短声疏密波诱发的耳蜗微音电位对听神经病的诊断意义  

Significance of Diagnosis for Auditory Neuropathy by Cochlear Micro Phonics Elicited by Condensation and Rarefaction Clicks

作　　者：邱素梅[1] 李湘辉[2] 陈越勃 刘佳浩 邹雨滴 陈惠娟[1] 谢薇 QIU Su-mei;LI Xiang-hui;CHEN Yue-bo;LIU Jia-hao;ZOU Yu-di;CHEN Hui-juan;XIE Wei

机构地区：[1]广东省残疾人康复中心,广州510000 [2]中山大学孙逸仙纪念医院,广州510000

出　　处：《中国听力语言康复科学杂志》2019年第4期263-265,共3页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：广东省自筹经费类科技计划项目(2017ZC0334)

摘　　要：目的人工耳蜗候选者中采用ABR短声疏密波诱发耳蜗微音电位(cochlear microphonics,CM)测试,探讨其在听神经病的诊断意义及应用价值。方法人工耳蜗植入候选者中筛选双耳ABR100dBnHL刺激无反应、耳声发射(OAE)引不出的婴幼儿共65例(130耳)。所有受试者口服水合氯醛镇静辅助睡眠,采用ABR测试,刺激声为短声,用疏波和密波诱发耳蜗微音电位测试(CM)。为验证真正CM存在,在相同测试条件下采用了夹紧插入式耳机导声管及拔出耳机等方法进行比较。结果65例(130耳)中能真正引出CM有8例(16耳),占12.3%。结论CM测试能客观反映内耳毛细胞的功能,稳定性比OAE好,在ABR严重异常或缺失、OAE引不出时,建议常规进行CM测试,有助于进一步鉴别诊断听神经病,避免漏诊,为蜗性及蜗后鉴别诊断及精准干预提供临床依据。Objective To investigate the clinical value of Cochlear Microphonics(CM)test on diagnosis of Auditory Neuropathy.In this research,we used condensation and rarefaction clicks to elicit CM among cochlear implant candidates.Methods 65 participants(130 ears),who showed no response at 100 dB nHL in ABR test and no emission present in OAE test,were selected.All of the 65 subjects aged 1-5 years,and the average age was 3.4±1.0 years.They all exhibited no external or middle ear disease after the examination of electro-otoscopy and 226 Hz acoustic impedence test(less than or equal to 1 year old kids were used 1000 Hz acoustic impedence test).All participants were sedated using chloral hydrate before CM test.ABR test was adopted,and the stimulus sound was short.Cochlea microphonic potential test(CM)was induced by sparse and dense waves,with the stimulus intensity of 100 dB nHL and the stimulation rate of 19.3 pps to elicit CMs.In order to verify the existence of real CM,the clamped and inserted earphone sound guide tube and the earphone pulling out were used for comparison under the same test conditions.Results 8 cases(16 ears)in 65 cases(130 ears)showed CM waves(12.3%).Conclusion CM test could objectively reflect the function of hair cells in the inner ear and it was more stable than OAE.In the cases whose ABR waves were absent or severe abnormal and also had negative results in OAE test,we recommended to do the CM test routinely.CM test was helpful to further diagnosis of auditory neuropathy,and could also provide clinical evidence for differential diagnosis and accurate intervention of cochlear and retrocochlear.

关 键 词：耳声发射 短声疏密波 耳蜗微音电位 听神经病 

分 类 号：R764[医药卫生—耳鼻咽喉科]