电生理测试在力声特人工耳蜗调试中的应用  

Application of Objective Test in Mapping after Chinese Cochlear Implanting

作　　者：黄美萍[1,2,3] 杨璐 李进 李孛 周嵌 黄治物 李蕴[1,2,3] Huang Meiping;Yang Lu;Li Jin;Li Bei;Zhou Qian;Huang Zhiwu;Li Yun(Department of Otolaryngology-Head and Neck Surgery,Shanghai Ninth People s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200011,China;Ear Institute,Shanghai Jiaotong University School of Medicine;Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases)

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科,上海200011 [2]上海交通大学医学院耳科学研究所 [3]上海市耳鼻疾病转化医学重点实验室

出　　处：《听力学及言语疾病杂志》2023年第5期434-438,共5页Journal of Audiology and Speech Pathology

基　　金：国家科技部重点研发专项(2020YFC2005205)。

摘　　要：目的分析电镫骨肌反射阈值(electrically evoked stapedius reflex threshold,ESRT)、电刺激听性脑干反应(electrically evoked auditory brainstem response,EABR)阈值、电刺激听神经复合动作电位(electrically evoked auditory nerve compound action potentials,ECAP)阈值与人工耳蜗心理物理量测试中的最大舒适阈值(maximum comfort threshold,C值)及最小反应阈值(minimum response threshold,T值)之间的关系,为力声特人工耳蜗植入者调试时参数设置提供参考。方法选择14例具有一定响度辨别经验及言语交流能力且配合良好的语后聋力声特人工耳蜗植入者,平均年龄22.47±13.37岁,植入体型号为LCI-20PI。在每个患者开机后6±1个月时,选取人工耳蜗低频(1号)、中频(11号)、高频(19号)区域电极各一个,分别测试其T值、C值、ESRT、EABR及ECAP阈值,并进行相关性分析。结果1、11及19号电极ESRT引出率均为100%;EABR阈值引出率分别为100%、100%、78.57%;ECAP阈值引出率分别为100%、100%、71.43%。各电极ESRT与C值均存在显著相关性(P<0.05),相关系数分别为0.76、0.73、0.70,与T值均没有显著相关性(P>0.05)。各电极EABR阈值、ECAP阈值与T值、C值均无显著相关性(P>0.05)。结论ESRT可以作为力声特人工耳蜗植入者调试中C值设置的首选参考指标。Objective To study the relationship between the electrically evoked stapedius reflex threshold(ESRT),electrically evoked auditory brainstem response(EABR),electrically evoked auditory nerve compound action potentials(ECAP),the maximum comfort threshold(C value)and the minimum response threshold(T value)in cochlear implant test,and to provide an objective reference for the parameter setting of domestic cochlear implant.Methods A total of 14 Chinese patients with postlingual hearing loss were selected.The average age was 22.47±13.37 years old.All subjects were implanted with LCI-20PI.Three to six months after switch on,one electrode in low(No.1),one in middle(No.11)and one in high(No.19)frequency region were selected and tested respectively.T value,C value,ECAP,ESRT and EABR threshold were analyzed.Results The extraction rates of ESRT were 100%,100%and 100%for No.1,11 and 19 electrodes,respectively.The extraction rates of EABR threshold were 100%,100%and 78.57%,respectively.The extraction rates of ECAP threshold were 100%,100%and 71.43%,respectively.There was significant correlation between No.1,11 and 19 ESRT and C value(P<0.05),the correlation coefficient was 0.76,0.73,0.70,which were not significantly correlated with T value(P<0.05).There were no significant correlations between EABR,ECAP thresholds and T and C values(P<0.05).Conclusion[KG1]ESRT can be used as a reliable index for setting C value in the mapping of domestic cochlear implants.

关 键 词：电镫骨肌反射阈 电刺激听性脑干反应 电刺激听神经复合动作电位 最大舒适阈值 最小反应阈值 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]