高频ESR测试与NRT测试在指导人工耳蜗C值调试中的联合应用  

The Combined Application of ESR Measurement Using Higher-Frequency and NRT Measurement in Forecasting C-levels During Cochlear Implant Mapping

作　　者：郭浩伟 李燕萍 林碧玉[1] 陈娟[1] 何志强[1] 陈婷[1] GUO Haowei;LI Yanping;LIN Biyu;CHEN Juan;HE Zhiqiang;CHEN Ting(Department of Otolaryngology,Shengli Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350001,China;Department of Otolaryngology,Fujian Provincial Hospital South Branch,Fuzhou 350028,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院耳鼻咽喉科,福州350001 [2]福建省立金山医院耳鼻咽喉科,福州350028

出　　处：《福建医科大学学报》2021年第4期330-336,共7页Journal of Fujian Medical University

基　　金：福建医科大学启航基金项目(2018QH1163)。

摘　　要：目的探讨高频(1000 Hz)探测音记录的电诱发镫骨肌反射(ESR)测试与神经反应遥测(NRT)测试联合使用指导人工耳蜗术后调试的可行性。方法选取植入人工耳蜗的耳聋患者30例,不间断使用至少1 a,有一定交流能力,可配合完成研究中的各项检测。对30例受试者进行高频(1000 Hz)探测音记录的ESR和NRT测试,测试电极为2、6、11、16和21号电极,并记录常用程序中相应电极的主观阈值(T值)和最大舒适阈值(C值)。分别对ESR阈值(ESRT)与NRT阈值以及2个阈值与T值和C值进行相关性和线性回归分析,并对ESRT、NRT阈值和C值进行多重线性回归分析。结果30例受试者的ESR和NRT总引出率分别为91.33%(137/150)和94.00%(141/150);5个测试电极的ESRT和NRT阈值均与C值显著相关(P<0.01);6和16号电极的ESRT与T值间不存在显著相关性(P>0.05),其余3个测试电极的ESRT与T值均显著相关(P<0.01);16和21号电极的NRT阈值与T值不存在显著相关性(P>0.05),其余3个测试电极的NRT阈值与T值均显著相关(P<0.05);5个测试电极的ESRT、NRT阈值和C值构建的多重线性回归模型均具有统计学意义(P<0.01)。结论高频(1000 Hz)探测音记录的ESR和NRT测试的联合使用可指导人工耳蜗术后C值的调试,但不可用于指导T值的调试。Objective To explore the feasibility of electrically evoked stapedius reflex(ESR)measurement using higher-frequency(1000 Hz)probe tone and neural response telemetry(NRT)measurement guiding mapping after cochlear implantation.Methods Thirty deaf patients with cochlear implant were selected.They had been using the cochlear for at least a year with considerable ability of communication,could cooperate with the tests in the study.The ESR measurement with higher-frequency probe tone and NRT measurement were performed on the participants.Five cochlear electrodes of the 2nd,6th,11th,16th,and 21st were selected for the measurements.Obtained the threshold levels(T-levels)and most comfortable levels(C-levels)of the corresponding electrode in the common program.Then correlation and linear regression analysis were performed for electrically evoked stapedius reflex thresholds(ESRTs)and C-levels,ESRTs and T-levels,NRT thresholds and C-levels,NRT thresholds and T-levels,ESRTs and NRT thresholds.Linear and multiple regression analysis were performed for ESRTs,NRT thresholds,and C-levels.Results The total elicitation rate of ESR and NRT were 91.33%(137/150)and 94.00%(141/150),respectively.The ESRTs and NRT thresholds at the five testing electrodes were significantly correlated with C-levels(P<0.01).There were no significant correlations between ESRTs and T-levels at the 6th electrode and 16th electrode(P>0.05),and there were significant correlations between ESRTs and T-levels at the other three testing electrodes(P<0.01).There were no significant correlations between NRT thresholds and T-levels at the 16th electrode and 21st electrode(P>0.05),and there were significant correlations between NRT thresholds and T-levels at the other three testing electrodes(P<0.05).The multiple linear regression models constructed with ESRTs,NRT thresholds,and C-levels at the five testing electrodes were statistically significant(P<0.01).Conclusion Combined use of ESR measurement with higher-frequency(1000 Hz)probe tone and NRT measurement can guide

关 键 词：人工耳蜗 高频探测音 电诱发镫骨肌反射 神经反应遥测 最大舒适阈值 主观阈值 

分 类 号：R764[医药卫生—耳鼻咽喉科]