听觉重塑中时间因素对人工耳蜗植入后电诱发中潜伏期反应的影响分析

Analysis of the Effects of Temporal Factors on Electrically Evoked Auditory Middle LatencyResponse after Cochlear Implantation in Auditory Remodeling

目的 对影响人工耳蜗植入后电诱发中潜伏期反应(electrically evoked auditory middle latency response,EMLR)的时间因素,包括植入时年龄、植入后时间及现年龄等进行分析研究,探究听觉重塑过程中不同时间因素的影响。方法 对46例2008年~2014年在北京大学第三医院耳鼻咽喉科进行人工耳蜗植入的患者在术后进行EMLR测试。比较语前聋儿童与语后聋成人EMLR的差异,以及语前聋儿童中现年龄、植入时年龄及植入后时间等因素对EMLR的影响。结果 语前聋儿童EMLR各波潜伏期及波间潜伏期普遍较成人组长,各波间幅值普遍较成人组大,其中Po、Na、Pa、Nb及Pb波潜伏期,PoNa、NaPa及PaNb波间潜伏期,PoNa、NaPa、PaNb及NbPb波间幅值均存在统计学差异(P<0.05)。语前聋儿童中,Pa、Nb波潜伏期及NaPa波间期与现年龄及植入后时间存在显著负相关、与植入时年龄存在显著正相关(P<0.05)。结论 EMLR在语前聋儿童与语后聋成人存在较显著差异,对于语前聋儿童,较大的年龄、较长的植入时间、较小的植入年龄对应更为成熟的EMLR波形,提示上述因素在听觉重塑过程中的重要性。

Objective To study the temporal factors affecting the electrically evoked auditory middle latency response(EMLR)after cochlear implantation,including age at implantation,post-implantation duration,and present age,in order to investigate the effects of different temporal factors in the process of auditory remodeling.Methods Forty-six patients who underwent cochlear implantation at the ENT Department,Peking University Third Hospital between 2008 and 2014 were tested for EMLR after surgery.Differences in EMLR between pre-lingual children and post-lingual adults were compared,as well as the effects of temporal factors such as present age,age at implantation,and post-implantation duration on EMLR in pre-lingual children.Results The latencies and intervals were generally longer and the inter-peak amplitudes were generally larger in the pre-lingual children than in the adults,with statistically significant differences(P<0.05)in Po,Na,Pa,Nb,and Pb latencies,PoNa,NaPa,and PaNb intervals,and PoNa,NaPa,PaNb,and NbPb inter-peak amplitudes on EMLR.In pre-lingual children,Pa and Nb latencies and NaPa intervals showed significant negative correlations with present age and post-implantation duration,and positive correlations with age at implantation(P<0.05).Conclusion There were significant differences in EMLR between pre-lingual children and post-lingual adults.In pre-lingual children,older age,longer post-implantation duration,and younger age at implantation corresponded to more mature EMLR waveforms,suggesting the importance of the above factors in the process of auditory remodeling.