摘要
目的:探讨内耳道狭窄患者电刺激听觉脑干诱发电位(EABR)的特点及与人工耳蜗植入术后听力言语康复效果的关系。方法:回顾性分析内耳道狭窄(IACS)的语前聋人工耳蜗植入患者16例(IACS组),筛选条件相近的16例内耳道解剖结构正常的语前聋人工耳蜗植入者配对(对照组),术中人工耳蜗植入前采用EABR评估听觉传导通路,记录EABR波形、阈值和动态范围;对患者家长和康复教师进行调查随访,根据听觉行为分级标准(CAP)和言语可懂度分级标准(SIR)对患者听力言语康复效果分级评估。采用配对样本T检验比较术前和术后1年患者CAP和SIR评分,Spearman检验对术中EABR分级和术后CAP评分进行相关性分析。结果:IACS组2例患者术中未记录到典型EABR波形,术后开机无反应。IACS组EABR波形分化差于对照组,其EABR阈值(192.5±11.73)高于对照组(168.75±6.94),动态范围(32.50±19.69)小于对照组(80.63±9.04)。术后1年IACS的听觉言语康复效果的CAP和SIR值分别为3.47±1.09、1.62±0.50,得分均低于对照组(分别为5.06±0.79、2.59±0.58),差异有统计学意义(均P<0.05)。术中EABR分级和术后CAP评分具有明显相关性(r=0.78,P<0.05)。结论:EABR能够较准确地反映听觉传导通路功能的完整性,有利于判断内耳道狭窄患者人工耳蜗植入后能否获得听觉反应。EABR辅助人工耳蜗植入前的全面评估,内耳道狭窄患者的听觉言语能力可得到不同程度的康复。
Objective：To investigate the intra-operative electrical evoked auditory brain stem response（EABR） characteristics and the hearing and speech rehabilitation effects of cochlear implantation（CI） in patients with inter- nal auditory canal stenosis（IACS）. Method：A retrospective study was performed on 16 patients with IACS （IACS group） matched with 16 implantees without IACS（control group）,who received muhi- channel CI because of pre- lingual sensorineural hearing loss. The integrity and functional stalus of the auditory pathway were assessed by EABR, recording waveforms, thresholds and dynamic ranges intra operation before C1. Interviewed the implant ees＇ parents or teachers, asking them to rate the implantees＇ hearing and speech ability according to Categories of Auditory Performance（CAP） and Speech Intelligibility Rating（SIR）. Paired T test was performed to compare scores of CAP and SIR between before and 1 year after CI, while Spearman test was performed to compare correlation between EABR grades and post-operative CAP scores. Result： Among the IACS group, 2 cases weren＇t recor ded typical EABR waveforms and without auditory response 1 year after a successful Ch The EABR waveforms in the IACS group were poorer than that in the control group, their EABR thresholds higher than the control group, and their EABR dynamic ranges less than the control group. The hearing and speech rehabilitation after CI showed that the results of CAP and SIR values （3.47±1.09 and 1.62±0.50） scored significantly lower than the control group（5.06±0.79 and 2.59±0.58）（P〈0.05）, but significantly increased compared with pre operation. Intra- operative EABR grades and post operative CAP scores showed significant correlation（r=0. 78,P〈0. 05）. Conclu- sion：Intra-operative EABR can accurately monitor the integrity and functional status of the auditory pathway, be of important clinical value in predicting whether patients can acquire auditory responses with the aid of CI. CI can help patients with IACS to improve the ability of hearing and speech with EABR to screen out compatible implant ees.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2013年第13期694-697,700,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
电诱发听性脑干反应
人工耳蜗植入
内耳道狭窄
疗效
康复
electrically evoked auditory brainstem response
cochlear implantation
internal auditory canal stenosis
treat effect
rehabilitation
