人工耳蜗植入对前庭诱发肌源性电位远期影响的初步研究

Long-term Effects of Cochlear Implantation on Vestibular Evoked Myogenic Potentials

目的分析人工耳蜗植入术对前庭诱发肌源性电位(Vestibular Evoked Myogenic Potentials,VEMPs)的影响。方法选择2013年2月至2015年10月就诊于我科并接受人工耳蜗植入患者17例(17耳)作为观察对象,对患耳进行颈肌前庭诱发肌源性电位(cervical Vestibular Evoked Myogenic Potential,c VEMP)和眼肌前庭诱发肌源性电位(ocular Vestibular Evoked Myogenic Potential,o VEMP)检测,将术后VEMPs波形引出率和参数分别与手术前和对侧耳进行对比。结果人工耳蜗植入前术耳c VEMP和o VEMP的引出率分别为59%和53%。术后1-3年术耳c VEMP和o VEMP引出率分别降至24%和12%(开机状态,P<0.05),24%和12%(关机状态,P<0.05),同时在引出VEMPs的患耳部分波形参数显示异常变化。结论人工耳蜗植入术后c VEMP和o VEMP的引出率下降,波形参数异常,提示人工耳蜗植入对术耳前庭耳石器机能有可能造成一定影响。

Objective To report long term effects of cochlear implantation on vestibular evoked myogenic potentials. Methods Seventeen patients（17 ears） undergoing cochlear implants in our department from February, 2013 to October, 2015 were randomly selected as subjects for observation of effects on cervical or ocular vestibular evoked myogenic potentials（c VEMP or o VEMP） results on the side of implantation, the rate of response extraction and waveform parameters were compared with data from before surgery and from the contralateral side. Results The response rate for c VEMPs and o VEMPs were 59% and 53% before cochlear implantation. Three years after surgery, the c VEMP and o VEMP response rates were reduced to 24% and 12%（with devices on or off）, with abnormal latency and threshold changes in the implanted ear. Conclusions o VEMPs and c VEMPs seem to decrease, with abnormal waveform parameters, after cochlear implantation, suggesting effects on the performance of vestibule otoliths by cochlear implantation.