电诱发听性脑干反应在人工耳蜗植入术后的临床应用分析  

Clinical application analysis of electrically induced auditory brainstem response after cochlear implantation

作　　者：刘金环[1] 张智风[1] Liu Jinhuan;Zhang Zhifeng(Department of Otorhinolaryngology,the Third People's Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第三人民医院耳鼻咽喉科,450000

出　　处：《国际耳鼻咽喉头颈外科杂志》2021年第6期321-324,共4页International Journal of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨电诱发听性脑干反应(electrically evoked auditory brainstem responses,EABR)的特性和其在判断人工耳蜗植入术后听觉传导通路完整性中的作用,以及不同脉冲宽度的EABR阈值与人工耳蜗植入术后调试行为测试数值之间的相关性,为人工耳蜗植入术后首次开机不会配合行为测试的植入者科学设定刺激参数提供参考。方法选取郑州市第三人民医院植入诺尔康晨星人工耳蜗(CS-10A植入体)、能配合行为测试的植入者20例,采用行为测试测得阈值(T值)和最大舒适阈(C值),在标准屏蔽室内做EABR检查,采用3、10、20电极分别测脉冲宽度为25、50、75μs/相的EABR平均阈值,分析引出率和波形分化特点,并对两种数据进行统计学分析。结果EABR越容易引出波形越清晰,患儿的听觉反应越灵敏,也反映了术后植入体系听觉传导通路越完整(P<0.05);EABR脉冲宽度为75μs/相的平均阈值与人工耳蜗的C值有良好的相关性(P<0.05)。结论EABR检测可客观的判断人工耳蜗植入术后植入体系完整的听觉传导功能,客观评价人工耳蜗植入效果。人工耳蜗调试中,可以通过EABR脉冲宽度为75μs/相的平均阈值来指导不能配合主观行为测试的植入者C值的判定,为患儿早期开始听觉刺激,建立听觉重塑带来帮助。Objective To investigate the characteristics of electrically evoked auditory brainstem responses(EABR)and its role in determining the integrity of auditory pathway after cochlear surgery.As well as the correlation between EABR threshold of different pulse widths and the value of behavioral test after cochlear implantation,it provides reference for the scientific setting of stimulus parameters for the implant who cannot cooperate with behavioral test after the first operation of cochlear implantation.Methods Twenty patients who were implanted with Norkang Morning Star Cochlear implant(CS-10A implant)in our hospital and could cooperate with behavior test were selected,and their threshold level(T level)and maximum comfortable level(C level)were measured by behavior test.Then electrically induced auditory brainstem Responses(EABR)were performed in standard shielded room,and the average EABR thresholds of pulse width of 25,50 and 75μs/phase were measured by 3,10 and 20 electrodes respectively.The extraction rate and waveform differentiation characteristics were analyzed,and the two data were statistically analyzed.Results The more easily EABR elicits the clearer waveform,the more sensitive the auditory response of the children,which also reflects the more complete auditory pathway of the postoperative implantation system(P<0.05).The mean threshold of EABR pulse width of 75μs/phase had a good correlation with the C value of cochlea(P<0.05).Conclusion EABR can objectively judge the complete auditory conduction function of the implanted system after cochlear implantation and objectively evaluate the effect of cochlear implantation.During cochlear debugging,the average threshold of EABR pulse width of 75μs/phase can be used to guide the judgment of C value of the implant who cannot cooperate with the subjective behavior test,which can help the children to start auditory stimulation and establish auditory remodeling in the early stage.

关 键 词：听觉障碍 耳蜗植入术 电诱发听性脑干反应 耳蜗植入物 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]