人工耳蜗植入者EABR和行为测听电流级阈值相关性研究  

Correlation between EABR Threshold and Behavioral Audiometry Current Level Threshold in Cochlear implant Recipients

作　　者：唐鸣[1] 张盼盼[2,3] 邓红霞 沈毅[1] 成立新[1] 王凯[1] 沈志森[1] 史文迪[2,3] TANG Ming;ZHANG Panpan;DENG Hongxia;SHEN Yi;CHENG Lixin;WANG Kai;SHEN Zhisen;SHI Wendi(Department of Otorhinolaryngology Head and Neck Surgery,Ningbo Medical Center Lihuili Hospital,Ningbo 315040,China;Zhejiang Chinese Medical University Hearing and Speech Rehabilitation,Hangzhou 310053,China;Hangzhou Ren Ai Rehabilitation Institute for Deafness,Hangzhou 310000,China)

机构地区：[1]宁波市医疗中心李惠利医院耳鼻咽喉头颈外科,宁波315040 [2]浙江中医药大学听力与言语科学系,杭州310053 [3]杭州仁爱耳聋康复研究院,杭州310000

出　　处：《中华耳科学杂志》2020年第3期475-480,共6页Chinese Journal of Otology

基　　金：浙江省自然科学基金项目(LY15H130003);浙江省医药卫生科技计划项目(2016KYB272和2020RC107);宁波市科技惠民技术研发项目(2015C50026);宁波市医疗卫生品牌学科建设项目(PPXK2018-02)

摘　　要：目的探究大龄儿童和成年人工耳蜗植入者术后电诱发听性脑干反应(electrically evoked auditory brainstem responses,EABR)反应阈和主观行为电量级阈值的相关性。方法对18名MEDEL人工耳蜗植入患者分别选取E1、E3、E6、E9、E12电极,进行EABR检测和主观行为电量级测试,比较两种测试电量级阈值的相关性;根据EABR反应阈和主观行为电量级阈值调试耳蜗,设置为程序①和程序②,同一患者佩戴调试后的人工耳蜗,随机先后进行声场评估,比较两个程序声场下行为阈值的相关性。结果电极E1、E3、E6、E9、E12的EABR的Ⅴ波潜伏期分别为(3.62±0.45)ms、(3.43±0.43)ms、(3.61±0.40)ms、(3.86±0.36)ms、(3.79±0.36)ms;EABR的反应阈分别为:(25.00±8.37)qu、(26.39±6.27)qu、(27.08±7.73)qu、(28.47±6.51)qu、(27.60±7.82)qu;主观行为电量级阈值分别为:(29.97±10.18)qu、(31.62±11.58)qu、(34.90±16.28)qu、(39.60±18.47)qu、(35.32±12.80)qu;二者有相关性,相关系数分别为0.479、0.623、0.525、0.653、0.825,P<0.05;程序①和程序②的声场下行为测听阈值在500Hz、1000Hz、2000Hz、4000Hz的相关系数分别为0.801、0.783、0.945、0.981,P<0.01;二者在四个频率点均显著相关,在高频区域相关性更强。结论人工耳蜗患者EABR电量的阈值和主观行为电量级有良好的相关性,对于无法配合行为测听的患者,可以采用客观的EABR测试来指导人工耳蜗调试。Objective To investigate the correlation between electrical evoked auditory brainstem response(EABR)threshold and behavioral audiometry current threshold in older children and adults with cochlear implants.Methods E1,E3,E6,E9 and E12 electrodes were selected from 18 MEDEL cochlear implant recipients for EABR detection and behavioral threshold tests,as well as correlation between their threshold current levels.The cochlea implant was debugged first based on EABR response thresholds and then using subjective thresholds,set as programs 1 and 2,respectively.Sound field audiometry was performed using the two programs in random orders,and correlation between thresholds using the two programs was analyzed.Results The EABR wave V latency for electrodes E1,E3,E6,E9,and E12 was 3.62±0.45 ms,3.43±0.43 ms,3.61±0.40 ms,3.86±0.36 ms and 3.79±0.36 ms,respectively.For the five electrodes,EABR threshold current levels were 25.00±8.37 qu,26.39±6.27 qu,27.08±7.73 qu,28.47±6.51 qu and 27.60±7.82 qu,respectively;and behavioral threshold current levels were 29.97±10.18 qu,31.62±11.58 qu,34.90±16.28 qu,39.60±18.47 qu and 35.32±12.80 qu,respectively,showing correlation coefficient at 0.479,0.623,0.525,0.653 and 0.825,respectively(P<0.05).The correlation coefficient between thresholds in the sound field using programs 1 and 2 was 0.801 at 500 Hz,0.783 at 1000 Hz,0.945 at 2000 Hz and 0.981 at 4000 Hz,respectively(P<0.01),showing increasing correlation at higher frequencies.Conclusions There is a good correlation between cochlear implant power levels at EABR and subjective behavioral thresholds.For patients unable to cooperate in behavioral audiometry,objective EABR test can be used to debug the cochlear implant.

关 键 词：人工耳蜗植入 电诱发听性脑干反应 行为测听 

分 类 号：R764[医药卫生—耳鼻咽喉科]