两种不同长度的人工耳蜗电极对不同频率残余听力的影响  

The Effects of the Cochlear Implants with Two Different Lengths on the Residual Hearing at Different Frequencies

作　　者：孙靖[1] 孙越峰[1] 

机构地区：[1]浙江大学医学院附属儿童医院听力中心,杭州310012

出　　处：《听力学及言语疾病杂志》2012年第5期483-486,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨植入两种不同长度的人工耳蜗电极对患者不同频率残余听力的影响。方法以中耳、内耳无明显异常的15例单侧植入Nucleus 24型人工耳蜗(A组,电极长度17mm)患儿与15例单侧植入Medel C40+15型(B组,电极长度29.2mm)人工耳蜗患儿为对象,两组对象于手术前后分别进行听性稳态反应(ASSR)测试,比较不同长度的人工耳蜗电极植入对不同频率听力的影响。结果①人工耳蜗植入后一月开机经耳蜗电刺激后,有51.67%患者植入耳保留残余听力;②手术前0.5、1、2、4kHz ASSR反应阈A组分别为98.93±6.28、107.80±8.16、104.07±8.83及104.73±5.93dB HL,B组分别为99.67±4.20、110.87±8.17、109.93±7.51及106.93±4.35dB HL;手术后一月上述各频率ASSR反应阈A组分别为101.60±4.64、112.60±6.11、106.13±5.19及106.60±6.25dB HL;B组分别为101.40±3.96、116.33±2.58、113.13±3.84及108.46±3.76dB HL;③术后B组0.5、1kHz的残余听力损伤明显,2、4kHz处残余听力损伤程度与A组差异无统计学意义;④A组术后残余听力损失以1kHz最显著,B组术后残余听力损失以500Hz最显著。结论人工耳蜗植入及耳蜗电极电刺激对植入耳的残余听力并非完全破坏,电极长短对不同频率残余听力会造成不同程度的损害,植入电极越长,植入耳蜗的部位越深,对低频残余听力损伤越明显。Objective To study the influences of the cochlear implants with two different lengths on residual bearing at different frequencies. Methods Pre-and post-implantation auditory steady state evoked responses were administered on 15 Nucleus cochlear recipients. Results 51.67 percent of patients still had residual hearing after cochlear implantation procedure. ASSR results before and after operations in the Nucleus group were at 0.5 kHz（98. 93±6, 28/101.60±4.64 dB HL）, 1 kHz（107.80±8.16/112.60±6.11 dB HL）, 2 kHz（104.07±8.83/106.13± 5.19 dB HL） and 4 kHz（104.73±5.93/106.60±6.25 dB HL）, while the same to Medel C40±15 were at 0.5 kHz （99.67±4.20/101.40±3.96 dB HL） , 1 kHz（ll0. 87±8.17/116. 33±2. 58 dB HL）, 2 kHz （109.93±7.51/113. 13±3.84 dB HL） and 4 kHz（106. 93±4. 35/108. 46±3. 76 dB HL）. The thresholds of the ears with Medel C40-F increased significantly at 500 Hz and 1 kHz,but there was no significant difference at 2 kHz and 4 kHz at the thresholds of the ears implanted with Nucleus. The patients with Medel C40＋ implanted had the most hearing loss at 500 Hz while Nucleus had at 1kHz. Conclusion The longer the electrodes of implantation are, the more hearing loss are noted at low frequencies. However, further study is needed to validate this observation in the future.

关 键 词：人工耳蜗植入 听性稳态反应 残余听力 耳蜗全覆盖 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]