人工耳蜗植入术后电诱发听性脑干反应的电生理特征与参数优化研究  

Electrophysiological Characteristics and Parameter Optimization of Electrically Evoked Auditory Brainstem Responses after Cochlear Implantation

作　　者：王宇[1] 林以鹏 鲁兆毅[1] 潘滔[1] 银力 高珊仙 WANG Yu;LIN Yi-peng;LU Zhao-yi;PAN Tao;YIN Li;GAO Shan-xian

机构地区：[1]北京大学第三医院,北京100191 [2]浙江诺尔康神经电子科技股份有限公司,杭州311100

出　　处：《中国听力语言康复科学杂志》2024年第4期346-350,365,共6页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：北京大学第三医院海淀创新转化专项(HDCXZHKC2022211);2023年海淀区卫生健康发展科研培育计划《人工耳蜗植入儿童的听觉可塑性研究》(HP2023-11-501004)。

摘　　要：目的研究不同测试参数对电诱发听性脑干反应(electrical auditory brainstem response,EABR)波形的影响,选择优化的人工耳蜗术后EABR测试参数,探讨EABR与人工耳蜗术后行为测试结果之间的关系。方法选取17名人工耳蜗植入者,记录和分析不同刺激电极位置、脉冲间隔和交替/非交替双相脉冲电流下EABR波V的引出率、阈值和潜伏期等特征,分析不同刺激电极位置下EABR阈值与行为学T、C值的相关性。结果(1)蜗顶处EABR的V波阈值(90.58±27.39 CU)显著小于蜗中处(106.98±15.66 CU);(2)蜗顶处的V波潜伏期(4.47±0.357 ms)显著短于蜗中处(4.72±0.335 ms);(3)采用交替双相脉冲电流的电伪迹幅值(9.40±12.35μV)显著小于非交替脉冲(19.49±15.12μV);(4)蜗顶处EABR阈值与行为测试的T值和C值均有显著相关性。结论EABR的刺激电极位置和脉冲电流类型均影响波形结果,蜗顶电刺激比蜗中更易引出理想的EABR波形,使用交替双相脉冲电流刺激可有效减少电伪迹的影响。EABR阈值可为人工耳蜗术后开机和调试提供参考。Objective This study aimed to investigate the effects of different test parameters on the waveforms of electrically evoked auditory brainstem responses(EABR),to select the optimized EABR test parameters after cochlear implantation,and to explore the relationship between EABR and behavioral test results after cochlear implantation.Methods The study included 17 Nurotron cochlear implant recipients.The characteristics of the EABR,such as the occurrence rate,threshold,and latency of wave V,were recorded and analyzed for stimulation at different electrode positions,pulse intervals,and alternating/non-alternating biphasic pulse currents.The correlation between EABR threshold and behavioral T and C values at different electrode positions was also analyzed.Results The threshold of EABR wave V at the apex of the cochlea(90.58±27.39 CU)was significantly lower than that at the middle turn(106.98±15.66 CU).The latency of wave V at the apex of the cochlea(4.47±0.357 ms)was significantly shorter than that at the middle turn(4.72±0.335 ms).The amplitude of the electrical artifact using alternating biphasic pulse current(9.40±12.35μV)was significantly smaller than that using non-alternating pulse(19.49±15.12μV).The threshold of EABR at the apex of the cochlea was significantly correlated with the T value and C value of the behavioral test.Conclusion The stimulation electrode position and pulse current type both affect the waveforms of EABR.The apex stimulation is more likely to evoke the ideal EABR waveforms than the middle turn,and the use of alternating biphasic pulse current stimulation can effectively reduce the impact of electrical artifacts.The EABR threshold can provide a reference for the activation and mapping after cochlear implantation.

关 键 词：电诱发听性脑干反应 人工耳蜗植入 脉冲间隔 电极位置 交替双相脉冲电流 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]