三种内耳畸形人工耳蜗植入术后效果的比较

Comparison of Postoperative Outcomes between Three Types of Inner Ear Malformation after Cochlear Implantation

目的回顾Mondini畸形、共同腔畸形和IP-Ⅲ畸形的人工耳蜗植入（cochlear implantation，CI）术后效果，为内耳畸形患者CI术后效果预估提供参考。方法回顾性分析218例重度或极重度双侧感音神经性耳聋伴内耳畸形患者的临床资料，根据颞骨高分辨率CT结果分为Mondini畸形（160例）、共同腔畸形（30例）和IP-Ⅲ畸形（28例）。对上述三组患者CI术后12个月的主、客观听力检查结果进行统计分析。结果所有患者CI术后检测电极阻抗均在正常范围内，电诱发听性脑干反应（electrically evoked auditorybrainstemresponse，EABR）检测均可引出波形。电诱发复合动作电位（electrically evokedcompoundactionpotential，ECAP）检查三组间检出率具有显著性差异（X2=50．69，P=0．000）。Mondini畸形、共同腔畸形及IP-Ⅲ畸形三组间术后12个月声场中助听听阈、单韵母识别率及单声母识别率均具有显著性差异（P〈0．05）。三组CI术前、术后汉语单韵母及单声母识别率均具有显著性差异（尸〈0．05）。结论三种类型内耳畸形cI术后EABR检出率高于ECAP；三种内耳畸形患者术后的主观听觉言语评估结果问有较大差别。

Objective To review the postoperative outcomes of Mondini malformation, common cavity malformation and IP-Ⅲ malformation and to facilitate the prediction for the efficacy of cochlear implantation. Methods 218 patients with bilateral severe or profound sensorineural hearing loss and inner ear malformation were divided into three types according to the temporal CT： Mondini malformation（160 cases）, common cavity malformation（30 cases） and IP-Ⅲ malformation（28 cases）. The subjective and objective examination results were statistically analyzed. Results The electrode impedance was normal in all patients after cochlear implantation. The electrically evoked auditory brainstem responses （EABR） were elicited in all patients. However, there were significant differences in the detection rates of electrically evoked compound action potentials（X2=50.69,P=0.000）. Twelve months after cochlear implantation, there were significant differences in the aided hearing thresholds, vowel recognition rate and consonant recognition rate（P〈0.05）.There were significant differences between the preoperative and postoperative vowel and consonant recognition rates for each group（P〈O.O5）.Conciusien The detection rate of EABR is higher than that of ECAP in patients with inner ear malformation after cochlear implantation. The differences are significant in the subjective examination results between the three types of inner ear malformation.