人工耳蜗植入术中电诱发听性脑干反应检测及其临床意义  

Preliminary Study on Intra-Surgical Detection of EABR during Cochlear Implantation and Its Clinical Significance

作　　者：张帆 何白慧[1,2,3] 沈佳丽 沈敏 何景春[1,2,3] 张青 伏杭江 杨军[1,2,3] ZHANG Fan;HE Bai-hui;SHEN Jia-li;SHEN Min;HE Jing-chun;ZHANG Qing;FU Hang-jiang;YANG Jun

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092 [2]上海市耳鼻疾病转化医学重点实验室,上海200092 [3]上海交通大学医学院耳科学研究所,上海200092 [4]东部战区总医院全科医学科,南京210002

出　　处：《中国听力语言康复科学杂志》2022年第4期277-280,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：新华医院院级临床研究培育基金:X-O AVT模式对助听患儿听觉言语语言发育的影响(17CSK03)。

摘　　要：目的研究人工耳蜗植入(CI)手术中电极插入前电诱发听性脑干反应(EABR)的特点及术后听觉言语能力的关系。方法选取上海交通大学医学院附属新华医院行人工耳蜗植入术的12例听神经病及内耳畸形其与患儿为特殊疾病组,选取同期10例未发现耳蜗结构及听神经发育异常、非听神经病患者作为对照组,回顾性对比分析CI术中植入前EABR的波形特点,随访其术后听觉行为分级(CAP)、言语可懂度分级(SIR)和有意义听觉整合量表(MAIS)/婴幼儿有意义听觉整合量表(IT-MAIS),分析EABR波形参数与术后听觉言语评估量表得分的相关性。结果(1)特殊疾病组患儿均引出EABR的Ⅲ波或Ⅴ波;(2)听神经病患儿与对照组Ⅴ波潜伏期之间的差异有统计学意义(P=0.01);(3)所有患者开机后均有听性反应;(4)两组患者中各有1例EABR的V波分化不清,术后听力随访结果较差;(5)两组患者术后6个月声场测试各频率差异无统计学意义;(6)特殊病例组中患儿V波的输入-输出曲线斜率(I/O值)与MAIS/IT-MAIS(21.9±6.3)存在相关性(P=0.01)。结论CI术中植入前EABR的V波引出率以及I/O值可能与术后听觉言语能力相关,尚需要更多数据支持。Objective To investigate the characteristics of preimplantation electrically evoked auditory brainstem response(EABR)and the relationship between EABR and auditory speech ability after cochlear implantation(CI).Methods Among the patients received CI in Xinhua Hospital,Shanghai Jiaotong University School of Medicine,12 cases with auditory neuropathy or inner ear deformity,such as large vestibular aqueduct syndrome,Mondini dysplasia and inner acoustic canal stenosis(cochlear nerve dysplasia),were selected as the special disease group,and another 10 cases with normal inner ear structure,cochlear nerve and no auditory neuropathy as the control group.The waveform characteristics of EABR before CI were analyzed retrospectively.The postoperative Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR)and Meaningful Auditory Integration Scale(MAIS)/Infant-Toddler Meaningful Auditory Integration Scale(IT-MAIS)were followed up.The relationship between EABR waveform parameters and postoperative auditory speech assessment scale score was then analyzed.Results(1)TheⅢorⅤwaveform of EABR was elicited in all 12 children in special disease group.(2)The V wave latency in children with auditory neuropathy was significantly different from that in the control group(P=0.01).(3)All patients had auditory response after cochlear implant fitting.(4)One case in each group had unclear V-wave differentiation of EABR,and the postoperative hearing follow-up results were poor.(5)There was no statistically significant difference in every frequency of sound field test between the two groups 6months after CI.(6)Input-output curve slope(I/O value)ofⅤwave in the special disease group was correlated with MAIS/IT-MAIS(21.9±6.3)(P=0.01).Conclusion The V-wave inducing rate and I/O value of EABR before electrode implantation during CI may be correlated with postoperative auditory and speech ability,which needs more data support.

关 键 词：人工耳蜗 电诱发听性脑干反应 听觉言语能力 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]