摘要
目的分析听神经发育不良患者人工耳蜗植入后引发听神经反应的刺激电量与正常者的区别以及听神经发育不良患者耳蜗不同区域听神经的功能状态是否相同。方法听神经发育不良人工耳蜗植入患者11例,其中男6例,女5例,平均年龄3.94±2.18年,术前均行颞骨HRCT和内听道MRI检查,明确诊断为听神经发育不良;筛选年龄相近的听神经发育正常的人工耳蜗植入患者8例作为对照组。全部患者均单耳植入澳大利亚CI24 RECA植入体,应用Custom sound EP (4.0)软件,分别对3,6,9,12,15,18,21号电极进行ECAP阈值的测试。结果 1. CND组与对照组间在3,12,21号电极处ECAP阈值刺激电量均存在明显的统计学差异(P<0.05),即CND组ECAP阈值处刺激电量明显高于对照组;2. CND组3,12,21号电极之间引出ECAP阈值所需的刺激电量差异明显(P<0.05),且21号电极刺激电量高于12号电极刺激电量,12号电极刺激电量高于3号电极刺激电量;而对照组三个电极之间差异不明显(P>0.05)3. CND组内各个电极ECAP阈值引出率亦不相同,3号电极引出率100%(11/11),6、9号电极ECAP引出率72.7%(8/11),12、15、18号电极ECAP引出率45.4%(5/11),21号电极ECAP引出率27.2%(3/11)。结论听神经发育不良的患者,需要采用较高的刺激电量才能引起听神经的反应;听神经发育不良患者低频区域听神经的功能明显低于高频区域,低频区域需要比高频区域更高的刺激电量;听神经发育不良患者在调试编程时需要采用较低的刺激速率及较大的脉宽。
Objective To report differences in stimulus charge for cochlear implant induced auditory nerve responses between patients with cochlear nerve deficiency(CND)and normal subjects,and investigate whether functional state of auditory nerve in different cochlear regions is different in CND patients.Methods Eleven patients with CND were enrolled,including 6 males and 5 females,with an average age of 3.94±2.18 years.Eight age-matched patients without CND were selected as controls.All subjects received Cochlear Nucleus CI24 RECA implants in the test ears,and ECAP thresholds were tested from electrodes No.3,6,9,12,15,18 and 21 using the Custom sound EP(4.0)software.Results(1)ECAP threshold stimulus charges for electrodes 3,12,and 21 in the CND group were significantly higher than those in control group(P<0.05);(2)within the CND group,the ECAP threshold stimulus charge for electrode 21 was higher than that for electrode 12 which was also higher than that for electrode 3(P<0.05),whereas no significant difference was found among the three electrodes in the control group(P>0.05);(3)The rate of successful ECAP elicitation was 100%(11/11)for electrode 3,72.7%(8/11)for electrodes 6 and 9,45.4%(5/11)for electrodes 12 and 15,and 27.2%(3/11)for electrode 21.Conclusion Higher stimulus charge is needed to induce auditory nerve responses in patients with CND.In patients with CND,auditory nerve appears to show diminished functioning in low frequency regions,requiring higher stimulation charges,than in high frequency regions.Lower stimulation rates and broader pulse widths are probably required in CI programming for patients with CND.
作者
罗建芬
晁秀华
王睿婕
樊兆民
王海波
徐磊
LUO Jianfen;CHAO Xiuhua;WANG Ruijie;FAN Zhaomin;WANG Haibo;XU Lei(Department of Otorhinolaryngology Head and Neck Surgery,Shandong Provincial ENT Hospital Affiliated to Shandong University,Shandong,China;Shandong Provincial Key Laboratory of Hearing Reconstruction,Shandong,China;Shandong Artificial Hearing Engineering Technology Research Center)
出处
《中华耳科学杂志》
CSCD
北大核心
2018年第6期816-821,共6页
Chinese Journal of Otology
