人工耳蜗植入术对大前庭水管综合征患者前庭功能的影响  

Effects of cochlear implantation on vestibular function in patients with large vestibular aqueduct syndrome

作　　者：丁映辉 李玲[1] 叶放蕾[1] 王乐[1] DING Yinghui;LI Ling;YE Fanglei;WANG Le(Department of Otology of the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院耳科,郑州450052

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第1期24-28,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:比较人工耳蜗植入(cochlear implantation,CI)术对大前庭水管综合征(large vestibular aqueduct syndrome,LVAS)患者及正常结构的极重度聋患者前庭功能的影响。方法:分别选择28例LVAS和内耳结构正常拟行单侧CI的双耳极重度聋患者,比较2组CI术前术后双温试验、骨导诱发的颈肌前庭诱发肌源性电位(cervical Vestibular-evoked myogenic potential,cVEMP)、眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potentials,oVEMP)、视频头脉冲试验(video head impulse test,v-HIT)参数,使用SPSS 26.0软件进行分析。结果:术前,LVAS组和对照组患者双温试验、v-HIT、oVEMP的P1及N1结果均差异无统计学意义(P>0.05),LVAS组较对照组cVEMP P1更短[(13.41±0.71)ms vs (16.28±0.89)ms,P<0.000 1];N1更短[(19.83±0.54)ms vs (28.18±1.56)ms,P<0.000 1];波幅更高[(123.60±83.80)μV vs (73.92±79.85)μV,P=0.049 4];oVEMP波幅更高[(16.60±13.87)μV vs (9.96±10.47)μV,P=0.028 5]。在CI术后,LVAS组及对照组双温试验异常率增高(25.00%vs 57.14%,P=0.028 8,32.14%vs 82.14%,P=0.000 3);v-HIT结果较术前差异无统计学意义;LVAS组cVEMP及oVEMP引出率较术前差异无统计学意义;对照组cVEMP引出率降低(96.42%vs 64.28%,P=0.005 2),oVEMP引出率降低(96.42%vs 57.14%,P=0.000 9)。LVAS组引出的患者中cVEMP P1缩短[(13.40±0.71)ms vs (10.30±0.60)ms,P<0.000 1];N1缩短[(19.86±0.53)ms vs (18.97±1.33)ms,P=0.004 7];振幅降低[(124.50±84.86)μV vs (64.35±61.57)μV,P=0.001 0];oVEMP波幅降低[(15.92±13.03)μV vs (9.16±9.20)μV,P=0.009 9],对照组较术前oVEMP N1延长[(11.73±0.91)ms vs (13.35±2.60)ms,P=0.019 6],其余VEMP参数差异无统计学意义。结论:术前LVAS患者较对照组双温试验和v-HIT结果并无显著差异,但对于声刺激诱发的肌源性电位更加敏感。CI术后2组的半规管低频区功能受损,而高频区功能基本不受影响。CI术后LVAS组耳石器的功能受影响较对照组更小,可能与LVAS患者扩大的前庭水管充当�Objective:This study aimed to compare the effects of cochlear implantation(CI) on vestibular function in patients with large vestibular aqueduct syndrome(LVAS) and in patients with extremely severe deafness with normal inner ear structure.Methods:A total of 28 LVAS patients and 28 patients with normal inner ear structure who suffered from extremely severe deafness were selected.The parameters of caloric tests,bone conduction evoked cervical vestibular-evoked myogenic potentials(cVEMP),bone conduction evoked ocular vestibular-evoked myogenic potentials(oVEMP) and video head impulse tests(v-HIT) were compared between the two groups before and after CI.The data were analyzed using SPSS 26.0 software.Results:There was no significant difference in the results of the preoperative caloric test,v-HIT,and oVEMP(P1,N1) between the LVAS group and the control group(P>0.05).Compared to the control group,the LVAS group exhibited a shorter cVEMP P1[(13.41±0.71)ms vs(16.28±0.89)ms,P<0.000 1],shorter N1[(19.83±0.54)ms vs(28.18±1.56)ms,P<0.000 1],higher amplitude[(123.60±83.80)μV vs(73.92±79.85)μV,P=0.049 4] and higher oVEMP amplitude[(16.60±13.87)μV vs(9.96±10.47)μV,P=0.028 5] before CI.The abnormal rate of caloric test increased in both groups after CI(25.00% vs 57.14%,P=0.028 8,32.14% vs 82.14%,P=0.000 3,respectively).There was no significant difference in the v-HIT parameters in both groups before and after the operation.As for the LVAS group,there was no statistically significant difference in cVEMP and oVEMP induction rates before and after operation.In the control group,there was a decrease in cVEMP induction rate(96.42% vs 64.28%,P=0.005 2) and oVEMP induction rate(96.42% vs 57.14%,P=0.000 9) after CI.LVAS group showed a shorter cVEMP P1[(13.41±0.71)ms vs(10.30±0.60)ms,P<0.000 1];shorter cVEMP N1[(19.86±0.53)ms vs(18.97±1.33)ms,P=0.004 7];decreased amplitude[(124.50±84.86)μV vs(64.35±61.57)μV,P=0.001 0] and shorter oVEMP amplitude[(15.92±13.03)μV vs(9.16±9.20)μV,P=0.009 9] after CI.The oVEMP N1 in t

关 键 词：人工耳蜗植入 大前庭水管综合征 前庭功能 

分 类 号：R764.35[医药卫生—耳鼻咽喉科]