoked stapedius reflex,ESR)及阈值(electrically evokedstapedius reflex threshold,ESRT)与人工耳蜗心理物理量测试中最大舒服级(Most Comfortable Level,M级)之间的关系,从而为低龄儿童、不合作者或多重残疾的人工耳蜗植入者的M级设定提供参考。方法选择植入美国Advanced Bionics公司的HiRes90K人工耳蜗共20例语前聋患者,使用Fidelity120通道言语编码策略至少6个月时间,有一定交流能力,对声音的响度有辨别能力,年龄为3至13岁,平均年龄为6.5岁。选择3、7、11、15号电极施加电刺激,用心理物理方法测M级,并测量植入耳对侧耳的ESRT。对四个测试电极之间的ESRT进行方差分析,并对测试电极的ESRT与M级进行相关性分析。结果20例受试者共70个电极引出ESR,引出率为87.5%;四个测试电极之间进行方差分析(F=0.072,df=3/66,P>0.05),没有统计学意义;对获得的70个ES-RT与M级之间进行相关性分析(r=0.91,t=0.000,P<0.01),有显著相关性。结论ESR可以协助判断人工耳蜗植入者术后的M级。Objective To investigate the relationship between electrically evoked stapedius reflex （ESR） and most comfortable level （M-levels） in order to help setting the speech processor parameter for cochlea implantees, especially for infants, non-cooperative or muhihandieap children. Methods Subject selection criteria were as follows： Fidelity 120 HiRes 90K implant （Advanced Bionics Corporation, Sylmar, CA） use for at least 6 months,considerable ability of communication and reasonable loudness scaling. A total of 20 prelingual children participated in the present study, with mean age 6.5 years（rang： 3 to 13 years）. Four cochlear electrodes （3,7, 11 and 15） were stimulated as tested electrodes. M-levels were obtained by perceptual measures, and ESR thresholds were measured by a probe placed in the ear contralateral to the implanted ear. One-Way analysis of variance was used to test for an association among complete ESR thresholds and linear correlation was used to examine the association between ESRT and M-levels of all four test electrodes. Results ESR was detected in 70 out of 80 patients （87.5%）. One-Way analysis of variance revealed no significant difference in ESR thresholds among four electrodes tested （F=0.072, df=3/66, P 〉 0.05）. There was a strong correlation between ESRT and M-levels （r = 0.91, t = 0.000, P 〈 0.01） in four test electrodes. Conclusion ESRT could provide helpful reference for setting the M-levels.

关 键 词：人工耳蜗植入 电诱发镫骨肌反射 心理物理测试 

分 类 号：R318.18[医药卫生—生物医学工程] R764.04[医药卫生—基础医学]