听觉皮层诱发电位在低龄人工耳蜗植入患儿中的应用

Application of Cortical Auditory Evoked Potentials in Young Children with Cochlear Implant

目的探究听觉皮层诱发电位在低龄人工耳蜗植入儿童中的应用价值。方法52例低龄人工耳蜗植入术后患儿,采用主观听觉言语能力评估量表,听觉行为分级量表(Categories of auditory performance,CAP)和言语可懂度分级量表(Speech intelligibility rating scale,SIR)和客观电生理检测[(皮层听觉诱发电位(cortical auditory evoked potential,CAEP)测试中的慢皮层反应P1-N1-P2和失匹配负波(mismatch negativity,MMN)]相结合,进行康复效果的评估,采用SPSS 25.0软件进行统计分析。结果随着听觉年龄的增长,人工耳蜗植入患儿的主观听觉言语能力评估量表分值呈现逐步升高趋势,CAP结果组间有统计学差异(F=22.387,P<0.001),SIR结果组间有统计学差异(F=25.780,P<0.001)。主观量表评估与客观电生理评估存在相关性,CAP结果与CAEP的P1波的阈值具有显著的负相关(r=-0.370,P=0.01),CAP结果与MMN的潜伏期具有显著的负相关(r=-0.309,P=0.029),SIR结果与CAEP的P1波的阈值具有显著的负相关(r=-0.335,P=0.021)。同时采用多因素回归分析探讨康复效果的可能影响因素。结论听觉皮层诱发电位的P1波反应阈值及MMN潜伏期为康复效果评估的独立影响因素。听觉皮层诱发电位可以有效地客观评估低龄人工耳蜗植入患儿的术后康复效果。

Objective To explore the application value of cortical auditory evoked potentials in young children with cochlear implantation.Methods The rehabilitation effect of 52 young children after cochlear implantation was evaluated by the combination of subjective auditory speech ability assessment scale and objective electrophysiological cortical auditory evoked potentials detection.SPSS 25.0 software was used for statistical analysis.Results With the increase of hearing age,the score of the subjective auditory speech ability assessment scale of cochlear implant children showed a gradually increasing trend.The CAP results showed statistical differences between groups(F=22.387,P<0.001),while the SIR results showed statistical differences between groups(F=25.780,P<0.001).There was a correlation between the subjective scale assessment and the objective electrophysiological assessment.The CAP result has a significant negative correlation with the threshold of P1 wave in CAEP(r=-0.370,P=0.01),the CAP result has a significant negative correlation with the latency of MMN(r=-0.309,P=0.029),and the SIR result has a significant negative correlation with the threshold of P1 wave in CAEP(r=-0.335,P=0.021).Simultaneously,multiple linear regression analysis was used to explore the possible influencing factors of rehabilitation outcomes.Conclusion The P1 response threshold and mismatched negative latency of cortical auditory evoked potentials were independent factors for the evaluation of rehabilitation effect.Cortical auditory evoked potentials can effectively evaluate the postoperative rehabilitation effect of young children with cochlear implantation.