摘要
目的:探讨听神经病的病变部位并观察听神经病人工耳蜗植入术后的疗效。方法:选择在我院行人工耳蜗植入术的8例听神经病患者,同时筛选背景接近的8例非听神经病极重度聋人工耳蜗植入患者作为对照组进行配对。回顾性分析2组患者术前听力学资料;术中耳蜗植入前采用自制电极行电刺激听性脑干诱发反应(EABR)评估听觉通路;植入后检测神经反应遥测(NRT)、EABR;并随访术后调机T、C值,采用听觉行为分级标准(CAP)、言语可懂度分级标准、言语识别率评估术前和开机后1年时听力言语情况。结果:8例听神经病患者术中植入前均可引出EABR波形,但是波形较正常有变异,需要刺激量加大或者调整参数,Ⅴ波潜伏期长短不一;植入耳蜗后NRT反应好,EABR和术中测试波形接近。术后开机均有听性反应,随访开机T、C值与对照组差异无统计学意义;听神经病组患者术前及开机1年CAP分别为6.50±0.94和6.90±0.77,言语识别率(双字词)分别为(85.00±11.66)%和(89.50±9.02)%,与对照组比较差异无统计学意义。结论:术前EABR可以做为评估听神经病(听同步不良患者)听觉通路的有效工具,筛选合适植入者;人工耳蜗可以帮助听神经病患者提高听力及言语能力。
Objective：To evaluate the pathological position of auditory neuropathy and investigate the hearing and speech rehabilitation results of cochlear implantation in patients with auditory neuropathy.Method：In our hospital,among the patients received cochlear implantation,8 cases with auditory neuropathy were selected,and 8 cases of non-auditory neuropathy patients with profound deafness were selected as matched control group with the background close to the study group.The preoperative hearing data of these two groups were retrospectively analyzed.During operation,the homemade stimulation electrodes were inserted to test the electric evoked auditory brainstem response（EABR） for assessing the auditory pathway;EABR and neural response telemetry（NRT） were tested after implantation,and T,C value were acquired 1 month later.CAP,SIR and speech recognition rate were used to assess hearing and speech rehabilitation effect 12 months after booting.Result：Intra-operative EABR wave can be derived in 8 cases of auditory neuropathy,but the wave pattern exhibited variations compared with normal wave.It needed increased stimulation or adjusted parameters,with variable Ⅴ latency.After cochlear implantation,the waveforms of NRT and EABR were similar between the two groups,and the post-operative V waveform was close to the intra-operative EABR.8 pairs of patients can present listening response after booting.There was no statistically significant difference in T,C value,CAP（6.50±0.94 and 6.90±0.77）and speech recognition rate（85.00%±11.66% and 89.50%±9.02%） between the auditory neuropathy group and the control group 1 year after booting.Conclusion：Pre-operative EABR can be used as an effective tool to assess the auditory pathway of auditory neuropathy patients,improving the pre-operative examination and helping with selecting the suitable cochlear implant patient.Cochlear implantation can help patients with auditory neuropathy to improve hearing and speech.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2013年第10期449-454,共6页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
