低频残余听力保留患者声电联合刺激短期效果观察  

Short-term observation of electrical acoustic stimulation in patients with low frequency residual hearing after cochlear implant

作　　者：王睿婕[1] 罗建芬[1] 晁秀华 胡方霞 樊兆民[1] 徐磊[1] 王海波[1] Wang Ruijie;Luo Jianfen;Chao Xiuhua;Hu Fangxia;Fan Zhaomin;Xu Lei;Wang Haibo(Department of Auditory Implantation,Shandong Provincial ENT Hospital,Shandong University,Shandong Second Provincial General Hospital,Shandong Provincial ENT Institute,Jinan 250022,China)

机构地区：[1]山东大学山东省耳鼻喉医院、山东省第二人民医院听觉植入科、山东省耳鼻喉研究所,济南250022

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第12期1173-1182,共10页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金(82271172,82071053);国家自然科学基金重大项目(82196821);山东省自然科学基金重点基础研究计划(ZR2021ZD40);山东省泰山学者工程-青年专家计划(tsqn202211357);山东大学横向课题(6010420001)。

摘　　要：目的分析低频残余听力(low-frequency residual hearing,LFRH)保留的人工耳蜗(cochlear implant,CI)植入患者使用声电联合刺激(electrical acoustic stimulation,EAS)后,其言语、声调识别以及音乐感知的改善情况。方法选取2017年1月至2020年10月行单侧CI手术且有LFRH保留的汉语普通话患者共12例,男8例、女4例,语后聋5例、语前聋7例,植入时中位年龄12岁(3~62岁);患者术前均有残余听力,及时佩戴助听器且康复效果良好,CI电刺激使用时间(37.0±16.2)个月。患者植入侧术后125 Hz和250 Hz纯音听阈均≤80 dB HL,使用EAS设备后,进行为期2个月的临床跟踪性研究。分别于EAS使用前、使用即刻、使用后2个月进行效果评估,包括言语识别率、声调识别和音乐测试。使用SPSS 23.0软件进行统计学分析。结果共10例患者完成2个月临床随访和效果评估,EAS使用即刻相比使用前,扬扬格词识别率明显下降[(71.7±4.3)%比(79.6±3.1)%,P=0.018]。EAS使用2个月后相比使用前、使用即刻,噪声环境中句子、噪声环境中声调识别率得分均显著提高,噪声环境中句子识别阈均显著改善(P值均<0.05)。使用EAS 2个月后的音高分辨能力较使用前显著提升(P=0.042),节奏分辨能力较使用前(P=0.021)和使用即刻(P=0.017)均显著提高。其余测试结果差异均无统计学意义(P值均>0.05)。结论EAS提供的低频声学信息以及声电刺激模式可为CI植入者在噪声下的言语、声调识别和音乐感知提供丰富的听觉线索,短时间内即可促进已接受长期电刺激CI患者复杂聆听能力的提高,综合改善其听觉水平。Objective To analyze the effects of electrical acoustic stimulation(EAS)on speech and tone recognition as well as music perception in children with low-frequency residual hearing(LFRH)after cochlear implant(CI).Methods A total of twelve Mandarin patients with LFRH who underwent unilateral CI from January 2017 to October 2020 were recruited,including 8 males and 4 females.There were 5 cases of pre-lingual deafness and 7 cases of post-lingual deafness.The median age at implantation was 12 years old(3-62 years).All patients had residual hearing(RH)before surgery,wore hearing aid(HA)timely,had an effective rehabilitation and the duration of use of electrical stimulation was 37.0±16.2 months.On the implanted side,the thresholds of 125 Hz and 250 Hz were less than and equal to 80 dB HL after implantation.A two-month follow-up clinical study was conducted with the EAS devices.The EAS effects were evaluated before,immediately after and 2 months after upgrade,including speech recognition rate,tone recognition and music tests.SPSS 23.0 software was used for statistical analysis.Results A total of ten patients completed a two-month clinical follow-up and efficiency evaluation.Compared to the electrical stimulation,the recognition rate of spondee word significantly decreased after the immediate use of EAS(71.7±4.3 vs 79.6±3.1,P=0.018).Compared to the electrical stimulation as well as immediate use of EAS,the results of sentence in noise,tone in noise,and SRT of sentence in noise were all significantly improved at 2 months after use of EAS(P<0.05).The pitch discrimination was significantly improved at 2 months after the use of EAS compared with that before the use of EAS(P=0.042).Compared with before(P=0.021)and immediately(P=0.017)use of EAS,the ability of rhythm resolution was significantly improved.There were no significant differences in other test results(P>0.05).Conclusion s The low-frequency acoustic information provided by EAS as well as the electrical-acoustic stimulation mode can provide rich auditory cues of spe

关 键 词：耳蜗植入术 声电联合刺激 测听法 言语 声调 音乐 

分 类 号：R764[医药卫生—耳鼻咽喉科]