电诱发听性脑干反应和电诱发镫骨肌反射阈值在内耳畸形儿童人工耳蜗植入术后调机中的运用

Application of EABR and ESRT in children with inner ear malformation after cochlear implantation

目的探讨内耳畸形小儿人工耳蜗植入手术后,植入体电诱发听性脑干反应(electrically evoked auditory brainstem responses,EABR)、电诱发镫骨肌反射阈值(electrically evoked stapedius reflex threshold,ESRT)的变化特点及规律,以指导术后设备调试。方法将88例澳大利亚Cochlear Nucleus24型人工耳蜗植入手术患儿分为耳蜗形态正常组与内耳畸形组,测试手术后1年内不同时期EABR和ESRT值,术后1年运用行为测试法检测主观阈值(T值)和最大舒适阈(C值),分析特点及变化规律。结果内耳畸形组患儿术后不同时期EABR和ESRT阈值较正常组高(P<0.05),两组EABR和ESRT阈值变化趋势相同,总的趋势是低频值较低,高频值较高,术后1年EABR和ESRT阈值逐渐增高;两组EABR与T值显著相关,ESRT与C值显著相关。结论内耳畸形组人工耳蜗植入手术后EABR和ESRT阈值变化规律及特点与正常组患儿相同,阈值可用于指导内耳畸形人工耳蜗植入者手术后设备的调试。

OBJECTIVE To invest igate the characteristics and laws of changes in electrically evoked auditory brainstem responses（EABR）, electrically evoked stapedius ref lex（ESRT） after cochlear implantation in children with inner ear malformation. METHODS 88 cases of Australian 24 multi-channel cochlear implants were divided into normal group and inner ear malformation group, The EABR and ESRT thresholds were measured at different periods within one year after operation. Behavior auditory responses, T-level and C-level were measured 1 year postoperatively to analyze their characteristics and changes. RESULTS The EABR and ESRT thresholds in the patients with inner ear malformation were significantly higher than those in the normal cochlear group（P0.05）. The changing trend of EABR and ESRT were the same in the 2 groups, the overall trend is that low frequency value is low, high frequency value is higher. EABR, ESRT threshold increased gradually after 1 year, EABR was significantly correlated with T-level, and ESRT was significantly correlated with C-level. CONCLUSION The changes of EABR and ESRT thresholds in the cochlear implantation of the inner ear malformation group were similar to those of the normal cochlear group, the thresholds can be used to guide mapping for the inner ear malformation of the cochlear implant.