大前庭水管综合征与内耳结构正常患儿人工耳蜗术后心理物理测试比较

Comparing the characteristics of psychophysical tests between cochlear implant children with large vestibular aqueduct syndrome and normal inner ear

目的:探讨大前庭水管综合征患儿人工耳蜗植入术后阈值、舒适阈和电极阻抗的特点,为这类患儿进行人工耳蜗植入术的可行性提供依据。方法:将131例语前聋患儿,根据CT检查结果分为A和B两组,A组111例,内耳结构正常;B组20例,双侧前庭导水管扩大,但不伴有其他内耳结构异常。所有患儿均使用澳大利亚Cochlear公司生产的Nucleus24M型人工耳蜗。术后4周左右安装体外设备并进行心理物理测试,使用与患儿年龄相应的方法进行阈值和舒适阈的测试;使用R116和R126软件自动测试电极阻抗。结果:经独立样本t检验,两组各电极的阈值和舒适阈的差异均无统计学意义(均P>0.05);两组心理物理测试值即阈值和舒适阈,在开机时和开机后1、2、3周,2、3、6、9个月及1年的差异无统计学意义(均P>0.05)。两组各电极阻抗之间的差异无统计学意义(均P>0.05);两组电极阻抗在开机时和开机后1、2、3周,2、3、6、9个月及1年的差异无统计学意义(均P>0.05)。结论:大前庭水管综合征患儿与内耳结构正常患儿人工耳蜗植入术后的差异无统计学意义,为大前庭水管综合征患儿制定术后调试计划及设置各电刺激参数时,均可采用与内耳结构正常患儿相同的方法。

Objective:The purpose of this study is to compare the characteristics of psychophysical tests between cochlear implant children with large vestibular aqueduct syndrome and normal inner ear and to analyse the characteristics of psychophysical and impedance tests for cochlear implant patients with large vestibular aqueduct syndrome.Method:One hundred and thirty-one cochlear implant pre-lingual deafness patients participated in this study. They received cochlear implant surgery at the age of 1.5 to 12 years old from Nov, 1998 to Aug, 2003. The patients were divided into two groups. Group A had 111 patients with normal inner ear.Group B had 20 patients with radiographically proven large vestibular aqueduct syndrome. All of the patients were inserted with Nucleus 24M. The time of the first programming session was approximately 4 weeks after surgery. The psychophysical tests included T and C-Level tests. The programming techniques used in the test were suitable for the age of the patients. The R116 and R126 software were used to test the impedance of the electrodes automatically.Result:Using the independent-samples t-test, the impedance and T/C-Level of each electrode did not differ significantly between group A and B (P>0.05). The impedance and T/C-Level were not significantly different between group A and B at the time of switch-on, 1 week, 2 weeks, 3 weeks, 2 months, 3 months,6 months,9 months and 1 year after switch-on (P>0.05).Conclusion:The parameters of mapping were not significantly different between cochlear implant children with large vestibular aqueduct syndrome and normal inner ear.The management and procedure of mapping used in cochlear implant children with normal inner ear can be used in the children with large vestibular aqueduct syndrome.