人工耳蜗植入的术中检测

Intra-operative Measurements for Cochlear Implantation

目的 评估人工耳蜗植入术中的电极阻抗测试、神经反应遥测的临床意义 ,探讨术中检测的方式。方法 对 6 5例植入NucleusCI2 4人工耳蜗的患者在术中进行电极阻抗测试 ,其中 37例进行了神经反应遥测 (neuralresponsetelemetry ,NRT)对测试步骤及注意事项进行了分析。结果 9.2 %的患者术中电极阻抗测试显示个别电极出现短路或开路 ;5 .4 %的患者 ,术中NRT测试得不到分化良好的ECAP。结论 电极坏损与植入过程中的重复插拔有一定的因果关系。不应把ECAP引出与否作为衡量手术成功的唯一指征 ,即使ECAP引不出 ,也不要多次插拔电极序列 。

Objective To evaluate the significance of intra-operative monitoring assessments including impedance measurement and neural response telemetry (NRT) during cochlear implant surgery and to explore intra-operative monitoring protocols.Methods The impedance of electrodes of 65 Nucleus CI24 recipients was measured and 37 recipients′ NRT was conducted during the surgery.Results Intra-operative electrode impedance measurements indicated that 9.2% patients′ electrode arrays had short or open circuit(s). Clear waveform of electrically evoked compound action potential (ECAP) could not be recorded for 5.4% patients during the intra-operative NRT tests.Conclusion Repetitive insertion-withdrawing of the electrode array during the surgery is likely cause electrode impairment. Presence of ECAP during the operation should not be regarded as the decisive indicator of the success of the surgery. Repetitive insertion-withdrawing of electrode array should be prohibited in order to avoid electrode impairment even if ECAP is negative during the operation.