语前聋小儿人工耳蜗植入术后调试结果的分析

Analysis of Debugging Results in Congenital Deaf Children after Cochlear Implantation

目的观察语前聋小儿人工耳蜗植入术后的电极阻抗、检测阈值(THR)、最大舒适阈(MCL)、动态范围(DR)的变化规律,为术后调机提供依据。方法回顾性分析20例植入Med-EL SONATAti100人工耳蜗语前聋患儿,对术中、术后1、3、6个月的电极阻抗值、THR值、MCL值及动态范围进行统计学分析。结果电极阻抗值术中最低,术后1个月最高(P<0.01),术后1个月蜗顶组电阻值和其他组之间差异有统计学意义(P<0.05),术后3、6个月各组间均差异有统计学意义(P<0.01)。术后6个月THR比较术后3个月降低(P<0.05)。术后3个月MCL比术后1个月升高(P<0.01)。动态范围呈逐渐上升趋势(P<0.05)。术中及术后电阻值与THR、MCL、DR之间无相关性(P>0.05)。结论电极位置不同将导致电极阻抗值不同;电阻值与THR、MCL及DR之间无相关性;DR随着时间推移逐渐增大,MCL比THR较早达到稳定状态,术后3个月重点调试MCL,术后6个月重点调试THR。

Objective To investigate the changes of electrode impedance,threshold（THR）,maximum comfortable level（MCL）,and dynamic range（DR）,providing the basis for debugging after operation in congenital deaf children. Methods A respective study was carried out on 20 cases of congenital deaf children who were implanted with cochlear Med-EL SONATAti100. The measurements and changing ranges of electrode impedances,THR,MCL and dynamic range during the operation and at postoperative one month,three months,and six months were statistically analyzed.Results Electrode impedances were the lowest during the operation and the highest at one month after operation（P 〈0.01）. The electrode impedance for the apical cochlear group was statistically different from that for other groups at one month（P 〈0.05）. After three and six months,there were statistically significant differences between groups（P 〈0.01）. THR at six months was lower than that at three months（P 〈0.05）. MCL at three months was higher than that at one month（P 〈0.01）. DR showed an increasing trend（P 〈0.05）. There was no correlation of perioperative and postoperative electrode impedance with THR,MCL,and DR（P 〈0.05）. Conclusion The electrode impedances varied due to different electrode position. The vales of THR,MCL and DR were unrelated with electrode impedance. DR was gradually increasing,MCL reached steady state earlier than THR. It is important that THR should be debugged at three months after operation and MCL should be debugged at six months.