不同单极刺激模式对ECAP波形幅值的影响

Effect of Different Monopolar Stimulation Modes on ECAPAmplitude

目的对人工耳蜗患者运用神经反应遥测技术(NRT),来测量听神经复合动作电位(ECAP)的阈值和幅值并进行比较,探索其在不同单极刺激模式下的区别。方法本研究选择20例植入体型号为Freedom植入体(CI24RE) Contour Advance的人工耳蜗患者,分别测试其电极3号,电极10号和电极20号的ECAP阈值,再测量其在MP1,MP2,MP1+2三种刺激模式下的ECAP幅值并进行比较。结果电极3号的平均ECAP阈值为175.35±17.42CL,电极10号的平均ECAP阈值为169.10±12.89CL,电极20号的平均ECAP阈值为161.25±17.28CL,电极3号的ECAP阈值显著高于电极20号(P<0.05)。对不同刺激模式下的ECAP幅值进行比较,在电极3号中,各种刺激模式相比较无明显差异(P>0.05),在电极10号中,MP1刺激模式与MP1+2刺激模式相比有统计学差异(P<0.05),在电极20号中,MP1刺激模式显著高于MP2刺激模式(P<0.05),同时MP1刺激模式也显著高于MP1+2刺激模式(P<0.05)。结论在MP1刺激模式下可以获得更大的ECAP波幅,且波形明显,在临床中进行NRT测试时可优先选择MP1刺激模式。

Objective To compare thresholds and amplitudes of electrically evoked compound action potentials(ECAPs)under different monopolar stimulation modes in cochlear implant patients using neural response telemetry(NRT).Methods In this study,20 patients with Freedom(CI24RE)Contour Advance implants were tested to measure ECAP thresholds at electrode 3,10 and 20.ECAP amplitudes in MP1,MP2 and MP1+2 stimulation modes were compared.Results The ECAP threshold was 175.35±17.42CL at electrode 3,169.10±12.89CL at electrode 10 and 161.25±17.28CL at electrode 20(P<0.05 for difference between electrode 3 and 20).ECAP amplitudes showed no significant difference under the three stimulation modes(P>0.05)for electrode 3,but a difference between MP1 and MP1+2 for electrode 10(P<0.05).ECAP amplitudes were significantly higher MP1 stimulation than under MP2 or MP1+2 stimulation for electrode 20(P<0.05).Conclusion Under MP1 stimulation,ECAP amplitude were larger with better waveform differentiation.In clinical NRT test,MP1 stimulation should therefore be considered first.