人工耳蜗植入治疗对综合征性感音神经性耳聋患者电诱发听性脑干反应的影响

摘要

目的 探讨人工耳蜗植入治疗综合征性感音神经性耳聋患者对电诱发听性脑干反应(EABR)的影响.方法 选取郑州市第三人民医院2016年1月至2018年1月收治的32例综合征性感音神经性耳聋患者为研究对象,均接受人工耳蜗植入治疗,且术后均行EABR、纯音听阈检查.观察EABR特点,分析不同电极刺激模式与EABR阈值的相关性、EABR潜伏期与刺激强度的相关性、手术前后双侧耳纯音听阈均值变化情况.结果 32例患者均观察到Ⅲ、Ⅳ波,15例(46.9％)患者观察到Ⅱ波,8例(26.7％)观察到Ⅰ波.初始强度均未观察到V波,但随着刺激强度增加,均出现V波.当刺激强度≥180 CL时,Ⅲ、Ⅳ波潜伏期时间与前一刺激强度的潜伏期时间比较差异有统计学意义(P<0.05).9、16电极EABR阈值分别高于1、5、13电极,差异有统计学意义(P<0.05).术后6个月双侧耳纯音听阈均值较术前降低(P<0.05).结论 综合征性感音神经性耳聋患者人工耳蜗植入术后EABR波形良好,听神经功能恢复好,EABR检查可较准确地评估听觉通路的传导速度和功能状态.%Objective To investigate the effects of cochlear implantation on the electrically evoked auditory brainstem response ( EABR ) in patients with syndromic sensorineural hearing loss . Methods Thirty-two patients with sensorineural hearing loss who were admitted to the Third People 's Hospital of Zhengzhou from January 2016 to January 2018 were selected as research subjects .Patients were treated by cochlear implantation and received EABR and pure tone auditory thresholds test after surgery.The characteristics of EABR were observed . The correlation between different electrode stimulation patterns and EABR threshold , the correlation between the latency of EABR and stimulation intensity , and the change of pure tone average of bilateral ears before and after surgery were analyzed . Results The wave Ⅲand IV were observed in all 32 patients , the wave Ⅱwas observed in 15 patients (46.9％), and the wave I was observed in 8 patients (26.7％).No wave V was observed at the initial intensity , but wave V appeared as the stimulation intensity increased .When the stimulating intensity ≥180 CL, there was a significant difference between the latency of wave Ⅲ and IV and the latency of previous stimulation ( P<0.05) .The EABR thresholds of the 9 and 16 electrodes were higher than those of the 1 , 5 and 13 electrodes , respectively , and the difference was statistically significant ( P<0.05 ) . The pure tone average of both ears at 6 months after operation were lower than those before surgery ( P<0.05 ) .Conclusions The EABR waveform and auditory nerve function is good after the cochlear implantation in patients with sensorineural deafness syndrome .EABR examination can accurately assess the conduction speed and function state of the auditory pathway .