蜗神经管狭窄患者人工耳蜗植入术后听觉康复效果分析  

Analysis of Auditory Rehabilitation Outcomes of the Cochlear Neural Canal Stenosis Patients after Cochlea Implantation

作　　者：苏金霏[1] 张道行[1] 

机构地区：[1]首都医科大学宣武医院耳鼻咽喉头颈外科,北京100053

出　　处：《听力学及言语疾病杂志》2016年第4期386-390,共5页Journal of Audiology and Speech Pathology

摘　　要：目的分析蜗神经管狭窄患者人工耳蜗植入术(cochlear implantation,CI)后康复效果。方法对30例术前颞骨高分辨率CT诊断为蜗神经管狭窄的双耳极重度感音神经性聋患者术中和CI术后3、6、9个月行听神经复合动作电位(evoked compound action potential,ECAP)和电刺激脑干诱发电位(evoked auditory brainstem response,EABR)检测,并于术前、术后3、6、9个月行声场测听,其中17例3岁以上(含3岁)患者行封闭式言语识别率测试,分析其听觉康复效果。结果 130例患者术后3、6、9个月ECAP和EABR的波形均无明显变化。2术后3、6、9个月声场听阈分别为65±8、62±4、61±7dB HL,较术前(100±5dB HL)明显改善。317例术后3、6及9个月的单韵母识别率分别为55%±7%、56%±8%、80%±4%,术后9个月时较术前(52%±8%)明显改善;单声母识别率分别为9%±3%、8%±4%、9%±2%,较术前(8%±2%)无明显改善。结论双侧蜗神经管狭窄患者CI术中、术后ECAP与EABR检测均不能引出典型波形,术后主观听力及言语识别率较差,语言交流存在障碍。Objective To study the analysis of auditory rehabilitation outcomes of patients with cochlear nerve canal stenosis after cochlear implantation（CI）.Methods A cohort of 30 patients with bilateral profound sensorineural hearing loss who were diagnosed with cochlear neural canal stenosis by high-resolution CT were tested with evoked compound action potential（ECAP）and evoked auditory brainstem response（EABR）during and 3,6,9months after CI.Audiometry in sound field was also assessed before and 3,6,9months after CI.Among the cohort,17 patients over 3years old underwent postoperative speech recognition rate test.All the auditory rehabilitation outcomes were analyzed.Results 1 For all 30 patients,there were no obvious differences of ECAP and EABR waveforms tested in 3,6and 9months after CI.2 The thresholds in sound field in 3,6,9months after CI were 65±8dB HL,62±4dB HL and 61±7dB HL,respectively.The thresholds in sound field were significantly improved after than before CI（100±5dB HL）.3 The single vowel recognition rates of 17 patients in 3,6and 9months after CI were 55%±7%,56%±8% and 80%±4%,respectively.The single vowel recognition rate was significantly improved in 9months after than before CI（52%±8%）.The single consonant recognition rates of 17 patients in 3,6and 9months after CI were 9%±3%,8%±4% and 9%±2%,respectively.The single consonant recognition rates were not significantly improved after than before CI（8%±2%）.Conclusion 1 For patients with bilateral cochlear neural canal stenosis,neither ECAP nor EABR waves were produced during or after CI.The language communication of patients is limited as a result of their poor subjective thresholds in sound field and speech recognition rates.

关 键 词：蜗神经管狭窄 人工耳蜗植入术 听神经复合动作电位 电刺激脑干诱发电位 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]