蜗外电刺激诱发听性脑干反应的实现及电极位置对参数的影响  

The relization of EABR test out of cochlea and the effects of different location of electrode on EABR wave

作　　者：张汝祥[1] 张道行[1] 丁秀勇[1] 

机构地区：[1]北京友谊医院耳鼻咽喉科,北京100050

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第5期462-465,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探索微创圆窗龛电刺激诱发听性脑干反应(EABR)的可行性,并研究相关刺激和记录参数。方法:取10只(20耳)健康清洁级Hartley豚鼠,经鼓膜将刺激电极正极置于圆窗龛,刺激电极负极分别置于外耳道口的不同位置,分3组记录EABR:A组正负极间电场平行于蜗轴体表投影,B组电场垂直于蜗轴指向乳突方向,C组电场垂直于蜗轴指向颧骨方向。应用系列减少伪迹的方法、合适的刺激和记录参数来记录EABR。结果:20耳听力正常健康豚鼠,经圆窗龛电刺激均可记录到分化及重复良好的EABR波形。其中,A组电极位置较B、C组更易引出分化良好且稳定的EABR波形。A、B、C组EABR阈值分别为(0.54±0.11)、(0.62±0.12)、(0.70±0.14)mA。刺激强度为0.8 mA时A、B、C组潜伏期分别为(1.71±0.05)、(1.77±0.03)、(1.86±0.04)ms,3组之间比较差异有统计学意义(P<0.05)。结论:经圆窗龛电刺激可成功记录到EABR波形,当刺激电场平行于蜗轴方向时EABR波形分化良好且稳定,可为临床人工耳蜗植入术前EABR的测试提供参考。Objective：To investigate the feasibility of the round window stimulation electrical evoked auditory brainstem response（EABR）test,and optimize the parameters of recording and stimulation electrodes positions.Method：Ten healthy Hartley guinea pigs（20ears）were used for the EABR test.The positive stimulation electrodes were placed into the round window niche,the animals were divided into three group according to the negative electrodes position,group A：the electric field was parallel with the projection of cochlear modiolus on the tympanic membrane,group B：the electric field was perpendicular to modiolus projection toward to the mastoid,group C：the electric field was perpendicular to modiolus projection toward to the zygomatic process.A series of optimized recording and stimulation parameters were uesed to reduce the electrical artifact.Result：All the 20 ears were normal in the ABR testing,and EABR waves were stable and well-differentiated in the EABR tests out of cochlea.But EABR waves of group A were more stable and differentiated than those of group B and C.In group A,the threshold of EABR was（0.54±0.11）mA,and latency of waveⅢ was（1.71±0.05）ms when the stimulus intensity was 0.8mA.In group B,the threshold of EABR was（0.62±0.12）mA,and latency of waveⅢ was（1.77±0.03）ms.In group C,the threshold of EABR was（0.70±0.14）mA,and latency of wave Ⅲ was（1.86±0.04）ms.The threshold of EABR and latency of wave Ⅲ were significantly different among the three groups by statistic analysis.Conclusion：EABR waves were stable and well-differentiated in the EABR tests out of cochlea.The EABR waves were recorded more stably and differentiated when the stimulating electrode and recording electrode were paralleled with the projection of modiolus on the tympanic membrane.

关 键 词：电刺激诱发听性脑干反应 聋 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]