弯、直电极阻抗和电诱发复合动作电位阈值观测在儿童人工耳蜗调试中的应用

An observation and application of the electrode impedances and electrically-evoked compound action potentials after cochlear implantation using two types of electrodes

目的:观察人工耳蜗弯、直两种电极植入后不同时间段的电极阻抗和电诱发复合动作电位阈值的变化,探讨其对调试间隔的指导意义。方法:对17例植入Nucleus24M型和15例植入Nucleus24R型人工耳蜗的患儿术中及术后30d开机时、开机使用10、20、30、40、50、60、90、150d的电极阻抗值和开机后的ECAP阈值进行观测和分析。结果:①两种植入体不同时间点阻抗值的两两比较,术中和术后30d两个时间点与其他各时间点的阻抗值的差异有极显著性意义(P<0.01),其余各点间比较结果未发现差异有显著性意义;②两种植入体电极的ECAP阈值变化趋势不同:M型植入体多数电极的ECAP阈值在开机后10d明显高于开机时,而R型植入体多数电极的ECAP阈值在开机10d后明显低于开机时,两者差异均有显著性意义(P<0.01);③两种植入体均在开机使用后2个月时ECAP降至最低,继续使用后又有上升。结论:①两种人工耳蜗植入电极的阻抗和ECAP阈值在开机使用后10d均有明显改变;②在开机使用后的开始3个月内需经常对言语处理器和植入体的有关参数进行调试,之后可以根据患者的表现适当推迟下次调试的时间。

Objective：To observe the change of the electrode impedances and the thresholds of the electricallyevoked compound action potentials in different time points after cochlear implantation with M type or R type electrodes for deciding the interval of the mapping.nethod：17 cases with Nucleus 24M and 15 cases with Nucleus 24R were inspected the electrode impedance in different time points： intra-operation,initial stimulation in 30 days after operation,and 10,20,30,40,50,60,90,150 days after initial stimulation,and their electrically-evoked compound action potentials were also tested after initial stimulation at the same time.Result： ①Compared with the other time points, the electrode impedances at intra-operation and initial stimulation were different with statistical significant （P〈0.01）; ②There were different change trends of ECAP thresholds between these two types： M type had a higher ECAP 10 days later after than initial stimulation,R type had reverse records; ③The ECAP thresholds of this two types were the lowest 2 months later after initial stimulation, then increased gradually.Conclusion：①The impedance and ECAP thresholds of these two types have obviously changes after initial stimulation; ②Mapping can be token regularly after initial stimulation within the 3 months. Then, mapping could be deferred according the performance of the patients.