摘要
目的评估极重度感音神经性聋伴蜗神经管狭窄患者人工耳蜗植入术后的听觉康复效果。方法回顾分析10例极重度感音神经性聋伴蜗神经管狭窄患者的临床资料，包括听力学、影像学、术中神经反应测试及术后听觉康复效果评估结果。结果10例患者术耳人工耳蜗植入前听性脑干反应、40Hz听觉事件相关电位、畸变产物耳声发射均未引出，颞骨薄层CT示不同程度的蜗轴与内听道之间的蜗神经管狭窄。术中神经反应测试2例患者有3个电极可引出神经反应波形，1例患者有2个电极可引出神经反应波形，6例患者有1个电极可以引出神经反应波形，1例患者术中未引出神经反应波形。8N患者术后超过2年，其3个月、6个月、9个月、1年、2年时的平均单元音识别率分别为60．3％、60．4％、60．3％、60．2％、60．2％，单辅音识别率分别为19．0％、19．1％、19．1％、19．2％、19．2％。2例患者术后仅3个月，其平均单元音、单辅音识别率分别为60．1％、18．2％。结论10例极重度感音神经性聋伴蜗神经管狭窄患者术前无残余听力，术中神经反应测试只有部分电极可以引出神经反应波形，术后听觉康复效果较差。
Objective To evaluate the auditory rehabilitation outcomes of profoundly sensorineural hearing-impaired patients with cochlear nerve canal stenosis after cochlear implantation. Methods The clinical data of 10 cases were analyzed including audiologic data, imaging findings, intraoperative neural responses and postoperative auditory performance. Results The auditory brainstem response, 40 Hz auditory event related potential and distortion product otoacoustic emissions （DPOAE） were absent before cochlear implantation in all the 10 cases. The temporal bone CT showed different degrees of cochlear nerve canal stenosis between the internal auditory canal and cochlear modiolus. The electrically evoked compound action potentials（ECAP）of auditory nerves can be elicited by 3 electrodes in 2 cases, 2 electrodes in 1 case and 1 electrode in 6 cases, but no ECAP waveform was observed in 1 case during surgery. The average vowel recognition rates of 8 patients 3 months,6 months,9 months,1 year and 2 years after cochlear implantation were 60.3%,60.4%,60.3%,60.2% and 60.2%,and the average consonant recognition rates were 19.0%,19,1%,19.1%,19.2% and 19.2%.The average vowel and consonant recognition rate of the 2 patients 3 months after cochlear implantation was 60.1% and 18.2%, respectively. Conclusion The 10 profoundly sensorineural hearing-impaired patients with cochlear nerve canal stenosis have no residual hearing before cochlear implantation and the intraoperative ECAPs can be evoked by only part of the electrodes. After cochlear implantation, the patients have poor auditory rehabilitation outcomes.
出处
《中国听力语言康复科学杂志》
2014年第1期30-32,共3页
Chinese Scientific Journal of Hearing and Speech Rehabilitation
基金
卫生行业科研专项项目（201202001）
关键词
蜗神经管狭窄
人工耳蜗植入
听觉康复效果
Cochlear nerve canal stenosis
Cochlear implantation, Auditory rehabilitation outcome
