客观听觉监测技术在人工耳蜗植入中的临床应用  

The clinical application of objective hearing monitoring technology in cochlear implants

作　　者：王铮[1] 李巍[1] 田颖[1] 姜学钧[1] 

机构地区：[1]中国医科大学附属第一医院耳鼻咽喉科,沈阳110001

出　　处：《临床耳鼻咽喉头颈外科杂志》2014年第7期435-439,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:比较电诱发镫骨肌反射技术(ESR)及神经反应遥测技术(NRT)的临床特点及应用价值。方法:对21例行Cochlear Nucleus 24R(CA)型人工耳蜗植入者分别选取1、7、11、17、22号电极,应用Cochlear公司提供的NRT3.0软件分别进行术中ESR和NRT检测、术后主观心理物理测试,测定电诱发镫骨肌反射阈值(ESRT)、电诱发听神经复合动作电位阈值(ECAP)和听阈阈值(T-levels),并对其ESRT、ECAP和T-levels进行相关性研究。结果:ESRT、NRT、T-levels检出率分别为96.19%、93.33%、100%。ESRT平均阈值为206.61±10.74、208.48±13.64、205.52±14.63、203.76±12.97、199.5±11.19;NRT平均阈值分别为184.11±6.35、188.55±11.70、187.00±12.29、181.85±13.22、179.00±10.50;T-levels平均阈值分别为145.48±18.66、148.62±8.22、146.62±18.08、142.52±13.11、140.33±13.68。各电极ESRT阈值均远远大于心理物理测试得到的T-levels阈值。ESRT、NRT、T-levels三者的均值趋势有较强的一致性。术中测试时间、测试方式、单方检出率、ESR均优于NRT。以所有电极作为观察对象,ESRT与NRT的相关性为0.69,NRT与T值的相关性为0.62,ESRT与T值之间的相关性为0.39。结论:术中应用ESR和NRT技术,可以第一时间反映植入体及听觉传导通路的情况,相对于NRT而言,ESR更为灵活、方便、精确和直观,在低龄患儿术后调试方面前者显示出更加客观的优越性。Objective：Compare the clinical characteristics and application value between elcetrically evoked stapedius responses and neural response telemetry.Method：Select number 1,7,11,17,22electrodes from 21 cochlear implanting nucleus 24 Rcochlear implants,using NRT3.0 software provided by Cochlear corporation to test the threshold of elcetrically evoked stapedius responses and neural response telemetry during operation and subjective psychological physical test after operation repectively named elcetrically evoked stapedius responses threshold,electrically evokded compound aciton potentials threshold,and T-levels.Respectively study the correlations of ESRT,ECAP threshold,and T-levels.Result：The detection rates of ESRT,NRT,and T-levels were 96.19%, 93.33%,100%.The mean thresholds of ESRT were 206.61±10.74,208.48±13.64,205.52±14.63, 203.76±12.97,199.50±11.19;The mean thresholds of NRT were 184.11±6.35,188.55±11.70, 187.00±12.29,181.85±13.22,179.00±10.50;The mean thresholds of T levels were 145.48±18.66, 148.62±8.22,146.62±18.08,142.52±13.11,140.33±13.68.The mean thresholds of ESRT in each electrode were rather greater than that of T-levels.There is a high degree of consistency in the mean thresholds of ESRT,NRT and T-levels.The test time,test means,unilaterally detection rate during operation,ESR is better than NRT.All the electrodes were set as observation objects,the correlation of ESRT and NRT is 0.69,the correlation of NRT and T is 0.62,and the correlation of ESRT and T is 0.39.Conclusion：The application of elcetrically evoked stapedius responses and neural response telemetry during operation can rapidly estimate wether the implant is in good condition and the pathway is normal.Rather than neural response telemetry,elcetrically evoked stapedius responses is more flexible,convienient,accurate and visual,while it is more objective superiority after operation especially for young children for the former detector.

关 键 词：人工耳蜗 电诱发镫骨肌反射 神经反应遥测技术 主观心理物理测试 

分 类 号：R764.35[医药卫生—耳鼻咽喉科]