正常耳蜗结构与Mondini畸形患者人工耳蜗术后电极阻抗及早期干预效果对比研究  

Comparison of Electrode Impedance and Early Intervention Outcomes between Normal Cochlear and Mondini Malformation Patients after Cochlear Implantation

作　　者：王敏[1,2] 腾白玉 郭文文 胡方霞 徐磊 罗建芬[1,2] WANG Min;TENG Bai-yu;GUO Wen-wen;HU Fang-xia;XU Lei;LUO Jian-fen

机构地区：[1]山东大学山东省耳鼻喉医院耳鼻咽喉头颈外科,济南250000 [2]山东省耳鼻喉医院听觉植入科,济南250000 [3]中国听力语言康复研究中心,北京100029

出　　处：《中国听力语言康复科学杂志》2023年第3期257-261,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的对比正常耳蜗结构与Mondini畸形患者人工耳蜗术后的阻抗变化,以及早期听觉言语康复效果。方法回顾性分析80例患者(正常组和Mondini组)人工耳蜗术后1、3、6、12个月的阻抗变化,术前、术后1、3、6、12个月的助听听阈变化及其中双侧语前聋患者术前、术后3、6、12个月的听觉言语效果。结果Mondini组术后1个月阻抗明显高于正常组(P<0.05),两组患者术后其他时间阻抗无显著差异(P>0.05);正常组术前和术后1、3、6、12个月的平均助听听阈均显著高于Mondini组(P<0.05),但两组术后12个月0.5、1、2及4 kHz的助听听阈差别均无显著差异(P>0.05);两组双侧语前聋患者术前听觉行为分级标准(CAP)和言语可懂度分极标准(SIR)评分无显著差差异(P>0.05),Mondini组术后3、6、12个月的CAP、SIR及有意义听觉整合量表(MAIS)/婴幼儿有意义听觉整合量表(ITMAIS)评分均高于正常组,仅术后3个月SIR、MAIS/ITMAIS评分有显著差异(P<0.05)。结论人工耳蜗是Mondini畸形患者重建听力的有效方法,患者术后会短暂地产生更高的阻抗,对调机无不利影响。术后助听听阈、听觉言语能力能达到和耳蜗正常患者相当水平,甚至在术后3个月内,表现出更快的适应能力。Objective The changes of impedance and early auditory and speech rehabilitation outcomes after cochlear implantation(CI)were compared between patients with normal cochlear and Mondini malformation.Methods The changes of impedance at 1,3,6 and 12 months after CI,the changes of hearing threshold before and 1,3,6,12 months after CI were retrospectively compared between 80 patients(the normal group and the Mondini group).The auditory and speech outcomes before and 3,6 and 12 months after CI were compared between patients with bilateral prelingual deafness in these two groups.Results The impedance in the Mondini group at 1 month after CI were significantly higher than those of the normal group(P<0.05),there was no significant difference in impedance between the two groups within other time after CI(P>0.05).The hearing threshold of the normal group was significantly higher than that of Mondini group before and 1,3,6 and 12 months after CI(P<0.05).However,there was no statistically significant difference in hearing threshold between the two groups at frequencies of 0.5,1,2 and 4 kHz 12 months after CI(P>0.05).There was no significant difference in preoperative CAP and SIR scores between patients with bilateral prelingual deafness in these two groups(P>0.05).CAP,SIR and MAIS/ITMAIS scores in the Mondini group were higher than those in the normal group at 3,6 and 12 months after CI,and only SIR and MAIS/ITMAIS scores at 3 months after CI were statistically significant(P<0.05).Conclusion CI is an effective treatment for patients with Mondini malformation.These patients will produce temporarily higher impedance after CI without adverse effects on the later mapping.Their hearing threshold with CI and hearing and speech abilities are comparable to those of patients with normal cochlear.Even 3 months after CI,Mondini patients show faster adaptation.

关 键 词：Mondini内耳畸形 人工耳蜗植入 电极阻抗 听阈 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]