人工耳蜗植入术前耳蜗神经及后通路功能评估  

Preoperative Evaluation of the Function of Cochlear Nerve and Posterior Pathway in Cochlear Implantation

作　　者：刘军[1,2] LIU Jun

机构地区：[1]解放军总医院耳鼻咽喉头颈外科医学部/国家耳鼻咽喉疾病临床医学研究中心,北京100048 [2]解放军总医院第七医学中心耳鼻咽喉头颈外科,北京100700

出　　处：《中国听力语言康复科学杂志》2023年第5期449-455,共7页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：北京市科技计划首都市民健康项目培育基金(Z131100004013019);解放军总医院临床科研扶持基金课题(2012FCTSYS-4017);解放军总医院科技创新基金项目(06ZY13)。

摘　　要：人工耳蜗植入(CI)是重度、极重度感音神经性聋且助听器验配无效或效果不佳患者有效地干预方法之一,CI术前对耳蜗神经及后通路功能的准确评估尤为重要,是一项涉及听力学、影像学和遗传学的综合评估。当常规听力学检测无听觉反应和(或)常规影像学检查提示耳蜗神经可能发育不良时,需重点评估耳蜗神经及后通路功能,可完善大功率助听器条件下测听、皮层听觉诱发电位(CAEP)、电诱发听性脑干反应(EABR)、电诱发听神经复合动作电位(ECAP)等特殊听力学检测,以及功能性磁共振成像(fMRI)、正电子发射断层显像(positron emission tomography,PET)等功能性影像学检查,判断是否有CI手术适应证和禁忌证,进而选择合适的人工耳蜗植入体、预估手术难度,并制订具体手术方案和并发症预案,同时可预估CI手术疗效。Cochlear implantation(CI)is one of the most effective interventions for patients with severe to profound sensorineural hearing loss who have ineffective or poor results with hearing aids.A preoperative accurate evaluation of cochlear nerve and auditory pathway function is particularly important.It involves a comprehensive evaluation of audiology,imaging,and genetics.When routine audiological testing shows no auditory response and/or routine imaging suggests poor cochlear nerve development,attention must be paid to evaluating cochlear nerve functions and the integrity of anatomical structures of auditory pathways.This can be done by testing auditory responses in high-power hearing aid conditions,conducting specialized audiology tests such as Cortical auditory evoked potential(CAEP),Electrically-evoked auditory brainstem response(EABR),and Electrically-evoked auditory nerve compound action potentials(ECAP),as well as functional imaging tests such as functional magnetic resonance imaging(fMRI)and Positron emission tomography(PET).This is done to determine if there are indications or contraindications for CI,to select an appropriate cochlear implant device,estimate surgical difficulty,develop a surgical plan and complications prevention plans,and preoperative evaluation of CI efficacy.

关 键 词：耳蜗神经 功能不良 人工耳蜗植入 评估 疗效 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]