84例唇腭裂患者听觉失匹配负波的研究

An Auditory Mismatch Negativity Study in 84 Cases with Cleft Lip and/or Palate

目的对纯音测听(pure tone audiometry,PTA)、听性脑干反应(auditory brain stem response,ABR)正常的唇腭裂患者行听觉失匹配负波(auditory mismatch negativity,AMMN)检查,并与健康正常人对照,判断唇腭裂患者听觉皮层的功能状态,为探讨其言语功能障碍机制提供理论依据。方法唇裂伴有腭裂(Cleft Lip and Palate,CLP)39例,单纯唇裂(Cleft Lip,CL)28例,单纯腭裂(Cleft Palate,CP)17例,健康志愿者(正常组)39例(纯音测听、听性脑干反应均正常)分别行AMMN检查,比较各组间潜伏期及波幅的差异。结果 CP组AMMN潜伏期较正常组、CL组显著延长(P<0.05),CP组潜伏期较CLP组无明显差异(P>0.05);CLP组潜伏期较CL组、正常组显著延长(P<0.05);CL组潜伏期与正常组无明显差异(P>0.05)。各组间AMMN的波幅无明显差异(P>0.05)。结论 CP及CLP患者听觉皮层的功能可能存在异常,可能为导致其言语功能障碍的一个原因,但仍然需要结合其言语识别能力、言语功能评定、磁共振(magnetic resonance,MR)、功能性磁共振(functional magnetic resonance imaging,fMRI)加以进一步研究。

Objective To investigate the function of auditory cortex by testing the mismatch negativity(MMN)in patients with cleft lip and/or palate who present with normal pure tone audiometry(PTA)and auditory brainstem response(ABR).Methods MMN was tested in39cases with cleft lip and palate(CLP),28cases with cleft lip(CL),17cases with cleft palate(CP),and39healthy volunteers(normal group)who present with normal PTA and ABR.The differences in latency and amplitude of MMN among these groups were analyzed.Results The MMN latency of CP group was significantly prolonged compared to normal group and CL patients(P<0.05),and had no significant difference compared to CLP patients(P>0.05);the MMN latency in CLP patients was significantly prolonged compared to CL and normalgroups(P<0.05);the MMN latency in CL patients showed no significant difference compared to normal group(P>0.05).There is no significant difference in MMN amplitude among all groups(P>0.05).Conclusions Dysfunction of auditory cortex could be present in CP and CLP patients,which probably results in speech dysfunction.