电诱发听觉脑干反应对人工耳蜗术后听功能的评估价值

Value of electrically evoked auditory brainstem response in evaluating the postoperative auditory function after cochlear implant

目的:以电诱发听觉脑干反应对人工耳蜗术后听功能进行评估,测试人工耳蜗植入者的电诱发听觉脑干反应波形特点及正常数值,并评价患者听觉传导通路功能。方法:测试于2002-07/2004-06在郑州大学第一附属医院测听室进行。对53例Nucleus24型人工耳蜗植入术后患者3,10,20电极进行电诱发听觉脑干反应测试,刺激率≤100Hz,脉冲宽度:25,50,75μs/相。结果:53例均进入结果分析。①交替极性刺激较单一极性伪迹小。对侧记录较同侧记录的电诱发听觉脑干反应伪迹小。②随刺激频率增加,电诱发听觉脑干反应各波潜伏期逐渐延长。改变高截止频率,Ⅴ波潜伏期缩短缩短(1.5～3kHz)或保持不变(3～25kHz);改变低截止频率(100～0.002Hz),Ⅴ波潜伏期保持稳定。③电诱发听觉脑干反应阈值随刺激脉宽增加渐降低,在20电极较3,10电极低(P<0.01),3,10电极间无差异(P>0.05)。④电诱发听觉脑干反应Ⅲ波、Ⅴ波潜伏期在3电极较10,20电极长(P<0.01);在10电极较20电极长(P<0.01)。⑤电诱发听觉脑干反应测试波形出现率为96.22%。结论:①建立了合适的电诱发听觉脑干反应测试模式。②刺激耳蜗不同部位电极时电诱发听觉脑干反应R阈值、潜伏期存在差异。③电诱发听觉脑干反应是对人工耳蜗植入者听功能进行客观评价的有效方法。

AIM： To evaluate the postoperative auditory function of cochlear implant patients with electrically evoked auditory brainstem response （EABR） test, and detect the characters and normal values of these EABR waves, so as to evaluate the auditory function of the patients. METHODS： The test was conducted in the Audiometric Room, First Hospital affiliated to Zhengzhou University from July 2002 to June 2004. EABR was recorded in electrode 3, 10 and 20 in 53 cases received Nucleus 24 cochlear implant with test parameters： frequency≤100 Hz, pulse wide： 25, 50 and 75μs/phase. RESULTS： All 53 cases were involved in the result analysis. ①Artifact of EABR in alternating polarity stimulus mode was smaller than that in simple polarity stimulus mode, and the bilateral recording mode was smaller than in the same lateral recording mode. Latencies of EABR prolonged with stimulus frequency increasing.②With the increase in stimulating frequency, the latency of each wave prolonged gradually. Latency of wave Ⅴ was shortened （1.5-3 kHz） or maintained （3-25 kHz） constant with the low cut-off frequency changing; Latency of wave Ⅴ maintained constant with cut-off frequency changing from 100 to 0.002 Hz. ③EABR thresholds were decreased with stimulus width widening, and it was lower in electrode 20 than in electrodes 3 and 10 （P〈 0.01）, but there was no difference between electrode 3 and 10 （P〉 0.05）. ④EABR latency of waves Ⅲ and Ⅴ in electrode 3 was longer than in electrode 10 and 20 （P 〈 0.01）, and in electrode 10 longer than in electrode 20 （P〈 0.01）. ⑤Wave rate of EABR test was 96.22%. CONCLUSION： ①Proper EABR test mode is established. ②EABR latency and threshold are different when stimulating different electrodes of cochlear. ③EABR is an effective method to evaluate the auditory function of cochlear implant patients objectively.