摘要
目的:探讨语前聋患儿耳蜗不同刺激部位的电诱发听神经复合动作电位(ECAP)之间是否存在差异。方法:应用NRT软件分别对32例Nucleus CI24R(CA)语前聋儿童植入者的第1、4、7、11、17、22号电极进行术中监测,对幅值增长函数进行线性拟合以确定ECAP幅值、阈值及幅值增长曲线斜率,按照耳蜗顶部、中部、底部不同刺激部位分析其差异,并且探讨不同刺激部位之间ECAP不应期的特点。结果:ECAP阈值自蜗底至蜗顶呈下降趋势,反应幅值自蜗底至蜗顶呈上升趋势,幅值增长曲线斜率自蜗底至蜗顶呈上升趋势,不应期恢复曲线幅值自蜗底至蜗顶呈上升趋势,耳蜗位置不同对不应期有整体影响,但不同部位之间两两相比无明显差异。结论:对于语前聋患儿,刺激耳蜗不同部位ECAP阈值、幅值及幅值增长曲线斜率、不应期恢复曲线幅值显著不同,对不应期有整体影响,但各部位间无系统差异。
Objective：To investigate the correlation between the site of prelingual cochlear stimulation and its effect on electrically evoked compound action potentials. Method： Recordings of auditory nerve responses were con- ducted in 32 prelingual subjects to demonstrate the feasibility of ECAP recordings using the nerve response telerne- try（NRT） feature of the Nucleus CI24R（CA） system software. These recordings were then analyzed based on the site of cochlear stimulation defined as basal, middle and apical to determine if the amplitude, threshold and slope of the amplitude growth function and the refractory time differs depending on the region of stimulation. Result： Find- ings of our prelingual children showed significant differences in the ECAP recordings depending on the stimulation site. Comparing the apical with the basal region, on average higher amplitudes, lower thresholds and steeper slopes of the amplitude growth function hadbeen observed. The refractory time showed an overall dependence on cochlear region~ however post-hoc tests showed no significant effect between individual regions. Conclusion： Obraining ECAP recordings is also possible in the most apical region of the cochlea. However, differences can be observed depending on the region of the cochlea stimulated. Specifically, significant higher ECAP amplitude, lower thresholds and steeper amplitude growth function slopes have been observed in the apical region. These differences between prelingual children and adults could be explained by the location of the stimulating electrode with respect to the neural tissue in the cochlea, a higher density, or an increased neural survival rate of neural tissue in the apex.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2016年第23期1854-1858,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
