听力正常者交替短声诱发的耳蜗电图特征  

A Clinical Study of Alternating Click Evoked ECochG in Normal-Hearing Subjects

作　　者：冀飞[1] 陈艾婷[1] 邓新生[2] 李兴启[1] 赵阳[1] 郗昕[1] 刘兴健[1] 

机构地区：[1]解放军总医院耳鼻咽喉-头颈外科,解放军总医院耳鼻咽喉科研究所,北京100853 [2]河北省涿州市医院

出　　处：《听力学及言语疾病杂志》2009年第1期32-35,共4页Journal of Audiology and Speech Pathology

摘　　要：目的分析听力正常者交替短声诱发的耳蜗电图(ECochG)特征,为耳蜗电图的临床应用提供参照。方法对听力正常者38人(49耳)行耳蜗电图检查。使用Nicolet Bravo诱发电位系统,用交替短声作为刺激信号。每只测试耳的起始测试强度为100dBnHL,以10dB为步距逐渐降低强度,直至无法引出CAP。观测各强度下CAP的潜伏期和幅度、CAP阈值以及高强度(90dBnHL)下SP/CAP幅度比值。绘制CAP的输入-输出曲线。结果49耳均引出良好ECochG波形,平均引出反应阈为28.37±6.81dBnHL。CAP峰潜伏期随刺激强度降低而延长。高强度下-SP与CAP幅度比为0.27±0.14。CAP幅度的I/O曲线呈明显的低、高两个强度段,在60dBnHL附近存在明显的拐点。结论听力正常者耳蜗电图可作为临床诊断的参照依据。CAP的I/O曲线及-SP/CAP幅度比可提供耳蜗病变的诊断信息。CAP的潜伏期和阈值可反应耳蜗内、外毛细胞的功能。Objective To analyze the characteristics of alternating click evoked ECoehG in normal-hearing subjects, and provide diagnosis references for clinical application. Methods 38 subjects （49 ears） with normal hearing were recruited in this study. ECochG tests were performed by Nicolet Bravo EP system and the ears were stimulated with alternating polarity clicks. The initial stimulation level was 100 dB nHL. The level was decreased by 10 dB step until the CAP failed to be observed. The latency and amplitude were measured. The CAP threshold and SP/ CAP amplitude ratio at 90 dB nHL were recorded. I/O curves of the CAP for each subject were plotted. Results ECochG waveforms were evoked from all the 49 ears, with a mean threshold at 28.37 dB nHL. The peak latency of CAP increased as the stimulation levels decreased. The mean amplitude ratio of SP and CAP was 0. 27±0.14 at 90 dB nHLo The I/O curve of CAP presented two distinct stages.the tow and high level stage. The knee point at 60 dB nHL was observed. Conclusion The ECochG data derived from normal-hearing subjects can be used as normal references in clinical applications. The CAP I/O function curve and amplitude ratios of - SP/CAP can provide more information about cochlear pathological changes. The latency and threshold of CAP can reflect the function of both IHC and OHC.

关 键 词：耳蜗电图 短声 总和电位 听神经复合动作电位 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]