人工耳蜗术前电刺激听觉脑干诱发电位评估残余听力及术后效果分析  

Assessment of residual hearing by EABR before cochlear implantation and postoperative effect analysis

作　　者：王斌[1] 曹克利[1] 魏朝刚[2] 高志强[1] 王素菊[1] 吕威[1] WANG Bin;CAO Keli;WEI Chaogang;GAO Zhiqiang;WANG Suju;Lyu Wei(Department of Otolaryngology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing,100730,China;Department of Otolaryngology Head and Neck Surgery,Peking University First Hospital,Beijing,100034,China)

机构地区：[1]中国医学科学院北京协和医院耳鼻喉科,北京100730 [2]北京大学第一医院耳鼻咽喉头颈外科,北京100034

出　　处：《中国耳鼻咽喉头颈外科》2022年第10期630-633,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：中央高水平医院临床科研专项(2022-PUMCH-A-031)。

摘　　要：目的探讨最大声刺激无反应患者人工耳蜗术前电刺激听觉脑干诱发电位系统(electrically evoked auditory brainstem responses,EABR)检测听觉通路的方法及分析术后康复效果。方法选取中国医学科学院北京协和医院2015~2016年最大声刺激无反应患者21例,分析临床资料,人工耳蜗术前采用EABR检测听觉通路,随访术后神经反应遥测(neural response telemetry,NRT)及调机结果,应用听觉行为分级标准(categories of auditory performance,CAP)和言语可懂度分级标准(speech intelligibility rating,SIR)问卷评价术后听力和言语结果;另选择有残余听力耳聋患者10例作为对照组。结果实验组21例患者术前EABR的Ⅴ波阈值(178.23±14.18)CL,术后听力言语康复CAP(5.50±1.75)等各指标和对照组统计学分析有显著差别(P<0.05);术后均获得不同程度电听觉,开机测试NRT引出率(33%)低于对照组(90%);两组患者I/O曲线斜率和术后CAP直线相关分析统计学上有显著相关性(P<0.05)。结论最大声刺激无反应患者术前EABR可以评估残余听力,人工耳蜗术后康复差异较大,但显著好于术前。OBJECTIVE To explore the method of preoperation EABR in patients without residual hearing and evaluate the effect of postoperative rehabilitation.METHODS Clinical data of 21patients without residual hearing who underwent cochlear implantation in our hospital from 2015 to 2016 were collected.The preoperative audiological characteristics were retrospectively analyzed.The electrical auditory characteristics were detected by EABR before operation.NRT after operation was followed up,CAP and SIR were used to evaluate the hearing and speech rehabilitation.Another 10 deaf patients with normal cochlear structure of the same age were selected as the normal control group.RESULTS The mean threshold of V wave of EABR before operation in the experimental group was(178.23±14.18)CL,and the CAP of hearing and speech rehabilitation after operation was 5.50±1.75.There were significant differences between the experimental group and the control group(P<0.05).NRT extraction rate of power on test was 33%,which was lower than that of 90%in the control group.There was a significant correlation between the slope ofⅤwave I/O curve detected by EABR and CAP after operation(P<0.05).CONCLUSION Preoperative EABR test should be evaluated in patients without residual hearing.Hearing and speech rehabilitation after cochlear implantation are different,which are significantly better than before.

关 键 词：耳聋 耳蜗植入术 诱发电位 听觉 脑干 残余听力 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]